Vitamin D is essential for the proper development of bones. Vitamin D deficiency can lead to cardiovascular diseases, loss of bone density, and osteoporosis.

Vitamin D

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Saad Ullah Siddiqui

Introduction

&ldquo;If it&rsquo;s not neat or on the rocks, I am too old to drink that&rdquo;.&nbsp;

But the thing is, <a href="https://merisehat.pk/disease/osteoporosis-80">osteoporosis</a>, a disorder that causes bones to grow abnormally and become overly dense, does not come knocking on your bones after confirming the age, but it comes due to the amount of vitamin D being inappropriate in the body.&nbsp;

The recommended daily allowance (RDA) for vitamin D is 15 mcg per day (600 IU) for individuals 19 years old and above regardless of gender. However, for adults over 70 years old, it bumps up to 20 mcg daily (800 IU)<a href="#accordion">[2]</a>.

&nbsp;

Vitamin D that comes from the skin or diet is in its inactive form and requires a 2-step process before it can be used by the body:

<ul>
	<li>Firstly, hydroxylation is carried out in the liver in which the enzyme vitamin D-25-hydroxylase (25-OHase) converts it into 25(OH)D.&nbsp;</li>
	<li>Secondly, 25(OH)D is subjected to further hydroxylation in the kidneys by the enzyme 25(OH)D-1-OHase (CYP27B1) to form the final active variant of vitamin D namely 1,25(OH)2D. It is usually referred to as cholecalciferol.&nbsp;</li>
</ul>

&nbsp;

Moreover, vitamin D initiates the absorption of calcium in the gastrointestinal system, the small intestine to be precise<a href="#accordion">[1]</a>.

Vitamin D always produces symptoms if it is not enough in the body. They would either be generalized or specific according to gender, age, and even routine sometimes.&nbsp;Diseases relevant to vitamin D deficiency are extremely disturbing and definitely not worth it. On the other hand, prevention is extremely simple: adequate diet and ample exposure. 
&nbsp;

Understanding Vitamin D

Vitamin D deficiency is characterized into 3 types:

&nbsp;

<ol>
	<li>Mild (20-30 ng/mL)</li>
	<li>Moderate (10-20 ng/mL)</li>
	<li>Severe (&lt;10 ng/mL)</li>
</ol>

&nbsp;

Studies prove that 1 billion people in the world go through vitamin D deficiency or insufficiency. A report presented by the National Health and Nutrition Examination Survey III (NHANES III) shows that 1% of individuals in the US suffered from vitamin D deficiency whereas 58% had insufficiency.&nbsp;

&nbsp;

<ul>
	<li>Vitamin D deficiency is when a person&rsquo;s level drops to less than 7ng/mL.</li>
	<li>Vitamin D insufficiency is when their levels are less than 25 ng/mL.</li>
</ul>

&nbsp;

A study carried out in the South Asian region concluded that Pakistan had the highest prevalence, around 63-85%, followed by Bangladesh (50-83%) and India (61-73%)<a href="#accordion">[3]</a><a href="#accordion">[4]</a>. 
&nbsp;

The major source for obtaining vitamin D is sunlight. Hence, if you do not go out in the sun enough, there is a huge probability you develop vitamin D deficiency or VDD.&nbsp;

The physical activities of Generation Z (anyone born between 1990 and 2010) have been consistently inconsistent because of their lifestyle, which revolves around indoor activities, surrounded by gadgets.&nbsp;

If only heated gadgets could also provide Vitamin D. But till they don&rsquo;t, going out in the sun is the only option to avoid VDD. Use sunscreen with a protection factor (PF) of 30 when you expose your skin to the sun.&nbsp;

Furthermore, an inadequate diet is why you might not have ample Vitamin D in your system. People nowadays refuse to intake milk as it is apparently a &ldquo;child&rsquo;s drink&rdquo;, and they also avoid items like salmon, egg yolks, and fruits. Everything is justified in balance; if you want to lose weight and do not have a pathological reason behind it, it is a much better approach to accommodate an egg yolk so you up your vitamin D without increasing your calorie intake<a href="#accordion">[1]</a>.

Some theories suggest that older people have fewer chances to get VDD because most people of that age take supplements,&nbsp;bridging the gap.

&nbsp;

<ul>
	<li>
	<h5>Protects Your Heart</h5>
	</li>
</ul>

Did you know vitamin D plays a cardioprotective role in your body? Following a heart attack, it&rsquo;s likely you end up with scar tissue that debilitates the heart&rsquo;s functionality. This scar is developed by specialized cells called the cardiac colony-forming unit fibroblasts (cCFU-Fs). Vitamin D is a natural antagonist to stop cCFU-Fs from forming this scar, thus ensuring the efficiency of the heart<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Reduce The Risk Of Cancer</h5>
	</li>
</ul>

Research has proved that Vitamin D would also reduce your risk of developing cancer. Your chances of getting colorectal cancer decrease by 22% if your Vitamin D is above the normal level, whereas the probability increases by 31% if the levels drop below normal.&nbsp;

Another study reveals that the higher the levels of Vitamin D, the lower the risk of breast cancer<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Manage Depression</h5>
	</li>
</ul>

Scientists have also seen that people suffering from depression had low levels of Vitamin D in their blood, and people with normal levels of vitamin D reported less depression, implying that there may be a direct relation between the two.

&nbsp;

<ul>
	<li>
	<h5>Improve Bone Health</h5>
	</li>
</ul>

Vitamin D is crucial to ensure your bone health. If a child lacks the optimum levels of vitamin D, he or she could develop rickets, which forces the bones to bend and give a bow-legged appearance. In adults, the variant is called Osteomalacia, which leads to softening of the bone and muscle weakness as well<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Additional Benefits</h5>
	</li>
</ul>

Scientists now believe that while basking in sunlight to synthesize vitamin D, you also expose yourself to the ultraviolet rays that help in preventing Multiple Sclerosis and Parkinson&rsquo;s disease<a href="#accordion">[5]</a>. 
&nbsp;

A study done in 2017 established that regulating vitamin D in the body prevented acute respiratory diseases.&nbsp;Along with the fact that it boosts the antimicrobial peptide production, vitamin D is the talk of town to help fight against COVID-19 as well. Researchers showed that 40% of the US population was deficient in vitamin D, and was among the population who readily contracted the viral disease. Hence, to put the theoretical knowledge to test, a study was conducted in which it was concluded that if you are Vitamin D deficient, your chances of getting COVID-19 were 1.77 times higher<a href="#accordion">[6]</a>.&nbsp;&nbsp; 
&nbsp;

Conclusion

Even though vitamin D seems like the most hyped vitamin, it is still underrated. This has to do with the fact that deficiency-related diseases are commonly dealt with by prescribed supplementation. Vitamin D deficiency needs to be taken more seriously as it could lead to extreme conditions ranging from weak bones to weak immunity. Hence, if you want to make sure that you are able to walk and are resistant to a number of sicknesses, get your vitamin D levels checked today! 
&nbsp;

Key Points

<ul>
	<li>The recommended daily allowance (RDA) of vitamin D is 15 mcg per day (600 IU) for adults who are 19 years old and above.</li>
	<li>For adults over 70 years, it bumps up to 20 mcg daily (800 IU).</li>
	<li>Vitamin D that comes from the skin or diet is in its inactive form and requires a 2-step process before it can be used by the body.</li>
	<li>First hydroxylation takes place in the liver; the second takes place in the kidneys assisted by enzymes Vitamin D-25-hydroxylase (25-OHase) and 25(OH)D-1-OHase (CYP27B1) respectively.</li>
	<li>Vitamin D also initiates the absorption of calcium in the small intestine.</li>
	<li>There are 3 categories of deficiency: mild, moderate, and severe.</li>
	<li>Studies prove that 1 billion people in the world go through vitamin D deficiency or insufficiency.</li>
	<li>A report presented by the National Health and Nutrition Examination Survey III (NHANES III) shows that 1% of individuals in the US suffered from vitamin D deficiency whereas 58% had insufficiency.</li>
	<li>A study carried out in the South Asian region concluded that the prevalence rate of vitamin D was highest in Pakistan - around 63-85%.</li>
	<li>The major source for obtaining vitamin D is sunlight.</li>
	<li>Use sunscreen with a protection factor (PF) of 30 when going out in the sun.</li>
	<li>Studies hypothesize that older people are less prone to get VDD because they usually take supplementation, hence bridging the gap.</li>
	<li>Vitamin D is a natural antagonist of the cardiac colony-forming unit fibroblasts (cCFU-Fs) and stops them from forming a scar, thus ensuring the efficiency of the heart.</li>
	<li>Studies support that your chances of getting colorectal cancer decrease by 22% if your levels are above normal whereas the probability increases by 31% if the levels drop below normal.</li>
	<li>People with normal levels of vitamin D have reported less depression.</li>
	<li>Vitamin D is crucial to your bone health as the deficiency could cause rickets in children and osteomalacia in adults.</li>
	<li>Your chances of getting COVID-19 are 1.77 times higher if you are deficient in vitamin D.</li>
</ul>

<div>&nbsp;</div>

[1] Nair, Rathish, and Arun Maseeh. “Vitamin D: The "sunshine" vitamin.” Journal of pharmacology & pharmacotherapeutics vol. 3,2 (2012): 118-26. doi:10.4103/0976-500X.95506

[2] Vitamin D. The Nutrition Source. March 7, 2023.

[3] Hovsepian, Silva et al. “Prevalence of vitamin D deficiency among adult population of Isfahan City, Iran.” Journal of health, population, and nutrition vol. 29,2 (2011): 149-55. doi:10.3329/jhpn.v29i2.7857

[4] Siddiqee, M.H., Bhattacharjee, B., Siddiqi, U.R. et al. High prevalence of vitamin D deficiency among the South Asian adults: a systematic review and meta-analysis. BMC Public Health 21, 1823 (2021).