New Delhi : If you’re considering a single dose of vitamin D to compensate for deficiency, don’t. Medical experts strongly advise against this for its potential harm to your health. The warning comes at a time when the persistent smog has limited people’s exposure to natural sunlight, the primary source of the vitamin.
According to doctors, injectable vitamin D should be avoided because it can cause excessive vitamin D levels and kidney stones. Research suggests that taking an annual dose at one go may also increase the risk of falls and bone deterioration.
Dr Ravinder Goswami of the department of endocrinology and metabolism at AIIMS cautioned that a 6,00,000-unit vitamin D injection could adversely affect bone health. Active analogues like calcitriol should also be avoided as these are specifically designed for treating kidney ailments. For individuals unable to get regular sun exposure, a monthly 60,000 IU sachet is adequate to maintain normal levels, Dr Goswami said.
Airing similar views, Dr SV Madhu, director professor, endocrinology, University College of Medical Sciences, said calcitriol should not be used to treat basic vitamin D deficiency. He explained that active analogues were pharmaceutical substances meant for specific medical conditions rather than for general supplementation or treating ordinary vitamin D deficiency.
Vitamin D deficiency, combined with excessive calcium or fluoride intake, severely impacts bone health. Daily calcium requirements of approximately 1gm can be met through either a glass of milk or a 500mg calcium supplement. “Nano vitamin D is costly and has no real benefit,” said Dr Goswami.
Vitamin D plays a crucial role in producing calcium transporters within intestinal cells. This process enables the absorption of calcium from food in the digestive tract. When calcium and phosphorus are present in the bloodstream, they work together to strengthen and mineralise the skeletal structure.
Dr Goswami advised consuming vitamin D supplements alongside milk, orange juice or water, ensuring the supplement was placed in the mouth before drinking the liquid. He cautioned against mixing the granules with milk as they could adhere to the container. For natural vitamin D synthesis, he suggested daily sun exposure of 15-30 minutes between 10am and 2pm when the sky is clear. Sunlight filtering through glass panes is ineffective because the glass blocks the essential ultraviolet rays required for vitamin D production in the skin.
The elevated pollution levels, especially in winter months, made sun exposure virtually ineffective for the purpose of producing the vitamin. Experts said that wheatish brown skin, characteristic of Indians, contains melanin, which provides natural protection against developing melanoma and other skin cancers. But, Dr Saptarshi Bhattacharya, senior consultant in endocrinology, Indraprastha Apollo Hospitals, pointed out, due to higher melanin levels in the Indian population, they required increased sun exposure and so in winter, vitamin D requirements were considerably higher than in summer.
Vitamin D3 production occurs naturally through skin exposure to sunlight. While irradiated mushrooms and plants contain vitamin D2, approximately 90% of vitamin D in our blood is D3, which comes from sunlight exposure. Though eggs and fatty fish like salmon and cod contain vitamin D, their quantities are limited. An egg provides merely 20 IU, making it impractical to achieve the daily 1,000 IU requirement through eggs alone. Similarly, one would need to consume 500 grams of fish daily to meet intake requirements.
Indoor workers such as office staff and bench workers and residents of areas with elevated fluoride levels in water are susceptible to vitamin D deficiency. Individuals with medical conditions like TB, epilepsy, kidney disorders and gastrointestinal issues are also vulnerable. Weight reduction surgery also leaves people prone to deficiency. People who work outdoors — hawkers, gardeners, policemen, security guards, farmers, et al — maintain adequate Vitamin D levels through sun exposure.
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