Vitamin D – What you need to know

Low levels of Vitamin D is one of the most hotly debated health topics of the recent times. This is of particular interest for South Asians living in the UK, in whom deficiency is an extremely common situation.

With an estimated 82% of the South Asian population in the UK suffering vitamin D deficiency in the summer months, and a massive 94% having low levels of the vitamin year round, this is clearly a health issue affecting many Asians living in Britain today.

Vitamin D is vitally important for maintaining health bones, muscles and teeth. It does this through controlling the minerals calcium and phosphate. Although it has not been proven to be a cause, low levels have also been linked with heart disease and type two diabetes, both prevalent in south Asians, with diabetes some four to six times more common than in the white UK population. At the current time there is no proof that low levels of vitamin D are linked to increased risk of developing cancer.

While low vitamin D is very obvious in growing children with the typical bowed legs appearance of rickets, it may not be so obvious in adults. Individuals may complain of being tired all the time or picking up infections very readily. The symptom of “all over body pain” can often be mistaken for and indeed treated as anxiety or depression, when in fact it is a symptom of low vitamin D. When vitamin D deficiency occurs with low levels of calcium, this can lead to thinning of the bones, with fractures after relatively minor falls.

The foodstuffs containing the highest levels of vitamin D are meat, oily fish and eggs. Despite this, it is important to note that vitamin D is still only present in these in small amounts. To put this into context, you would have to eat approximately ten hens’ eggs every day to consume enough vitamin D.

The majority of our vitamin D is absorbed through the skin. Unfortunately it has been worked out that you would need just under an hour of direct exposure to UK summertime midday sun on a daily basis, to receive enough of the vitamin.

At this point you would rightly think, if there is not enough vitamin D in most diets and the UK climate does not provide enough sunshine, why isn’t everyone in the UK vitamin D deficient. Although low vitamin D is certainly recognised in the white British population, darker skin absorbs less vitamin D so requires longer exposure to sunlight to receive the same dose. At the same time, for cultural reasons many South Asians dress very modestly, which limits the amount of skin available to receive the sun’s rays. Furthermore some people purposely avoid the sun, for fear of becoming more tanned. Strict vegetarian or vegan diets limit the availability of vitamin D even further. The exception to this is those who regularly consume oily fish, which is a good source of the vitamin.

The current advice from Public Health England (PHE) is that adults and children over one should consider a vitamin D supplement in the autumn and winter months, while some high risk groups may need to take the vitamin throughout the year.

If you are suffering with any of the symptoms of vitamin D deficiency, a simple blood test will easily demonstrate the level in your system.

PHE recommends that all babies under one should have precautionary daily vitamin D supplement. However formula fed babies should not need this as powdered milk preparations are already fortified with the vitamin.

Drops containing vitamins A, C and D are available for children, and the dose of vitamin D advised for all those over the age of one is the same. Some groups will be eligible for free prescriptions, but a 3 month course bought over the counter costs as little as a few pounds.

It is important to remember that even if you do take vitamin D supplements, your body stores may drop back down once stopped, particularly if you are in a high risk group, hence the recommendation for year round medication.

Dr Z Uddin

MB ChB, MRCS, DRCOG, MRCGP

General Practitioner

www.doctorzak.co.uk

@AskDoctorZak