How to make sure you are getting enough Vitamin D

A long-prevalent health issue — that’s come into sharp focus during our long days indoors given the Coronavirus lockdown — is deficiency of vitamin D. It feels as though we are not getting our daily dose of this integral fat-soluble prohormone (it gets converted into a hormone in the body). And we could very well be right, unfortunately.

Researchers in a 2018 study ‘Vitamin D deficiency in India’ by P Aparna et al published in the Journal of Family Medicine and Primary Care sum up the role of vitamin D well: “[The vitamin] is needed for the maintenance of normal blood levels of calcium and phosphate that are required for normal mineralisation of bone, muscle contraction, nerve conduction, and general cellular function in all cells of the body.” The researchers describe its scarcity as “a silent epidemic” and “the most under-diagnosed and under-treated nutritional deficiency in the world.”

Dr Sushila Kataria, Senior Director of Internal Medicine at Medanta The Medicity, Gurugram, agrees that vitamin D deficiency has been a long-prevalent issue in India anyway, and that we should be vigilant about these levels throughout the year, lockdown or not. Dr Kataria explains that in certain amounts of UV light, cholesterol in the blood gets converted into vitamin D, adding, “It acts like a hormone, helping in calcium homeostasis and, in turn, bone and muscle strength, as well as optimising the nervous system.” There are two sub-sects of vitamin D: D2 (found in plants) and D3 (found in fatty animal sources). But Dr Kataria says that it is difficult to find abundant sources of both in India, hence the need for fortified foods.

Meet the mark

Mumbai-based Tanvi Dalal, founder of WellNest Nutrition, recommends her clients to take multivitamin supplements, adding, “Many people, without testing their levels, assume they are eating a lot of vitamin D-rich foods, such as one piece of salmon for dinner or a whole bowl of cereal which is fortified with vitamin D. These portions are not enough; matching up to 800 IU is very tough. A can of tuna can claim to have 500 IU, but you will not eat the whole can, only two tablespoons most likely. For people up to 70 years of age, between 600 to 800 IU of vitamin D is required, and the multivitamin covers this exactly, without going over or under.”

Tanvi says it’s best to spend between 30 minutes and an hour on the balcony or terrace, between 11 am and 2 pm, when the sun is at its nexus. The big key here is to not wear any SPF. Sunscreen-lovers may balk at such a suggestion, but Tanvi affirms that SPF will filter out your sunlight exposure and stop vitamin D production. If you are prone to sunburn, opt for shorter bursts through this period.

At-risk groups — children younger than five years old, those who are pregnant or breastfeeding, people with dark skin, those who are obese, and those over 65 years — definitely need the supplements. “But everyone needs vitamin D, not just at-risk groups,” says Tanvi. During the time of lockdown, pharmacies across the country have, in fact, upped their stock on vitamin D supplements, so Tanvi advises speaking to your doctor or nutritionist before finding the best one for you and your family.

Dr Kataria adds that there are vitamin D intramuscular cholecalciferol injections which have doses upwards of 3,00,000 IU, which can sustain the body for three to four months, but it is not wise to go to a clinic to take these right now, unless your doctor recommends it. She suggests we keep these in mind once the lockdown lifts.

Fit, inside-out

As the lockdown continues, our home workouts become something of a must-do. Tanvi talks of the link between vitamin D deficiency and exercise, explaining, “Your ability to exercise reduces significantly because it is also needed for calcium absorption for the muscles.” If you’re fatigued quickly and can’t understand why, speak to your doctor — you may be D deficient.

Lockdown blues are also on the prowl and vitamin D deficiency is linked to declining mental health, so it does not hurt to cover your bases, as your mental health is already vulnerable in these difficult times.

Dr Kataria says, “Both vitamin D and B12 deficiencies are related to depression and anxiety, especially at this time. Medically, before prescribing an anti-anxiety tablet, your doctor may check these levels, and prescribe a supplement along with psychotherapy.”

However once again, because we cannot go to a lab for a test or have a lab technician come home, a supplement may be the way to go. That and a good diet, exercise, and sunshine. Cut out smoking and reduce drinking, because these have a significant bearing on vitamin D metabolisation.

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