Vitamin D

Vitamin D is known as the sunshine vitamin because our bodies create this important vitamin when the skin is exposed to the sun. The deficiency of this vitamin is becoming more common in cities all over the world. This is because many people spend most of their time living and working indoors and avoid the sun or use sunscreen because of the fear of skin cancer or damaging their complexion. Smog and pollution in cities can also block the sun’s rays. In a random study of people from Indian metro cities we found that 50% had vitamin D deficiency.

The importance of Vitamin D

Vitamin D is very important for calcium absorption. It also helps boost immunity by fortifying the white blood cells, which defend against bacteria. In addition, it has anti-inflammatory properties. A link has been made between influenza and vitamin D deficiency in countries which experience long winters with low levels of sunlight. Depression, mental health problems and Seasonal Affective Disorder have also been linked to low vitamin D levels in patients. Other diseases which can be caused by a deficiency in vitamin D include high blood pressure, diabetes, autoimmune diseases, excess fat accumulation around vital organs, different types of cancer, atherosclerosis (thickening of arteries), osteoporosis (deterioration of bone mass) and osteopenia (thinning of bones).

Getting Vitamin D naturally

There are two types of vitamin D. Ergocalciferol (Vitamin D2) is found in a few foods like fatty fish. In some countries, fruit juices, milk or cereals are often fortified with this vitamin. Cholecalciferol (Vitamin D3) is what is produced by the body when the skin is exposed to sunlight. It is difficult to get enough vitamin D through food sources. This is why sunshine is the best option. And it’s free! However, it’s not always available and air pollution is an increasing impediment to getting this vitamin from the sun.

You can get vitamin D is from the sun just by spending 15 to 20 minutes a day in direct sunlight, 3 to 5 times a week. The sun rays should directly act upon the skin. Do not wear sunscreen during this time as this will prevent your skin from absorbing the vitamin. Vitamin D is not absorbed through clothes, windows, or even smog. That’s why it’s hard to get vitamin D from the sunshine in Indian metros.

Taking excess vitamin D supplements can cause hypervitaminosis D, which can be dangerous. However, you can never get too much vitamin D from the sun.

Do avoid sunburn by limiting exposure. If you are eating plenty of raw fruits and vegetables, the anti-oxidants in these will help prevent sunburn and also reduce the risk of skin and other cancers.

Vitamin D is stored by the body. If you have enough stored you can get by on cloudy days without any problems. If you’re concerned that you may be vitamin D deficient, and have symptoms like depression, chronic fatigue, weight loss and muscle ache get a test done to determine your level of vitamin D. In places with long winters, or cloudy or smoggy weather, it’s very important to get vitamin D levels checked. In case of deficiency, supplementation is required but even then, levels should be checked to avoid over-dosage.

It is also important to note that people with darker skin tones absorb vitamin D more slowly and in lower quantities than people with light skin.

Cholecalciferol is further converted into an active form, calcitriol, mainly by the kidneys and also by a few other tissues in the body. It is possible that people with kidney disease cannot utilise cholecalciferol supplements easily and require calcitriol supplements instead.

Vitamin D is actually a hormone even though it is called a vitamin and therefore should not be in the body either in excess or lack.

Testing for Vitamin D

A blood test can be done to check vitamin D3 levels. 30 to 50 ng/ml (70 – 125 nmol/L) is the normal range. Less than 15 ng/ml (38 nmol/L) is far too low, and over 100 ng/ml (250 nmol/L) constitutes hypervitaminosis which is also dangerous.

Most commercially available vitamin D3 is not vegan since it is usually made from lanolin fat from sheep’s wool. Vegan vitamin D2 is made from vegan sources like yeast and mushrooms and has been available but there is some debate on the virtues of D2 over D3. Many say vitamin D3 is more easily used than vitamin D2. Luckily now vegan vitamin D3 is available too. Please scroll down for information on this.

Supplementation can be oral or by injection. If the values are very low, injections may be best.

Some supplements available in India:

Oral sachet: Calcirol made by Cadila. It is cholecalciferol, 60,000 IU in 1 g sachets in granule form. 1 sachet can be taken orally at an interval of 1–4 weeks as required.

Oral capsules: D-Rise by USV Ltd or D-360 by Torrent or Sunbless by Cadila are capsules of 60,000 IU of cholecalciferol. (There are several others too). 1 capsule can be taken orally at an interval of 1–4 weeks as required.

Injection: Injection Arachitol 6,00,000 IU intra muscular (IM), every fortnight for two months. Contains cholecalciferol.

Vegan vitamin D supplements are now available in India and you can find these with a simple Google search, as new brands keep getting added. Please make sure that they do not have calcium or other ingredients and check the amount of vitamin D in the dose to understand the quantity you would need. If your levels are normal, then taking 2000 IU per day should be fine.

You could check Unived as it’s a 100% vegan company https://www.unived.in/product/vegan-vitamin-d3-with-organic-coconut-oil-2000-i-u-60-vegan-caps/

Note: Vitamin D levels take some time to build up after depletion.

Requirements

  • 1 to 70 years of age: 600 to 2000 IU per day
  • More than 70 years: 800 to 2000 IU per day
  • 5000 IU per day for 9 weeks can be advised for deficiency.

Suggested dosage:

Level of 25-OH Vitamin D (total):

  • 0-10 ng/ml: 60,000 IU twice a week for 4 weeks followed by once a week for 6 weeks for levels to reach above 30 ng/ml
  • 10-20 ng/ml: 60,000 IU twice a week for 3 weeks followed by once a week for 6 weeks for levels to reach above 30 ng/ml
  • 20-26 ng/ml: 60,000 IU once a week for 10 weeks for levels to reach above 30 ng/ml
  • 26-30 ng/ml: 60,000 IU once a week for 2 weeks for levels to reach above 30 ng/ml or 1000 IU daily
  • 30-40 ng/ml: 60,000 IU once every 4-6 weeks lifelong or 1000 IU daily

In case lower dosages are taken, they can be calculated on the same basis, ie 60,000 IU per month is equal to 2000 IU / day or 15,000 IU per week etc