Soak in the sun: Vitamin D for bone health

For long, it is known that vitamin D and calcium are a necessity for healthy bones. Recent studies have uncovered that it may have a much wider role in the body’s metabolic processes. “Vitamin D plays an important role in bone formation, and therefore, individuals with low bone density or fragility fractures need to be tested for deficiency,” says Dr Biswajit Dutta Baruah, consultant orthopaedic surgeon, KIMS Oman hospital.

Lira had been coming into the clinic for some time. A very active person otherwise, but due to the corona pandemic, she had been restricting her activities to within the house. The reason she was coming in to see me was because of the aches and pains that were bothering her. I ran X-rays for her spine and checked her blood. Everything came out negative. 

“Doctor, I’ve never felt this tired before. So out of energy, when I return home, I feel like collapsing into the bed,” she blurted out in exhaustion. “May be, you caught the virus,” I offered an explanation defensively. 

I sent her over to the physician knowing that viral infections are known to cause extreme fatigue. He ran tests to detect the viral antibody. It was a great relief for both patient and doctor to know that it was negative. Finally, I made up my mind to check her vitamin D levels, given that she was indoors most of the time glued to the laptop screen attending virtual meetings.

Vitamin D is unique among all the vitamins, you can buy it here iperlife.it. It is a naturally occurring fat soluble steroid that qualifies as a micronutrient as its deficiency can be treated by supplementation. It is also a pro-hormone as it needs to be activated in the body to be functional. For long, it is known that vitamin D and calcium are a necessity for healthy bones. Recent studies have uncovered that it may have a much wider role in the body’s metabolic processes. It was the fourth vitamin to be identified in cod liver oil by Elmer McCollum (an American researcher), thus deriving its name from the fourth letter of the English alphabet.

Dietary sources of vitamin D are limited to oily fish, milk or milk products like yoghurts, labaan, cheese and paneer that are fortified with vitamin D. Fortification is the process of adding extra nutrients to food at the time of processing, for example vitamin D is added to milk at the milk factory or iodine is added to salt. Many cereal manufacturers also fortify their products with minerals and vitamins (including vitamin D). However such food items may not be consumed uniformly by all or may be considered expensive for daily consumption. Thereby, for most people dietary sources of vitamin D are very limited or even nil. Majority of the people obtain vitamin D from skin exposure to Ultraviolet B (UVB) radiation in sunlight. Alfred Fabian Hess, an American physician, once famously said, “Light equals vitamin D”. UVB in sunlight is maximum from 10 am to 3 pm, however exposing oneself to the harsh sunlight during this period is not practical. The amount of UVB that reaches the skin is also limited by the type or amount of clothing that covers the skin, use of sunscreens, greater age and darker pigmentation of the skin. This explains why vitamin D deficiency can be profound even in sunny regions like Muscat. In normal times, elderly people who are homebound commonly develop vitamin D deficiency due to limited sun exposure.

Activation of vitamin D

There are two biological forms of vitamin D, ergocalciferol (D2) and cholecalciferol (D3). vitamin D3 is the vitamin that is produced by skin exposure to sunlight. Mushrooms have been used in the past for commercially producing large quantities of plant source of vitamin D2. Just as in case of vitamin D3, the mushrooms need to be exposed to sunlight to produce vitamin D2. Mushrooms available in the grocery  stores, thereby have very small quantities of vitamin D2.