What is Vitamin D?
Vitamin D is a fat-soluble vitamin that has important functions in the body. The task of Vitamin D is to ensure the absorption of calcium from the bones and intestines, increase mineralization in the bones, and prevent bone resorption. Vitamin D is obtained in two ways. First, the precursor in the skin is transformed into another form under the influence of sunlight, absorption, and then it becomes an active metabolite first in the liver and then in the kidney, and the other way is obtained by taking the vitamin D precursor with the diet and converting it to its active form in the same way. Vitamin D is needed for the absorption of dietary calcium from the intestines. There are two important forms of Vitamin D for humans; Ergocalciferol (Vitamin D2) , Cholecalciferol (Vitamin D3).
How to detect vitamin D deficiency?
Vitamin D status in the human body is evaluated by 25-hydroxyvitamin D 10-30 (25-OH D) level. Serum 25-OH D level varies according to exposure to sunlight, altitude of the living area, skin pigmentation density, age and amount of vitamin D taken with diet. Although there are changes due to these reasons, in general; A threshold value of 30 ng/ml is taken as the 25-OH D level that will not cause an increase in parathyroid hormone (PTH) in adults, and values below 30 ng/ml are considered insufficient/low, and below 10 ng/ml are considered normal as deficiency.
How to prevent vitamin D deficiency?
Vitamin D is formed in the skin under the influence of sunlight. Daily requirement of vitamin D; can be countered by exposing the arms, legs and face to sunlight for 20 minutes. The amount of sunlight required depends on the person’s age, skin color, exposure time, and other medical problems, if any. The production of vitamin D in the skin gradually decreases with age. People with dark skin need long-term sunlight, especially in winter, for adequate vitamin D to form in the skin. Vitamin D cannot be formed in the skin in those who use sunscreens (factor 20 or more).
What are the sources of vitamin D?
Another important source of vitamin D is food. Vitamin D is naturally found in some foods (oily fish, fish oil, eggs). It is found in butter, milk, oats, sweet potatoes, egg yolks, oils, liver, especially oily saltwater (sea) fish such as salmon, geranium and tuna. It is available in parsley, nettle, clover from plants. In some countries, milk and dairy products, bread and cereals are enriched with vitamin D. There is no such practice in our country yet.
What can happen to the child of a mother who has vitamin D deficiency?
Fetus meets its calcium requirement from the mother; The mother’s vitamin D level should be sufficient for normal calcium balance during pregnancy and lactation. For this reason, if no external support is provided in babies born to mothers with vitamin D deficiency, serum 25-OHD levels decrease rapidly and this causes low calcium in the newborn period and congenital rickets. Vitamin D deficiency in the mother can cause birth poisoning, high blood pressure in pregnant women, low birth weight in the baby, tooth enamel development disorder in children, congenital cataract, Type 1 diabetes, mental retardation. It weakens the immune system in children.
What are the causes of vitamin D deficiency?
Low exposure to the sun, insufficient dietary intake, advanced liver diseases, kidney failure, drugs (barbiturates, phenytoin, rifampin, etc.) etc. can cause vitamin D deficiency.
How is vitamin D deficiency treated?
Vitamin D deficiency occurs when people do not have enough sunlight or do not get enough vitamin D with food. Exposure of the face, arms, hands, legs, face or back to sunlight for 10-15 minutes at least twice a week provides optimal serum vitamin D levels. The use of sunscreens reduces the synthesis of vitamin D. Oily fish (salmon, geranium) and egg yolk are rich in vitamin D. The most important cooking method that causes vitamin D loss during food preparation is frying with vegetable oils. If patients have advanced vitamin D deficiency, patients are treated with 50,000 IU/week of vitamin D, 6-8 weeks of treatment, and it is aimed to bring serum 25OHD levels to normal levels.
What effects does vitamin D deficiency have outside of the musculoskeletal system?
In recent years, it has been understood that vitamin D deficiency has 2 very important functions outside the skeletal system. It is known that the immune system has important effects on the formation of cancer, aging and life process, as well as its effects on cardiovascular system disorders, obesity, glucose intolerance, which are the elements of metabolic syndrome. Although sufficient exposure to the sun can prevent vitamin D deprivation or insufficiency in general, problems in reaching the skin of the sun (closed clothing styles, being at high altitudes or latitudes, conditions that cause air pollution and deprivation in old age) or susceptibility to certain diseases occur
What does osteomalacia mean?
It is a metabolic bone disease characterized by impaired mineralization of newly formed osteoid (organic protein matrix of bone) and accumulation of unmineralized osteoid in the bone in adults. It generally occurs due to vitamin D deficiency
What symptoms does osteomalacia cause?
Osteomalacia begins insidiously and is usually asymptomatic. When symptomatic, it presents with widespread bone pain, bone tenderness, proximal muscle weakness, and sometimes muscle wasting. The pain is blunt. It increases with palpation and movement. It is often found in the lower back, hips, lower extremities and fractured areas. pain occurs. Fractures of the ribs, vertebrae, and long bones can occur without trauma or with mild trauma. Muscle weakness can lead to wobbly walking, difficulty getting up from a chair or climbing stairs.
