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. Quoting the abstract from a study conducted by Beloyartseva M et al, “Information on vitamin D status of Indian health care professionals is limited. Among 2,119 subjects studied, just 6 % were found to be sufficient in vitamin D status. There is urgent need of an integrated approach to detect and treat vitamin D deficiency among health care professionals to improve on-the-job productivity.” This study is very clear in its recommendation of increasing the screening for Vitamin D deficiency and proper and 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 multi systemic 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 promoting exposure to the ultraviolet rays of the sun, ie. restarting our “morning walks”. 

 

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 is the mainstay of 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 current 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 is recommended to be continued for a further 6 months. Most of the commercially available preparations of Vitamin D are available in doses of 60000 IU. These are available as either tablets or granules. 

 

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.