In an analysis of over 1,10,000 samples tested over a period of one month, over 50% samples tested insufficient in Vitamin D at Metropolis Healthcare Ltd, a leading diagnostic chain. Out of these, 19% of the samples tested ‘Deficient’, 52% of the samples tested ‘Insufficient’ and 29% of the samples tested ‘Sufficient’.
There are many nutritionists who encourage people to ensure a healthy intake of Vitamin D through safe supplementation. But is self administering Vitamin D safe?
According to Dr. Sandeep Doshi, Consultant Internal Medicine, Kokilaben Dhirubhai Ambani Hospital, self administering of Vitamin D is not entirely safe. He recommends that one must check Vitamin D levels before taking Vitamin D supplements and a test should be repeated after finishing the course as well. However, Dr Girish Parmar, Senior Consultant, Endocrinology and Diabetes adds, “Safety margins for administration or consumption of Vitamin D is quite high. However, excess intake of Vitamin D can lead to toxicity and high calcium levels which may necessitate hospitalisation. Hence, administration of Vitamin D should be modest and performed under clinical observation.”
So how much is too much? Talking about the right dosage, Dr. Mahendra Dadke, Senior Consultant- MD Medicine, Jupiter Hospital, Pune shares, “Capsules of vitamin D 60,000 iu once weekly and daily exposure to sunlight is enough.” He further adds that there are daily doses too, of 1000 iu. However, the duration of supplements required depends upon the deficiency.
So ideally, the first and loading dosage of Vitamin D can be a weekly dosage of 60,000 units for eight weeks. It can be followed by a monthly maintenance dosage of 60,000 units for those with low Vitamin D levels.
“If one is deficient then weekly dose is better but if one wants to maintain the level, then a daily dose of 800 international unit (iu) is recommended. Also taking the sachet once a month if one has normal levels of Vitamin D, helps maintain that level.”
As per Institute of Medicine, US, Vitamin D levels over 50ng/mL are considered as excess. Clinical studies have registered high toxicity levels in individuals post the levels of 100ng/mL. Another doctor said that vitamin D toxicity can happen if consumption goes above 80 nanogram per ml.
Talking about pregnant women, Dr Jayasree Reddy, MD, DGO (OBG), Senior Obstetrician & Gynecologist, Apollo Cradle & Children’s Hospital, Jubilee Hills – Hyderabad shares, “The recommended daily intake of vitamin D for pregnant women is 2000 International Units daily from 20th week onwards. Excessive vitamin D can cause vomiting and nausea, frequent urination, appetite loss, feeling too thirsty, abdominal pain, constipation, fatigue, joint and muscle pain, etc.”
If one is deficient in Vitamin D on the blood test and takes Vitamin D for a limited amount of time, it is considered okay, however, if one continues to take Vitamin D without checking blood levels, that can lead to a lot of issues. “If the blood levels go very high on Vitamin D beyond the recommended range, very many problems like bone issues, kidney stone, kidney failure, muscles could become even weaker than before, there could also be heart problems. One should best avoid getting into such a situation,” adds Dr Doshi.
Signs and symptoms
Vitamin D deficiency is extremely common and usually non symptom specific. But most common symptoms of the deficiency are pain in the bones and muscles. Additionally, there are other signs like unexplained fatigue, generalised weakness, body aches, muscle and bone pain, low backache, low immunity.
“The first thing when levels go low people do not usually develop symptoms. In many cases people come for other checkups and we find low Vitamin D levels. However the three main symptoms of vitamin D deficiency are persistent fatigue where they get tired very easily and also feel tired all the time, bone, joint and muscle pains and last but not least, recurrent infections due to low immunity. In fact COVID infection is seen more often in patients with Vitamin D deficiency,” adds Dr Doshi.
Myths about Vitamin D
Most common myth is that the morning sun is the best source to support Vitamin D creation in the body. However, the ideal time for sun exposure and in turn Vitamin D production in the body is during 11am to 3pm. Also, the UVB rays cannot penetrate the window glass or concrete and direct exposure to your skin is essential for creation of Vitamin D. Hence sitting at home or in a balcony during won’t produce Vitamin D. Also there is a common misconception that certain food items can provide Vitamin D. The levels of Vitamin D in any food item is quite sparse and hence it cannot be an effective source of the same.