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.
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.
There are vitamin D level assessments available that can precisely identify the amount of vitamin D present in the bloodstream. 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 Institute of Medicine (IOM) and The Endocrine Society of Thailand (EST) states that people with vitamin D levels of 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.
An important natural source of vitamin D is sunlight, which contains Ultraviolet B (UVB) rays that stimulate the vitamin D production, with the hours of 09:00–15:00 being the best time of day for this type of sunlight. 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.
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.
The First class honors M.D., Faculty of Medicine Siriraj Hospital, Mahidol University, 2005.