Not enough of the sun
DR. HIRAMALINI SESHADRI
Vitamin-D deficiency, which impacts the body’s immune system, is on the rise across the country.
Photo: Shaju John
Desk-bound: Lifestyle changes are an important reason for Vitamini-D deficiency.
Time was when we thought that all Vitamin-D was needed for was for strong bones; and mothers used to give children cod liver oil. Then came fears of Vitamin-A overdose and news that sunshine was enough to help one make the Vitamin-D needed; and cod l iver oil faded out of people’s minds.
But, cod liver oil is in for a big comeback now. With the IT revolution, a huge chunk of our young population is closeted indoors all day; and studies done on software professionals coming for check-ups at the Apollo Hospitals, Chennai, by a young postgraduate student, Dr. Vidya, under the guidance of an astute physician, Dr. Vijaikumar, threw up the stunning fact that a lot of the back aches of the software professionals was due to Vitamin-D deficiency! Studies done across the country on other population groups such as pregnant women, post-menopausal women, middle-class housewives, the elderly, home-bound cancer patients have also shown that the sunshine vitamin is deficient in up to a startling 80 per cent of those studied, even in tropical India!
More than a vitamin
These figures become more worrying because research over the past two decades has shown that Vitamin-D is much more than a vitamin; it is in fact the precursor of an important hormone, calcitriol, that has a vital role in regulating the immune system inside cells and outside it. The main role of the immune system is to recognise “self” from “non-self”. Thereafter it protects cells and antigens identified as self and keeps under surveillance and check what is identified as “non-self”. When the immune system puts up a fight it results in inflammation, which is a normal defence response of the body. A confused immune system can end up inciting inflammation against “self” cells and antigens; resulting in what are known as autoimmune diseases like arthritis, vasculitis, thyroiditis and certain types of diabetes. The immunoregulatory role also includes keeping the proliferation of cells recognised as self, under control, for, it is uncontrolled proliferation that results in cancer. Vitamin-D has a role in all of these and may be more areas, say researchers.
In short, Vitamin-D is not just a vitamin for healthy bones and joints but a key player in the prevention of many of the “lifestyle” diseases that plague us in this 21st century. Indeed, at the last count, the National Institute of Health, Bethesda, reported that Vitamin-D deficiency could be a contributory factor for at least 17 types of cancer, autoimmune diseases, vascular problems (read as heart attacks and strokes), diabetes, neuropsychiatric problems, osteoporosis, osteoarthritis, muscle wasting and weakness, chronic pain, birth defects, dental problems and skin problems such as psoriasis. This is not to say that Vitamin-D deficiency is the only cause of these conditions, or that Vitamin-D is a cure-all, but to bring to public awareness that Vitamin-D deficiency increases the risk of developing these problems. In fact, while treating these problems, it would be a good idea to check for Vitamin-D deficiency if the persons lifestyle warrants it; correcting any deficiency picked up would be a beneficial adjuvant therapy.
How much Vitamin-D does one need? The usual rule of thumb is around 400 international units a day, with home-bound folks like the elderly, the bed-ridden who don’t get enough sunshine, needing more. However recent research reports suggest that our needs may actually be much higher, since now we know that we not only need adequate blood levels of the Vitamin for bone health but also need adequate tissue levels of calcitriol for the well-being of the immune system. The next decade is bound to throw up lots more news on this new avatar of Vitamin-D! Can one end up with too much Vitamin-D? Yes, and that’s why Vitamin-D should not be taken indiscriminately; for, too much can be bad too. Checking D-3 levels therefore helps. Taking a cod liver oil capsule a day is fine; but tablets of calcitriol, the active hormone form of the vitamin should be taken only under a doctor’s guidance.
Why should we in India, the sun-kissed land, worry, did you ask? Sunshine helps make Vitamin-D best in light skinned people. Pigment retards sun-aided Vitamin-D production; not the best of news for us dark skinned Indians. Clothing is also anti-Vitamin-D. The bare-chested Indian villager working in the fields under the sun is therefore far better off than the suited-booted urban Indian working U.S. or U.K. hours closeted in a tech park or corporate set up. Others who need to watch Vitamin-D levels are those on long term medication, for example, anti-epileptic medication; some of these could have an adverse effect.
How does one check out Vitamin-D levels? A simple blood test can tell one the D-3 level, D-3 referring to the active hydroxylated form of the vitamin in the body.
Reports from across the world indicate that in the 21st century, across populations globally, Vitamin-D deficiency seems to be present in 30 to 40 percent of the people! In fact, healthcare bodies refer to it as the “Vitamin-D deficiency epidemic”! The worst afflicted are blacks of Afro-Caribbean origin living in the U.S. Dark skin colour, too much clothing and inadequate sunshine conspire to create a deficiency state despite Vitamin-D fortification of foods such as breakfast cereal by legislation ! In India we have no such food fortification with Vitamin-D. We have been slumbering under the notion that in sunny India all that is not needed. But looks like we may be wrong. The urban Indian is an ideal candidate for Vitamin-D deficiency.Cod Liver Oil Is Back for Good!
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