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VITAMIN D & VITAMIN D DEFFICIENCY

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Vitamin DVitamin D is a fat soluble vitamin. Fat-soluble vitamins are stored in the body's fatty tissue. Synthesized by the body after exposure to UV rays or obtained from food sourcesBy increasing calcium absorption, vitamin D helps to form and maintain strong bonesStable to heat, acid, alkali & oxidation.

FunctionsImmunityvitamin D enhances immunity and inhibits the development of autoimmune disease. Maintain Calcium balance Vitamin D helps the body to absorb calcium. Calcium is a mineral that is essential for normal bone formation. Vitamin d helps in maintaining the calcium balance in the body.

FunctionsHeart diseaseRenin, important in regulation of blood pressure and heart health, is associated with vitamin D levelsMaintaining normal phosphorus levelsBone cannot be properly mineralized without phosphorus During pregnancy:Low levels of vitamin D in pregnancy are associated with gestational diabetes, pre-eclampsia, and small infants.

Absorption, Distribution, MetabolismAbsorptionVitamin D is absorbed from the small intestine as bile saltDistributionStored in adipose tissueMetabolismTransported to the liver, then kidneys, where it is activatedExcretionExcreted in bile Excreted in urine as well

Vitamin D SourcesSunshineFood and SupplementsIs our primary sourceVitamin manufactured by our body after exposureThree times a week For 10-15 minutesContained in few foodsSome fish liver oilsFlesh of fatty fishFortified productsMilk and cerealAvailable as supplement

Sources of Vitamin D - Sun

UVB light converts cholesterol in skin into D3Dark skinned people require a longer duration of sun exposure for adequate production of Vitamin DLess UVB light is available in the winter months, higher latitudes, and with cloud cover and air pollution

8Asian Indian person requires 3 times and black person 6-10 times as much UV-B exposure than light skinned people to achieve equivalent vitamin D ConcentrationsClothing and sunscreen decrease Vitamin D synthesisSubclinical rickets common in Saudi Arabia, veiled Kuwaiti womenBlook wool twice as effective in absorbing UV-B radiationSunscreen 8 decreases Vitamin D sythesis by 95%Adequate Vitamin D synthesis: exposure to midday sun (10 3 pm) 10-15 minutes in spring, summer, and fall for light skinned.

Natural Food Sources:Egg YolkMushroomsShrimpBeef liverTunaPorkCanned salmon

Sources of Vitamin D- FoodFortified Food Sources: Vitamin D milk Cheese Formula Butter Cereal Cream Yogurt Margarine

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Side Effects

Too much vitamin D can make the intestines absorb too much calcium. This may cause high levels of calcium in the blood. High blood calcium can lead to:

Calcium deposits in soft tissues such as the heart and lungs

Confusion and disorientation

Damage to the kidneys

Kidney stones

Nausea, vomiting, constipation, poor appetite, weakness, and weight loss

Recommendations:-Infants (adequate intake of vitamin D)0 - 6 months: (10 micrograms (mcg) per day)7 - 12 months: (10 mcg/day)

Children1 - 3 years: (15 mcg/day)4 - 8 years: (15 mcg/day)

Recommendations:-Older children and adults9 - 70 years: (15 mcg/day)

Adults over 70 years: (20 mcg/day)

Pregnancy and breast-feeding: (15 mcg/day)

In general, people over age 50 need higher amounts of vitamin D than younger people.

Vitamin D Deficiency

Groups at risk for vitamin D deficiency

RICKETS & OSTEOMALACIADef.: reduction in bone mineralization !

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Vitamin D: Deficiency RICKETS:-

Rickets in infants and childrenCharacterized by failure of bone to mineralizeLong bones of legs bow and knees knock as weight-bearing activities begin (walking)Spine becomes curved and pelvic and thoracic deformities occur

Infants on breast milk

Causes of rickets:-

Regardless of the type of rickets, the cause is always either due to a deficiency of vitamin D, calcium, or phosphate. Three common causes of rickets include nutritional rickets, hypophosphatemic rickets, and renal rickets.

symptoms and signs of rickets:-

Signs and symptoms of rickets include:-bone pain or tenderness, dental deformities, delayed formation of teeth, decreased muscle strength, impaired growth, short stature, number of skeletal deformities, including abnormally shaped skull, bowlegs, rib-cage abnormalities, breastbone, pelvic, and spinal deformities.

RICKETS

Rickets

Treatment for rickets:-

The first step is to prevent the complications of calcium and phosphate deficiency by correcting any abnormal levels with supplemental calcium or phosphate as well as the activated vitamin D (calcitriol). Once the diagnosis of rickets is confirmed, initiation of vitamin D supplementation is recommended, as well as a diet rich in calcium.

Osteomalacia:-

Osteomalacia is softening of the bones due to a lack of vitamin D or a problem with the body's ability to break down and use this vitamin.

Causes of Osteomalacia:-

Not enough vitamin D in the dietNot enough exposure to sunlight, which produces vitamin D in the bodyMalabsorption of vitamin D by the intestines

Other conditions that may cause osteomalacia include:

CancerDisorders of vitamin D metabolismKidney failure Lack of enough phosphates in the dietLiver diseaseSide effects of medications used to treat seizures

Symptoms:-

Bone fractures that happen without a real injuryMuscle weaknessWidespread bone pain, especially in the hips

Symptoms may also occur due to low calcium levels. These include:

Numbness of the arms and legsNumbness around the mouthPain of the hands or feet

Treatment:-

Treatment may involve vitamin D, calcium, and phosphorus supplements taken by mouth. People who cannot properly absorb nutrients through the intestines may need larger doses of vitamin D and calcium. People with certain conditions may need regular blood tests to monitor blood levels of phosphorus and calcium.

Prevention:-

Eating adiet rich in vitamin D and getting plenty of sunlight can help prevent osteomalacia due to a vitamin D deficiency.

Organ system

Signs of rickets

Signs of osteomalacia

General

Loss of appetite, retarded growth

None

Dermatologic

None

Muscular

Weakness

Weakness

Skeletal

Failure of bone to mineralize: swollen joints, delayed tooth eruption, bone pain and tenderness

Demineralization of formed bone: fractures, bone pain and tenderness

Vital organs

None

None

Nervous

Tetany, ataxia

None

Ocular

None

None

Signs of vitamin D deficiency

REFRENCES:-Vitamin & mineral: A basic guide By Karen Sullivan www.NUTRI-FACTS.comUnderstanding Vitamins And Minerals By William Gottlieb Human nutrition: a health perspective By Marry E.BarasiVitamins: that heal natural immunity for better health By H.K Bakhru

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