In spite of living in largely sunny climates, Asians have a strange predisposition to Vitamin D deficiency which is causing serious concerns in their native countries and in the countries they are migrating to. For instance, a recent study in the UK analysed the medical records of children suffering from Vitamin D deficiency between 1994 and 2005 at the Burnley Health Care Trust. It found 14 cases, 13 of which were in Asian children. The UK government has realised that it is far more economical to supplement the Asian population with Vitamin D through fortified foods rather than fund treatment of grave health repercussions that Vitamin D deficiency causes.
Vitamin D is found abundantly in sunlight. It is found in some foods and diet fortification does not ensure deficiency treatment on its own, and only if the body has enough Vitamin D will it enable the absorption of calcium which is vital for healthy bones. At particular risk are women and children from middle to upper middle classes since their lifestyle has effectively curtailed outdoor activities.
In Pakistan, the problem is now surfacing like a monster, with women and children at high risk. Some studies suggest that 90 per cent of the population is suffering from Vitamin D deficiency. Children of Vitamin D deficient mothers naturally acquire the condition at birth.
The requirement of modest dressing by women in our society coupled with the new age architecture sans a courtyard or roof terrace (for many) effectively cuts out sun exposure for women in Pakistan. Ironically, in spite of this condition spreading in epidemic proportions, the use of sun block reigns high!
Symptoms and repercussions
In adults the symptoms include muscular and joint pain, backache, progressively weakening eye sight and chronic fatigue. In children, this deficiency is manifest by rickets (legs curving outwards), delayed teething and hardening of the skull bone, chronic flu and an overall ill health.
If untreated, Vitamin D deficiency can cause serious diseases like osteoporosis, osteomalacia, rickets, kidney stones, psychiatric disorders like Alzheimer’s, auto immune diseases, infectious diseases and even cancer.
Toxicity
Doctors recommend supplementation via intramuscular injection, or through tablets and syrups.
However, in some people the high dosage supplementation is not absorbed easily, which causes severe Vitamin D toxicity in the body. It is better to avoid the intra muscular injection which is an instant 300,000 IU of Vitamin D going into the body whereas the daily requirement is 600 IU.
Toxicity adversely affects the liver, kidney and even the heart, and causes dehydration, constipation or diarrhoea and vomiting over a prolonged period till the excess amount is flushed out.
Of particular concern is the irresponsible way in which paediatricians recommend supplementation for infants without investigating baseline Vitamin D levels. For instance, my 13-month-old son suffered a severe bout of toxicity following repeated injection supplements insisted on by the paediatrician. Post supplementation, his blood levels showed a Vitamin D level of 160-plus whereas 40 – 100 is the optimum level. It took him three months to recover from a terrible bout of diarrhoea, fatigue, pain and allergic skin eruptions.
Treating infants for this deficiency ought to be a very careful affair. Never go for repeated dosages within six months even if your paediatrician recommends it. Even the manufacturers of the in-drop injections warn against repeated dosage for infants within six months.
It is strongly advisable to get a wrist X-ray and blood test before giving supplements to an infant. Children over two years of age must not be supplemented via injections without an initial blood test to check base Vitamin D level.
Important Vitamin D facts
• You need a 20 - 30 minute exposure to the morning or later afternoon sun everyday for free and harmless Vitamin D generation in your body. Full body exposure can result in almost a 20,000 IU. And the best part is that the body accepts this high dosage graciously since it’s natural!
• Fairer people tend to generate more Vitamin D from a thirty minute exposure as compared to darker people. People with dark skins therefore need longer exposure.
• Fish from the sea is a rich source of Vitamin D as compared to farm fish or river fish.
• Fortified foods on their own do not meet Vitamin D daily requirement.
• Children who spend more time indoors gaming, net surfing and TV viewing are at a higher risk of Vitamin D deficiency.
• Pregnant women must include tablets in their daily diet if they do not expose themselves to the sun, otherwise the newborn has a high chance of acquiring/being born with rickets.