Vitamin D deficiency commonly affects both genders, at every age, all over the world with the elderly or those who suffer from osteoporosis being particularly at risk.
Vitamin D deficiency directly affects bone strength. An Infant with severe vitamin D deficiency may have a form of brittle bone disease called rickets. For the elderly, on the other hand, a severe deficiency can lead to osteomalacia. However, in most cases, it doesn’t get as severe, but it is common for those with a vitamin D deficiency to have an increased risk of osteoporosis.
The Institute of Medicine (IOM) and The Endocrine Society of Thailand (EST) states that people with vitamin D levels below 20 ng/ml are considered to be suffering from a vitamin D deficiency. High risk groups, such as people suffering from osteoporosis, should have vitamin D levels of 30 ng/ml and above to be considered within the safe range.
There are vitamin D level assessments available that can precisely identify the amount of vitamin D present in the bloodstream (25(OH) vitamin D). These assessments are usually recommended for the elderly, those suffering from osteoporosis, and people who are susceptible to bone fractures. Those who suffer from liver or kidney disease that negatively affect vitamin D production rates, people with a BMI of over 30, and people who don’t get enough sunlight, such as people who work inside or people who regularly apply sunscreen before going outside, are also advised to undergo vitamin D level screening.
The most important natural source of vitamin D is gained from our skin’s exposure to sunlight, which contains Ultraviolet B (UVB) rays that enable the body to produce vitamin D. The best times of day to expose the skin to sunlight are 08:00-10:00 and 15:00-17:00 as this is when the sun’s rays are not too strong or dangerous for the skin. Spending just 15-30 minutes in the sun at these times is enough for the body to produce sufficient amounts of vitamin D.
It is also possible for us to increase our vitamin D intake by eating certain foods, including mushrooms grown in sunlight; oily fish like salmon, tuna, mackerel and sardines; as well as eggs or milk that have added vitamin D.
The vitamin D we get from our diet each day may not be enough for our body’s needs due to there being a limited amount of foods that are rich in this vitamin. As a result, we should be supplementing dietary vitamin D with suitable exposure to sunlight. People under the age of 70 should be getting 600 IU of vitamin D per day, while those over the age of 70 should be receiving 800 IU* of the vitamin each day due to the reduction in ossification occurring in their body as they age.
For cases where vitamin D levels are extremely low, or where people cannot make any of the aforementioned lifestyle changes to increase their vitamin D level, doctors may prescribe vitamin D supplements depending on the specific needs of each individual case.
Studies have found that vitamin D supplements help to build muscle strength, aid balance, improve muscle function, help to increase movement fluency and can even reduce the risk of falling in the elderly. Most importantly, getting the right amount of vitamin D helps to reduce the risk of bone fractures, which is especially important for the elderly or those groups of patients that suffer various issues as a result of a bone fracture. Such issues include pain where the fracture occurred, which can lead to a decreased movement range or a reduction in functioning ability in the affected area. Also, some patients are rendered bedridden by a hip fracture, and this can lead to several other complications including an increased susceptibility to infections and, in some cases, other life-threatening conditions.
*Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010
The First class honors M.D., Faculty of Medicine Siriraj Hospital, Mahidol University, 2005.