Vitamin D Information

• Vitamin D is produced in the skin after exposure to UV B light in sun rays (wave length 290-315 nm). Sun exposure for 30 minutes may be adequate but for dark skinned individuals longer time may be needed as melanin pigment in the skin reduces the efficiency of vitamin D production in the skin. However, we need to balance the risks of sun exposure and vitamin D production.
• The reasons for vitamin D deficiency include low outdoor activities, lack of UV B radiation due to geographical locations, ageing leading to reduced vitamin D synthesis in the skin and low vitamin D content of most foods.
• Vitamin D is not present adequately in our normal diet.
• Vitamin D is needed for adequate absorption of calcium from our diet.
• Vitamin D helps to regulate our immune system and helps us to fight infections. Hence, you may be prone to develop autoimmune diseases or the control of your autoimmune disease may be better with adequate vitamin D levels like in the case of lupus.
• Vitamin D improves bone density and reduces fracture risk in elderly patients.
• Vitamin D also helps to decrease the levels of inflammatory chemicals (like TNF-alpha, IL-6) in our body which are implicated in the development of atherosclerosis (thick and stiff arteries due to cholesterol deposition).
• There is a growing body of evidence which suggests that vitamin D deficiency increases the risk of hypertension, heart attacks, infections, diabetes, overall mortality and certain cancers (colon, breast, prostate).
• Adequate vitamin D levels also can reduce the incidence and mortality (death) from colon, breast and prostate cancer. Vitamin D is anti-proliferative (reduces the growth and division of abnormal cells), promotes cellular maturation and induces apoptosis (programmed cell death) in cancer cells.
• Vitamin D deficiency can cause low bone density and weak bones which can fracture with trivial injury.
• Vitamin D deficiency can lead to muscle pain and proximal muscle weakness (especially thighs).
• Other symptoms of vitamin D deficiency include fatigue, tiredness, muscle aches and cramps and bone pain.
• Prevention of vitamin D deficiency can be by two ways – adequate sun exposure or oral supplementation. There are concerns about photo-aging and skin cancer with increased UV B radiation. Also the amount of UV B varies with time of the day, season and geographical location. Therefore, the easiest way is to take vitamin D supplements.
• A consultation with by a Rheumatologist is needed if you have any of the above symptoms. Your Rheumatologist will ask you questions about your illness, perform a physical examination and order tests to check your Vitamin D and calcium levels. Your Rheumatologist will tailor your vitamin D supplementation as per your requirements as excess of vitamin D can also cause problems. Supplementation with the right dose of vitamin D is of utmost importance to obtain an adequate vitamin D level in your body.
• Not all muscle and joint symptoms that you experience can be explained by deficiency of vitamin D. Therefore a medical consultation with a Rheumatologist is necessary for a through evaluation. Feel free to discuss your problems with your Rheumatologist and possible ways to rectify them.