Vitamin D, commonly known as the sunshine vitamin, is needed not just for the absorption of calcium but also for the proper function of the muscles and nerves. Its benefits range from maintaining the skeletal health to lowering the risk of respiratory, liver, cardiovascular, diabetes and neurological diseases. However, Vitamin D deficiency has become a worldwide health problem. Vitamin D sufficiency is when the blood levels of Vitamin D are more than 30 ng/ml and Vitamin D insufficiency is when the levels are between 20-30 ng/ml. However, if the levels are lower than 20 ng/ml, it is termed as Vitamin D deficiency.
According to a study[1], Vitamin D insufficiency affects around 50% of the global population worldwide. It is estimated that almost 1 billion people worldwide across all ethnicities and age groups have Vitamin D deficiency (VDD).
Vitamin D Deficiency and Indians
In India, approximately 70-90% of an apparently healthy population is vitamin D deficient revealed a study published in the Indian Journal of Pharmaceutical Sciences[2]. Low levels of Vitamin D is prevalent irrespective of age, sex, profession, urban or rural settings. The deficiency of this vitamin not only impacts the musculoskeletal health but also various acute and chronic diseases. Vitamin D deficiency has been associated with an increased risk of diabetes, cardiovascular disease, cognitive decline, autoimmune disorders, pregnancy complications, and certain cancers.
Sunlight is the major source of Vitamin D. Most people think that Indians have sufficient levels of this vitamin due to adequate sunshine all around the year. But due to limited exposure to UV rays owing to increased skin pigmentation and suntan, application of sunscreen and covering the body with full layers of clothing, there is a reduced synthesis of Vitamin D in the body. Also, the availability of Vitamin D through diet such as natural food sources like salmon, cod liver oil, mushrooms or through Vitamin D fortified foods is not widespread. Due to the lack of adequate sun exposure, deficient intake of foods rich in Vitamin D and lack of food fortification, Indians are susceptible to Vitamin D deficiency.
This is the reason why supplementation of Vitamin D is the need of the hour to prevent and treat Vitamin D deficiency in people at risk such as[1]:
-Breastfed infants, vitamin D requirements cannot be met by human milk alone. Hence, mothers are advised for supplementation which can lead to high levels of Vitamin D in their milk.
-Elderly people because due to age and a long time spent indoors, their skin fails to synthesize Vitamin D efficiently.
-People with limited sun exposure such as housebound individuals and people with jobs that limit sun exposure causing them to spend most of the time indoors may lack Vitamin D.
-People with dark skin because of the large amounts of the pigment melanin in the skin may reduce the ability of the skin to produce Vitamin D from sunlight.
-People with fat malabsorption because Vitamin D is a fat-soluble vitamin which require some dietary fat for the absorption by the intestine.
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What Is The Right Way To Take Vitamin D?
Take two glasses of water, add a spoon of sugar in one and oil in another. Now give them both a thorough mix separately. What happens? The sugar dissolves completely in the water making a sugary sweet solution, useful to drink and make sweet beverages. On the other hand, the oil breaks down into small drops, floats on the top and makes a gooey mess, it’s useless. Similar to this we have two types of vitamins in our body, fat soluble and water soluble.
Water-soluble vitamins are absorbed easily by our body but also easily excreted. These include Vitamin B and C. Whereas fat-soluble vitamins are absorbed by the fat in our body and remain stored in our fat cells. These include Vitamin A, D, E and K. Vitamin D is a fat-soluble vitamin and can only be absorbed in the presence of fat in our gut.
If you have gone to your doctor for a checkup in the last year, chances are that you might have undergone Vitamin D deficiency test and taken supplements to correct your levels.
Taking a Vitamin D supplement is no rocket science. You need to take one dose, once a week or as advised by your doctor and you are done! But are you taking your supplements correctly? Being a fat-soluble vitamin, Vitamin D requires fat to be absorbed by our body in the absence of which, there is an incomplete absorption.
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So, what are the correct ways of taking Vitamin D supplements? Let’s find out.
1) With the largest meal of the day: If you take Vitamin D with the largest meal of the day, there is a 50% increase of Vitamin D levels in your blood. This is because your largest meal of the day contains the most amount of fats helping in the absorption of the vitamin.
2) With Milk: If not with the largest meal of the day, you can take your Vitamin D supplements with milk. It also contains magnesium which promotes the absorption of fat-soluble vitamins.
Vitamin D helps our body in utilizing calcium and phosphorus as well as boost our immune system. With the adoption of a sedentary lifestyle and limited exposure to sunlight, it’s not surprising that we are suffering from Vitamin D deficiency. However, there are few things to keep in mind when taking Vitamin D supplements.
These supplements should not be taken on an empty stomach or in between the meals like most medicines. To get an optimum absorption it’s important to take these supplements correctly.
Vitamin D supplements may interact with several medications. For example, corticosteroids can reduce calcium absorption, which results in impaired vitamin D metabolism. So talk to your doctor about the medications you are taking.
The Indian Council of Medical Research (ICMR) recommends a daily supplement of 400 IU/day of vitamin D for Indians under situations of minimal exposure to sunlight[2]. Traditional multivitamins contain about 400 IU of Vitamin D, but many multivitamins now contain 800 to 1000 IU[1]. To check the right type of supplements, consult your doctor who after weighing the pros and cons might recommend the right dosage and type of supplements.
You can choose from a variety of options available for Vitamin D supplements which include capsules, chewable tablets, liquids, and drops. But remember to follow your doctor’s advice without fail to reap its health benefits.
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(The article is reviewed by Dr. Lalit Kanodia, General Physician)
Recommended Reads:
Know Your Food: Vitamin D Sources – Sun, Diet And Supplements
6 Signs And Symptoms Of Vitamin D Deficiency
References:
1. Nair R, Maseeh A. Vitamin D: The “sunshine” vitamin. J Pharmacol Pharmacother. 2012 Apr;3(2):118-26.
2. Lhamo Y, Chugh PK, Tripathi CD. Vitamin D Supplements in the Indian Market. Indian J Pharm Sci. 2016 Jan-Feb;78(1):41-7.
3. Gani LU, How CH. PILL Series. Vitamin D deficiency. Singapore Med J. 2015 Aug;56(8):433-6; quiz 437.
4. Pludowski P, Holick MF, Grant WB, et al. Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol. 2018 Jan;175:125-135.