05 Mar 2016

Treatment of Vitamin D deficiency

TREATMENT OF VITAMIN-DEFICIENCY

 

  • TREATING VITAMIN D DEFICIENCY

Vitamin D deficiency is a widespread concern as it affects most of the population of the world. Urban citizens are more at risk of developing the same since their exposure to sunlight is limited. According to a study conducted on Healthcare Professionals: Among 2,119 subjects studied, just 6 % were found to be sufficient in vitamin D status. This indicates that there is an urgent need for an integrated approach to detect and treat vitamin D deficiency among health care professionals to improve on-the-job productivity.” This study recommends the requirement of increased screening for Vitamin D deficiency and proper &prompt treatment of the same.

As we have seen above, vitamin D has multiple functions. It affects not only the skeletal system but has functions in many other systems. Its deficiency/insufficiency are associated with multisystemic dysfunction and hence needs to be treated promptly. Initially, we should aim to replenish the depleted stores of Vitamin D by providing enteral and parenteral treatments. However, we must plan to start the generation of natural Vitamin D in the body by increasing our exposure to the ultraviolet rays of the sun, i.e. restarting our “morning walks”. 

  1. ENTERAL TREATMENT

Vitamin D supplementation is the mainstay of long-term treatment. Many countries have adopted Vitamin D fortified foodstuffs especially milk. The recommended daily dose of Vitamin D through diet is 800 IU per day. Along with these fortified foodstuffs, daily exposure to sunlight remains the mainstay of this treatment. Proper exposure to the Ultraviolet rays of the sun is the only way of building up the necessary stores of Vitamin D.

Oral preparations of both vitamin D2 and D3 are available but since Vitamin D3 has a longer half-life it is the preferred form of supplementation. The currently recommended dose of Vitamin D is 800-1600 IU per day or a weekly dose of 50000 IU. This supplementation must be given for at least 6 to 12 weeks.

In severe cases of Vitamin D deficiency following the weekly treatment schedule, 50000 IU once a month recommended being continued for a further 6 months. is Most of the commercially available preparations of Vitamin D are available in doses of 60000 IU. These are available as either tablets or granules. 

  1. PARENTERAL TREATMENT

In cases of severe malabsorption, intramuscular injections of Vitamin D are recommended. The doses available for injections are 300000 IU and 600000 IU. These injections are to be given intramuscularly once a week. In some rare cases, UV radiations are also recommended for treating Vitamin D deficiency. In most cases, simultaneous supplementation of calcium and Vitamin D is the preferred practice to ensure bone strength and avoid osteoporosis and osteomalacia. 

 

DOES TAKING VITAMIN-D IN EXCESS HAS ANY BAD EFFECT ON OUR BODY?

  • HYPERVITAMINOSIS D

Sometimes as a result of excessive intake of Vitamin D supplements, people have elevated levels of Vitamin D. The exact value over which vitamin D toxicity manifests is still debatable but values over 100 ng/ml are definitely worrisome.    An excess amount of vitamin D in the blood causes increased calcium levels in the blood (serum). This translates into over-calcification of bones and soft tissues. It may cause kidney stones subsequently leading to kidney damage. The cardiovascular system is also prone to damage from hypocalcaemia resulting from raised serum vitamin D levels

The clinical signs and symptoms of hypervitaminosis D are

  1. Vomiting,
  2. Dehydration,
  3. Constipation,
  4. Muscle weakness,
  5. Muscle pain and mental irritability.

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