What is so important about Vitamin D?

Dr Anees Fatima, Family Medicine Specialist at The City Hospital, explains the importance of Vitamin D.

Posted on

19 September 2013

| Last updated on 31 December 2017

What is so important about Vitamin D?

This essential nutrient is called a vitamin, but dietary vitamin D is actually a precursor hormone; the building block of a powerful steroid hormone in your body called calcitriol. It’s been known for many years that vitamin D is critical to the health of our bones and teeth, but deeper insight into D’s wider role in our health is quite new.

“Vitamin D is one of the most powerful and underrated healing chemicals,” says Dr. Anees Fatima of The City Hospital, “and unlike others, it’s actually generated by our own bodies. This happens when our skin is directly exposed to sunlight.”

Vitamin D enhances our immunity, protects us against breast and colon cancers, depression and diabetes. “Studies conducted in the US showed high incidences of colds and flu during the winter months and lower incidences during the sunnier months. This had a direct correlation to drop in blood levels of Vitamin D throughout the winter,” Dr Fatima explains. “The same correlation applied for depression.”

We also know that low levels of Vitamin D affect optimum calcium metabolism in the body. “Hence it follows that Vitamin D is essential for the prevention of Osteoporosis and plays a vital role in the early treatment of Ostopenia [the beginning stages of osteoporosis],” says Dr Fatima.

What causes a deficiency and how do I know if I have a Vitamin D deficiency?

Your body can’t create vitamin D on its own. Instead, it’s designed to make it through sun exposure. In theory, you can make an ample supply of vitamin D with as little as a couple of hours per week in the sun — provided the UVB rays are strong enough. You can also ingest D through food, especially fatty fish like wild – harvested salmon. Plus, lots of foods are fortified nowadays, so vitamin D deficiency should be an easy problem to solve, right? But the truth is, we’re just not getting enough, and so many of us aren’t even close.

The symptoms of Vitamin D deficiency are nonspecific but they often include fatigue, lack of energy, muscle ache and bone pain (often experienced as a dull ache in the bones), low mood and irritability. However, for many people, the symptoms are subtle. Yet even without symptoms, too little vitamin D can pose health risks.

Low blood levels of the vitamin have been associated with the following:

Increased risk of death from cardiovascular disease
Cognitive impairment in older adults
Severe asthma in children
Cancer

Research suggests that vitamin D could play a role in the prevention and treatment of a number of different conditions, including type1 and type 2 diabetes, hypertension, glucose intolerance, and multiple sclerosis.

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How is a diagnosis confirmed?

“At The City Hospital, we provide a blood test which gives accurate results immediately,” says Dr Fatima. "We also have an advanced digital bone density scanner to identify thinning bones or Osteoporosis. This is used in routine screenings for women over the age of 65 or those with risk factors such as family history of Osteoporosis, history of easy fractures or early menopause.”

Vitamin D deficiency is being diagnosed more frequently in the UAE because of increased awareness and testing. “It affects between 60 and 80% of the total UAE population, which is probably not different from anywhere else in the world, but we’re finding an alarming number of patients with deficiency on a daily basis,” says Dr Fatima.

How can I prevent or treat Vitamin D deficiency?

According to Dr. Fatima, “10 – 30 minutes of sun exposure daily or on most days of the week will be beneficial to all people, but your exposure can be done with breaks in between, meaning few minutes at a time, if the intensity of the sun rays is too much, like in UAE summers. While there is a legitimate concern that too much sun exposure can damage skin and cause skin cancer, a few minutes won’t do much harm.”

Vitamin D deficiency can occur for a number of reasons:

You don't consume the recommended levels of the vitamin over time. This is likely if you follow a strict vegetarian diet, because most of the natural sources are animal-based, including fish and fish oils, egg yolks, cheese, and beef liver.
Your exposure to sunlight is limited. Because the body makes vitamin D when your skin is exposed to sunlight, you may be at risk of deficiency if you are homebound, live in northern latitudes, wear long robes or head coverings for religious reasons, or have an occupation that prevents sun exposure.
You have dark skin. The pigment melanin reduces the skin's ability to make vitamin D in response to sunlight exposure. Some studies show that older adults with darker skin are at high risk of vitamin D deficiency.
Your kidneys cannot convert vitamin D to its active form. As people age their kidneys are less able to convert vitamin D to its active form, thus increasing their risk of vitamin D deficiency.
Your digestive tract cannot adequately absorb vitamin D. Certain medical problems, including Crohn's disease, cystic fibrosis, and celiac disease, can affect your intestine's ability to absorb vitamin D from the food you eat.
You are obese. Vitamin D is extracted from the blood by fat cells, altering its release into the circulation. People with a body mass index of 30 or greater often have low blood levels of vitamin D.

Can’t I just take supplements?

Dr. Fatima recommends sun exposure as a long term lifestyle management approach, as the Vitamin D produced naturally by the skin is better utilised by the body. However, if you are found to have a deficiency, a course of supplements would be prescribed in conjunction with ‘sun therapy’.

Dr Fatima’s advice to UAE residents is to make Vitamin D while the sun shines, all year round!