Find your place in the sun with Vitamin D

Dr Hemant Thacker Nov 2 is D-Day - Yes, Vitamin D day. As they say in common parlance, everyone deserves their time in the sun (to mean a phase of glory in life), but we in medicine preach: you must always have a regular place in the sun. Despite being a sun-rich country, more than 70% of the Indian population across all age groups is D-deficient.

The evolution in society whereby Indians have become increasingly heliophobic (they avoid or limit exposure to sunlight) is hurting health. Urban lifestyles, long indoor working hours, reduced outdoor games, sunscreens and tanning concerns, all these compound the issue. This reduced exposure to ultraviolet B rays, along with the man-made cloud cover of smog which interferes with these rays reaching the human skin where actually the photoproduction of Vit D starts, is responsible for the epidemic of hypovitaminosis D.

Besides being the bone vitamin, we now know that D plays an important role in normal muscle function and immunity. Its role in metabolic health involving glucose regulation and cardiovascular and neurological health has also been researched. The receptors for D are found in several tissues of the body, reflecting its widespread biological significance.

This fat-soluble vitamin is essential all through life from paediatric to geriatric ages, with daily requirements varying from 600 to 2,000 IU depending on individual needs and health status. Children of today are so bogged down with school work and indoor activities that their requirements need to be swiftly attended to, to allow healthy skeletal growth.

Vulnerable people include the infirm and elderly, obese, pregnant women and immunocompromised individuals who need supervision and topping up. Now here’s the punchline - patients repeatedly come to the clinic for every annual check-up with inadequate levels. On enquiry, they confess that they took the advised ‘course’ in the last year’s prescription but not the maintenance.

It is absolutely mandatory to understand that the quick course is to catch up the levels BUT the monthly course is to MAINTAIN it. You don’t brush your teeth in a ‘course’ format but do it every day and like so, D intake must be regular and punctual if you want to retain your muscle and body strength.

Again, our patients are a docile and easily satisfied lot when it comes to reports. The normal value of Vitamin D3 is between 30 and 100 but you should not be satisfied with 35. Aspire for 60, which is closer to the mean and gives you a buffer, so aim for that rather than roost at low-normal.

While D deficiency usually manifests with fatigue, bone and muscle pain and unexplained weakness, mood changes and other non-specific symptoms are not unusual. While correction of low levels is easy (best done with oral capsules and shots and doesn’t require injections), over-correction is a problem.

When patients go symptom-shopping and doctor-hopping without disclosing the previous prescription, they run the risk of hypervitaminosis D, which is a known syndrome and needs to be avoided. Vit D health is a direct function of awareness and sunshine. With the famous song ‘Ain’t no sunshine anymore’ and cultural habits favouring ‘moonlighting’ rather than sunbathing, regular supervised intake of the correct dose on an ongoing basis is the way to go.

Luckily our country has access to very affordable sources of both, so ‘Tu Hai Meri SURYA Kiran’ should be the rhyme when you look up early morning or early evenings (best times to expose to the rays). That way, with the ‘Sun God’, you make peace in the mind and D in the skin. (Dr Hemant Thacker is a Consultant Physician & CardioMetabolic Specialist in Mumbai and affiliated to TOI.

Email: dochpt@gmail.com)