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Vitamin D

Vitamin D is a fat-soluble vitamin, which can be produced by exposure to sunlight. Ultraviolet B rays of the sun activate a protein in the skin called 7-dehydrocholesterol (7-DHC), which then is metabolized to the active form of vitamin D, which is vitamin D3. Dietary sources of vitamin D include egg yolk, milk, cheese, beef or calf liver and certain fish, certain cereals, soy milk, etc.

Vitamin D has a number of critical roles in your body. Among these, key functions include absorption of calcium that helps strengthen bones, efficient muscle movement, aids in nerve conduction to and from the brain. Besides, vitamin D is important for immunity as it helps regulate immune system to fight off invading pathogens like bacteria and viruses.

Vitamin D and viral infection

Various studies have shown that Vitamin D supplementation helps in reducing the susceptibility of developing a flu by acting as a physical barrier against the infection, or through modulation of natural and/or adaptive immunity mechanisms to reduce the risk of infection.2 Research also supports the finding that low levels of vitamin D increases the risk of community acquired-pneumonia.

Get your vitamin D levels tested within the comfort of your home.

Association of vitamin D and COVID-19

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the COVID-19 disease, has been implicated in the deaths of over 3.5 million people globally.

Currently, there is no definite treatment available for this infection, hence, measures are being taken to discover aids that can help in reducing the risk of COVID-19. Moreover, owing to its high infectivity rate, the population also requires strategies that can limit progression and severity of COVID-19 infection.

A study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, revealed that over 80% of COVID-19 patients in a hospital exhibited vitamin D  deficiency. Therefore, the appropriate approach includes identification and treatment of vitamin D deficiency, particularly in high-risk individuals such as the elderly, patients with comorbidities, who are the main target population for the COVID-19.

Moreover, low levels of vitamin D are associated with 3.7-fold increase in the odds of dying from COVID-19 infection. Similar findings were seen in a Asian study that showed vitamin D insufficiency might compromise respiratory immune function, increasing the risk of severity and death rate in patients with COVID-19.

The most commonly encountered symptom in patients with COVID-19 is fever and dry cough, whereas severe forms of the disease can lead to the development of acute respiratory disease syndrome (ARDS). Researchers have found out that vast majority of COVID-19 ARDS patients had vitamin D deficiency, and these patients required longer mechanical ventilation and were associated with a higher death rate.

In addition to ARDS, heart failure is one of the fatal adverse outcomes of COVID-19. Studies have shown that Vitamin D supplementation, because of its protective effect on cardiac muscle cells, can be beneficial by reducing the risk of heart disease in these patients. Besides, comorbidities like high blood pressure, diabetes, obesity are considered as risk factors in increasing complications in people with COVID-19. Various studies have found strong correlation between deficiency of Vitamin D and increased risk of high blood pressure, diabetes and obesity. Hence, the hypothesis suggests that its supplementation can decrease the likelihood of complications in patients infected with COVID-19.

Furthermore, vitamin D deficiency has been related to reduced immune function and may enhance the cytokine storm and its supplementation may reduce complications related to cytokine storm and uncontrolled inflammation in people with COVID-19.

Hence as per some experts, one of the management strategies for reducing severity and death rate in patients with COVID-19 should include normalization of vitamin D levels.

Beneficial effects of vitamin D supplementation in COVID-19 patients

Numerous research have shown that having healthy levels of vitamin D can help keep your immune system healthy and may protect against respiratory illnesses.

Although there is currently no cure for COVID-19, studies have highlighted the importance of vitamin D supplements in the prevention and treatment of COVID-19 complications.

Some of the evidence suggesting benefits of vitamin D supplementation in COVID-19 are as follows:

  • It has been reported that a high dose of vitamin D could reduce the need for intensive care stays in patients infected with COVID-19.

  • Vitamin D supplementation was considered as a safe therapy, and it protected against acute respiratory tract infection.
  • An Indian study suggested that high dose of Vitamin D3 (60000 IU) supplementation for seven days helps in coronavirus clearance.
  • Although most older individuals, often have lower vitamin D levels and are most susceptible to COVID-19, a study showed that supplementation of vitamin D could decrease death rate in this group.

Make sure to take extra care of your elderly. Book an exclusive health package for seniors.

The general recommendation is to supplement people who do not belong to a risk group, are healthy with a recommended daily dose (800 IU).

In view of the positive effects of vitamin D supplementation on vitamin D-deficient patients with COVID-19, few practical recommendations are as follows:

  • Current public health guidelines for normalizing vitamin D status should always be followed
  • Vitamin D levels should be measured in patients hospitalised with COVID-19 and should be supplemented to a level >30ng/mL (optimal 40–60ng/mL), specifically when the baseline level is <10ng/mL
  • In Covid-19 patients with vitamin D levels under 20ng/mL, the recommended dose for correction of deficiency is 6000–7000 oral IU/ day for 6–8 weeks. For maintenance, the dose varies from 2000 to 3000 oral IU/day according to the age and clinical condition of the individual.

To summarize

Although India is a subtropical country with sufficient sunlight, vitamin D deficiency is extremely common. It is crucial for people to understand the importance of Vitamin D so that they can take relevant supplements to fill the gaps. Vitamin D will not prevent a patient from contracting the COVID-19 infection; however, it may reduce complications and prevent death in those who are infected.

It is hard to ascertain the most appropriate beneficial dose for COVID-19, it is evident that vitamin D deficiency is harmful, and can be easily addressed with implementation of low-cost and low-risk vitamin D supplementation. It is unclear how soon the majority of the population will receive vaccines, routine vitamin D supplementation to high-risk people such as the elderly, children, those who are malnourished, and those living in overcrowded environments can be a worthwhile exercise.

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Why You Need More Vitamin D In The Winter

The sunshine vitamin, vitamin D, requires exposure to ultraviolet-B (UVB) rays from the sun for its synthesis. During the sunny summer days, making enough vitamin D can be very efficient. However, as soon as the winter arrives, less sunlight is available and the risk of vitamin D deficiency increases. As per many researchers, your body needs vitamin D not only to maintain bone health but also to keep healthy and to fight infections. The irony is that in winter, when you need vitamin D the most, you end up getting deficient for this essential vitamin.

You can fix a problem only when you know it exists. Especially during the winter months, experts recommend a blood test that assesses the amount of vitamin D in the body. It is particularly important for you to get tested for vitamin D if you are over age 70, have darker skin, have malabsorption problems or take medicines that interfere with vitamin D absorption (for example, glucocorticoids). If you have liver and kidney disease, you can be often deficient in vitamin D. These organs are required to make the active form of the vitamin, whether it comes from the sun or from food.

For a good gut health during winter

Enough has been known and written about vitamin D deficiency leading to bone diseases like rickets in children and osteoporosis in adults. However, research has shown that vitamin D plays an important role in maintaining a healthy digestive tract. One of the ways vitamin D functions is by keeping the gut microbes healthy. If you have sufficient vitamin D levels, you are more likely to have those healthy gut bacteria just right in number and diversity. This helps reduce inflammation throughout the body. On the other side, low vitamin D levels can be associated with inflammatory bowel disease in some people.

Strong immunity needs vitamin D

There has been a lot of buzz around the role of vitamin D in boosting immunity. This holds great significance in the times of COVID-19 pandemic. Some scientists have claimed that the immune system has vitamin D receptors that determine which cells can use vitamin D. Having enough of this sunshine vitamin might help improve your ability to fight infections and reduce inflammation.

Less time spent outside

In the winter, you are more likely to catch infections. Also, you are more likely to lie comfortably in your cozy blanket and spend less time outside. This leads to more and more of us getting vitamin deficiency in the winter.

Vitamin D and Calcium, the best friends

Vitamin D helps you absorb calcium from your diet. Along with vitamin D, calcium plays a significant role in keeping your bone and muscles health intact.  

Eat healthy to get enough vitamin D

Apart from exposure to the sun, you can get enough vitamin D for your body through certain food items as well, including tuna, sardines, mushrooms and fortified dairy and orange juice. Adding vitamin D supplements can be a good way to reach the recommended vitamin D intake.

Lack of sun exposure during the winter months would be less of a problem if diet provided adequate vitamin D. But there aren’t many vitamin D–rich foods , and you need to eat a lot of them to cover up the recommended vitamin D intake of 10 μg/day (400 IU/day) for adults.

The COVID-19 angle

Some of the recent researchers have claimed that people who are deficient in vitamin D are more likely to get severe COVID-19 illness. Vitamin D deficient people might have a higher chance of getting hospitalized too. Whether vitamin D has any role in preventing coronavirus infection or not, it isn’t clear yet and needs more data and robust evidence.
Think you have symptoms suggestive of COVID-19? Book a COVID-19 test and get tested at home. 

Overdoing is prohibited, too

While you aim to get enough vitamin D, keep in mind that too much vitamin D can be harmful. Want to know exactly how much vitamin D healthy adults should have? Or confused about when to get tested for vitamin D? Check out this article to stay in the know.

Remember that the same UVB rays that help in vitamin D synthesis, can damage your skin as well. Under the right circumstances, 10 to 15 minutes of sun on the arms and legs a few times a week can generate nearly all the vitamin D we need. However, various factors affect this synthesis: the season, the time of day, where you live, cloud cover, and even pollution levels. In addition, your skin’s production of vitamin D is influenced by age, skin color, and sunscreen use.

Book a vitamin D test to be sure if your levels are enough to support a healthy you. This winter, get tested on time and don’t let your body suffer from lack of vitamin D by taking early steps.  

Also read “Why and when you should get tested for Vitamin D?

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When was the last time you saw the mild sunrays in morning? Or waited for few minutes while your skin soaked in the sunlight at dawn.

Are you feeling depressed? Are you always hungry? Are you facing anxiety issues? Have you put on extra belly fat?

If yes to all the above, then your body might be deficient in Vitamin-D.

Vitamin-D deficiency is quite common, and yet most people are not aware when they suffer from it.

That’s because the symptoms are often subtle and non-specific, meaning that it’s hard to know if they’re caused by low Vitamin-D levels or something else.

Mild sunlight in morning is the best source of Vitamin-D. Other sources of Vitamin-D are cheese, egg yolks, soymilk, fatty fish, salmon, tuna, mackerel, mushrooms. If your daily exposure to sunlight is limited because you wake up at later hour, if you stay indoors for long duration, live in northern latitudes or have an occupation that prevents sun exposure you may be at risk of Vitamin-D deficiency.

If you think you may have a deficiency, it’s important that you speak to your doctor and get your blood levels measured.

Fortunately, a vitamin D deficiency is usually easy to fix.

You can either increase your sun exposure during morning, eat more Vitamin-D-rich foods, such as fish or fortified dairy products. You can also find a variety of Vitamin-D supplements. Vitamin-D supplements should be taken by advice of a doctor.

Common signs and symptoms of Vitamin-D deficiency –

Common signs and symptoms of Vitamin-D deficiency –

  • Depression and anxiety

Body produces serotonin from the body chemical melatonin, melatonin is produced in response to sunlight, the more exposure to sunlight results in more melatonin thus more serotonin.

Too little of serotonin leads one to feel cranky, irritable, depressed, anxious.

  •  Muscle pain, bone pain, low bone density

Due to vitamin-D deficiency, there will be inadequate absorption of calcium in the body, vitamin-D helps in absorption of calcium. In case of inadequate Vitamin-D in body low bone mineral density can occur which results in chronic muscular pain, pain in joints, osteoporosis.

  • Hair loss

Stress, anxiety, depression, low immunity gradually causes hair loss. As all the above are signs of vitamin-D deficiency. Calcium, vitamins and minerals are major building components of hair and skin and nutritional deficiencies do affect their vitality.

65% of Indians have Vitamin-D deficiency! Get yourself and your family checked up for Vitamin-D. Click here to know more

  • Unexplained infertility

It is observed that the vitamin-D deficient women have less chances of getting conceived.

  • Poor wound healing

It’s also been suggested that vitamin-D’s role in controlling inflammation and fighting infection which is important for proper healing.

  • Poor immune function, increased risk of illness or infections

One of vitamin-D’s most important roles is keeping your immune system strong so you’re able to fight off viruses and bacteria that cause illness. It directly interacts with the cells that are responsible for fighting infection.

  • Constant feeling of fatigue and tired are the signs of low vitamin-D

If you find these symptoms then you lack vitamin-D, though it’s not life threatening initially but it does affect quality of life.

Wishing you a very happy and healthy life. Take care.

Contributed by – Dr. Anushree MV, an Ayurvedic physician specializing in weight loss, PCOS, thyroid disorders, diabetes, infertility and childcare.

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