Vitamin D deficiency – Identify causes and address them in time

Vitamin D Deficiency – Causes

Those who spend a lot of time indoors have a higher risk of developing a vitamin D deficiency.The body needs sunlight to produce vitamin D. For this, it is necessary for the skin to come into direct contact with the sun's rays, as this is the only way to stimulate the production of vitamin D. If the skin cannot be exposed to enough sunlight, for example during the winter months, it is advisable to obtain vitamin D through vitamin D-rich foods or supplementary preparations.

The German Society for Nutrition recommends a daily intake of 20 µg for adults who cannot produce enough vitamin D solely through sunlight. However, it is also not easy to meet the daily requirement of vitamin D with a balanced diet. Researchers suspect that about 60% of the population has a vitamin D deficiency.In addition to insufficient sunlight exposure, the following circumstances can lead to a corresponding deficiency:

• Malnutrition
• Increased demand, for example during pregnancy or breastfeeding. Children also need to take in more vitamin D.
• Medication intake, particularly antiepileptics should be mentioned.
• Nephrotic syndrome
• Increased excretion through the kidneys
• Reduced absorption from the intestine, for example in celiac disease

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Vitamin D deficiency – Symptoms

Since vitamin D is involved in numerous bodily functions, the symptoms can vary widely. In addition to maintaining bone health, vitamin D also plays a crucial role in supporting the immune system. It even has an influence on hair.

The symptoms present themselves quite diffusely and are often not immediately recognized by patients. This can lead to a vitamin D deficiency going unnoticed for an extended period. The literature describes the following symptoms in adults with vitamin D deficiency:

• Concentration difficulties
• Sleep disturbances and fatigue
• Nervous conditions
• Headaches
• Growth disorders
• Hair loss
• Mood swings
• Heart rhythm disturbances
• Epileptic seizures
• Reduced muscle strength and muscle tone

Vitamin D deficiency endangers health 

As already mentioned, vitamin D is involved in many bodily processes. Almost every body cell relies on the fat-soluble nutrient in its daily regulation.Therefore, the human organism is threatened by numerous diseases when the vitamin D level is too low. For the body, vitamin D2, found in plants and mushrooms, and vitamin D3 from animal foods are particularly important.

Vitamin D and Calcium Metabolism

Vitamin D significantly influences the calcium and phosphate metabolism of the body. This fat-soluble nutrient ensures that calcium from the consumed foods is better absorbed. Additionally, it contributes to the incorporation of calcium into the bones, thereby promoting bone health. The calcium level in the blood can also be influenced by vitamin D.

If this level drops, the body produces the so-called calcitriol from the inactive precursor of vitamin D. This, in turn, allows for the release of calcium from the bones, thereby significantly raising the calcium level.Through this complex process, the vital metabolic functions can be maintained.

Vitamin D and the Immune System

So far, it has not been precisely clarified why vitamin D seemingly makes a valuable contribution to maintaining the immune system. Researchers assume that special cells of the immune system (T-lymphocytes) instruct vitamin D to assist in the defense against pathogens.

If the body does not have enough T-lymphocytes, it is unable to fend off harmful pathogens. These can then spread unchecked in the body. Vitamin D deficiency: a cause of depression and other diseases? A vitamin D deficiency is associated with numerous diseases, as studies also indicate.

• Influenza: During the winter months, many people suffer from the true flu, which is caused by a weakened immune response to the viruses that trigger influenza. In contrast, fewer people are observed with influenza in the summer. This is due to the fact that during the summer months, sufficient UV light can be absorbed, which in turn strengthens the immune system. Studies also show that individuals with a low vitamin D level are more likely to contract influenza¹.

• Multiple Sclerosis: Current knowledge suggests that vitamin D could stop multiple sclerosis. The fat-soluble nutrient is capable of preventing aggressive immune cells from penetrating the central nervous system.

• Asthma: So far, the triggering factors in asthmatic diseases have not been fully elucidated. However, new scientific evidence suggests that vitamin D may play a role in the development of the disease. Researchers have demonstrated that both the severity and symptoms of asthma can be influenced by adequate amounts of vitamin D. One explanation for this could be that vitamin D strengthens the immune system and promotes the production of blood cells, which in turn keep inflammatory reactions in check ².
• Type 2 Diabetes: A study found that a vitamin D deficiency can exacerbate the symptoms of metabolic syndrome. In the study group, which consisted of HIV patients, changes regarding insulin resistance and lipid metabolism disorders were observed.
  The researchers also stated that the risk of type 2 diabetes is lower when sufficient amounts of vitamin D are present in the bloodstream. It seemed irrelevant how the vitamin D supply was replenished (through sunlight or dietary supplements)³.

• High blood pressure: A scientific study confirmed the influence of vitamin D on blood pressure. According to this, blood pressure was found to be dependent on the existing vitamin D level ⁴.

• Chronic inflammatory bowel diseases: Researchers from the USA, India, and Europe have investigated the hypothesis of whether vitamin D may have an influence on inflammatory bowel diseases. It was found that an increased incidence of disease was associated with a low vitamin D level in the blood ^5,6.

• Depressions: Scientists suspect that a vitamin D deficiency may also be related to winter depression. This could be attributed to the fact that vitamin D is involved in the production of serotonin and dopamine. A deficiency of these hormones could exacerbate depression.

• Cavities: As early as the 1940s, it was known that a vitamin D deficiency can lead to poor teeth. Current studies support this thesis. A low vitamin D level can contribute to an increased incidence of cavities. Vitamin D triggers the formation of antibacterial peptides in the body. These short chains of amino acids inhibit the development of bacteria that can cause cavities.⁷.

• Arthritis (rheumatic): In a study, a significant correlation was found between rheumatic arthritis and a low vitamin D level. Accordingly, participants with a low calcidiol blood level, which is a hormone precursor of the fat-soluble nutrient, were up to five times more susceptible to the disease. With a low vitamin D level, the inflammatory activity in the joints steadily increases in the body ⁸.

• Hair loss: Research shows that women can suffer from hair loss when their body has insufficient vitamin D. Therefore, in cases of hair loss, a possible vitamin D deficiency should be investigated ⁹.

• Malignant tumors: Under certain circumstances, a vitamin D deficiency could also promote cancer diseases.According to studies, cancers of the breast, prostate, uterus, and esophagus are particularly found among population groups with low vitamin D levels. In contrast, individuals who consume sufficient vitamin D seem to have a significantly lower risk of developing cancer ¹⁰.

• Cognitive performance: A vitamin D deficiency may also fuel dementia diseases. Researchers found that older adults with low vitamin D levels experienced increased memory loss. Thus, an adequate intake of vitamin D could help prevent memory disorders.

Experts warn: Sunscreen can hinder vitamin D absorption. The population is increasingly spending time indoors. This is partly because employees often have to remain at their desks due to their work.The prevailing artificial light, however, is not capable of boosting vitamin D production. Therefore, people rely on sunlight, but even when walks are taken, the skin is often protected with sunscreen.

The "good" UVB rays then have no opportunity to reach the skin. This circumstance is particularly relevant for children. The sensitive skin of children is often coated with sunscreen products to protect it from aggressive rays.

Vitamin D deficiency in children

The child's organism is constantly growing. Therefore, an adequate supply of vitamins is important. Vitamin D plays a crucial role as it ensures that minerals from the blood are stored in the bones. In particular, premature infants or children who follow a vegetarian diet tend to develop a vitamin D deficiency.

This can lead to changes in the skeletal system. The German Society for Nutrition recommends 10 µg of Vitamin D daily for children who have a lack of endogenous synthesis. If the child plays a lot outdoors, half of the daily amount is sufficient in the first year of life.

Vitamin D Deficiency – Diagnostics

If there is a suspicion of Vitamin D deficiency, the doctor will order a test. This involves checking the serum level, specifically the marker 25-hydroxyvitamin. This storage form of Vitamin D provides indications of intake, for example, whether the fat-soluble vitamin is produced by the body or obtained through food.

Furthermore, a physician can determine whether there is an elevated calcium level in the blood or if the Vitamin D metabolism is disturbed. For the determination of blood values, the patient must be fasting.Currently, there are also so-called kits for home use to determine the vitamin D level in the blood by oneself. This allows potential symptoms to be correlated with the values. A small amount of blood is taken with a finger prick and then sent to an appropriate laboratory. The results are either communicated in writing or can be viewed online.

Vitamin D in the blood: What value is considered good?

The human body is capable of producing up to 90% of the necessary amount of vitamin D through sunlight. Vitamin D is not a conventional vitamin, as it can be produced by the body itself. Generally, it is assumed that 20-30 nanograms of vitamin D per milliliter of blood corresponds to a normal value. However, experts are still discussing what constitutes an optimal vitamin D level.

Research provides evidence that cancer may only be positively influenced starting from a value of 32 nanograms/milliliter of blood. However, to achieve such a high level, sufficient intake through sunlight exposure or food is necessary. Dietary supplements can also optimize vitamin D levels. However, not all sunlight exposure is the same. The amount of vitamin D the body can produce from sunlight depends on various factors, such as age, skin pigmentation, and sun intensity. Pregnant and breastfeeding women, as well as babies and young children, have an increased need for vitamin D and therefore particularly benefit from spending time outdoors.

Addressing Vitamin D Deficiency

If a vitamin D deficiency is present, it can be addressed with various measures. 

Soak up sunlight

If it is a mild deficiency that has been detected early, spending time outdoors can help increase vitamin D levels. Affected individuals should spend at least 3 to 5 times a week outdoors for extended periods. It is important that about 20% of the body surface is exposed to the sun, for example, by exposing the face, hands, and forearms.

Depending on the skin type, usually 15 minutes are sufficient to stimulate vitamin D production. A visit to a tanning salon and artificial lamps in general cannot currently help to compensate for a deficiency. This is because tanning salons primarily rely on UVA rays. While these do tan the skin, they do not have a vitamin D-producing effect.Even with daylight lamps, the synthesis cannot necessarily be stimulated. The composition of daylight is too complex, consisting of UVA and UVB components, which can vary significantly depending on the time of day.

Eat vitamin D-rich foods

Especially during the winter months, it is advisable to consume foods that are rich in vitamin D.This includes:

• Eel with 90 μg of Vitamin D /100 g
• Trout with 19 μg of Vitamin D /100 g
• Sardines with 11.1 μg of Vitamin D /100 g
• Salmon with 3.67 μg of Vitamin D /100 g
• Morels with 3.41 μg of Vitamin D /100 g
• Eggs with 2.78 μg of Vitamin D /100 g
• Mushrooms with 2.15 μg of Vitamin D /100 g
• Avocados with 3.75 μg of Vitamin D /100 g
• Emmental cheese with 1.10 μg of Vitamin D /100 g

It is important to note: Vitamin D and Vitamin K2 are good partners. Vitamin K2 is primarily found in green vegetables and salads. This vitamin ensures good calcium utilization and prevents excess from depositing in blood vessels, which can lead to calcifications.When vitamin D is taken together with calcium, it is important to ensure an adequate amount of K2. However, experts are still discussing whether vitamin D should be taken together with calcium.

Substances are particularly often prescribed or recommended in combination for the prevention of osteoporosis. Primarily, the vitamin D requirement should be met with appropriate foods and sufficient sunlight exposure. It is important in nutrition that a corresponding fat content is included in the foods, as vitamin D is a fat-soluble vitamin.

Are vitamin D-rich foods sufficient to meet the needs?

Nutrition experts emphasize that it may be difficult to meet the need for vitamin D through food. However, it should be noted that the requirement is largely met through sunlight exposure anyway.Diet can additionally supplement the supply of vitamin D. Especially trout, herring, and sprats are suitable for taking in a good amount of vitamin D.

Particularly during the low-light winter months, diet plays a significant role. However, one group of people can hardly benefit from this, as vitamin D is scarcely found in plant-based foods. Vegans, therefore, only obtain a small amount of vitamin D through their diet. It is recommended that vegans regularly check their vitamin D levels. If these are too low, supplementation with vitamin D preparations may be advisable.

The amount of vitamin D that vegans need to take daily is individual and can depend on blood values. In some cases, it may be necessary to resort to appropriate injections to raise the vitamin D level.If too little vitamin D is consistently absorbed, it can lead to negative effects on bone health and an increased susceptibility to infections. Furthermore, other dangerous disorders may arise. According to current studies, even severe illnesses are associated with a pronounced vitamin D deficiency.

Vitamin D Supplements - When Do They Make Sense?

Certain groups of people can benefit from taking a vitamin D supplement. This includes individuals who spend little time outdoors or follow specific dietary concepts (vegans). Vitamin D products are also suitable for those who have a severe deficiency that cannot be easily addressed with sunlight exposure and a balanced diet. Especially during the winter months, many users resort to vitamin D supplementation. In contrast, during the warmer months, it is often people who are afraid of skin cancer and therefore avoid the sun. 

Vitamin D – Dosage

The amount of Vitamin D that should be taken depends on the purpose of use and the season. The initial therapy aims to replenish the body's stores after a Vitamin D deficiency. It is recommended to take 1x 50,000 IU. After that, the recommendations are: 10,000 IU daily for a period of 4 weeks. For maintenance therapy in winter, 3000-5000 IU daily is sufficient. In summer, however, only 400-2000 IU per day is necessary. Here, 1 I.E. Vitamin D3 ≙ 0.025 micrograms of Vitamin D3.

Supplementation with Vitamin D – Side Effects

With Vitamin D-rich foods, over-supplementation cannot occur. However, with dietary supplements, serious side effects such as kidney damage, nausea, headaches, and depression can occur. Furthermore, there is a possibility that calcium deposits may form in lung, heart, and kidney tissue.Here, the corresponding preparations must be consumed excessively.

Even when people have taken over 100 µg per day for an extended period, no overdose symptoms occurred. However, over-the-counter vitamin D preparations are considered by some experts to hardly contribute to an overdose. In some cases, it may make sense to have the vitamin levels checked when regularly taking vitamin D preparations.

Buy Vitamin D

Vitamin D products are available in tablet and drop form. They allow for easy intake without any issues. Higher dosed preparations require a prescription and are often injected with a syringe. Vitamin D preparations in the form of dietary supplements are subject to low dosing (up to 1000 IU). Buyers should ensure that the products ideally contain Vitamin D3 (Cholecalciferol).

This form of vitamin is a natural variant of vitamin D and plays a special role in physiology. Vitamin D2 (ergocalciferol) is the synthetic variant of vitamin D. The body does absorb this form as well, but it does not have the same value. This variant is also noticeable in price, as it is often much more expensive due to the more complex manufacturing process. Buyers should also ensure that no additives are used. Ideally, they should obtain a vitamin D product from a trusted retailer.

Sources:

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2. Litonjua AA.Childhood asthma may be a consequence of vitamin D deficiency. Curr Opin Allergy Clin Immunol. 2009 Jun;9(3):202-7. https://www.ncbi.nlm.nih.gov/pubmed/19365260

3. Szep Z, Guaraldi G, Shah SS, Lo Re V 3rd, Ratcliffe SJ, Orlando G, Carli F, Rossi R, Rochira V, Tebas P. Vitamin D deficiency is associated with type 2 diabetes mellitus in HIV infection. AIDS. 2011 Feb 20;25(4):525-9. https://www.ncbi.nlm.nih.gov/pubmed/21178753
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5. Ananthakrishnan AN. Environmental risk factors for inflammatory bowel disease. Gastroenterol Hepatol (N Y). 2013 Jun;9(6):367-74. https://www.ncbi.nlm.nih.gov/pubmed/23935543

6. Miznerova E, Hlavaty T, Koller T, Toth J, Holociova K, Huorka M, Killinger Z, Payer J.The prevalence and risk factors for osteoporosis in patients with inflammatory bowel disease. Bratisl Lek Listy. 2013;114(8):439-45. https://www.ncbi.nlm.nih.gov/pubmed/23944617

7. Dale BA, Tao R, Kimball JR, Jurevic RJ. Oral antimicrobial peptides and biological control of caries. BMC Oral Health. 2006 Jun 15;6 Suppl 1:S13. https://www.ncbi.nlm.nih.gov/pubmed/16934114%20

8. Sabbagh Z, Markland J, Vatanparast H. Vitamin D status is associated with disease activity among rheumatology outpatients. Nutrients. 2013 Jun 26;5(7):2268-75. doi: 10.3390/nu5072268. https://www.ncbi.nlm.nih.gov/pubmed/23803739

9. Rasheed H, Mahgoub D, Hegazy R, El-Komy M, Abdel Hay R, Hamid MA, Hamdy E. Serum ferritin and vitamin D in female hair loss: do they play a role? Skin Pharmacol Physiol. 2013;26(2):101-7. https://www.ncbi.nlm.nih.gov/pubmed/23428658

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