Vitamin D and Associated disorders

Men's Health, Women's Health, Pregnancy, Bones | September 18, 2019 | Author: Naturopath

menopause, pregnancy, women's health

Vitamin D and Associated disorders

The cold weather is coming to an end and we are looking forward to some sunshine. Vitamin D absorption via the skin is limited in winter, and then summer comes along with sunblock and block-out clothing. This could mean stores of vitamin D may be low. Vitamin D is needed for a number of important functions in our body, such as skin health, immune health and bone health, but as well, vitamin D deficiency has been associated with chronic diseases such as cancer, coronary heart disease, neurological diseases, type II diabetes, autoimmune diseases, depression and various inflammatory disorders.

Those at greater risk

Studies have shown all ages and all ethnical groups are at risk of vitamin D deficiency. It has been shown to be more severe in men and the elderly.

Lifestyle factors

  • Pregnancy - babies can be deficient due to low intake by mother
  • Low dietary intake
  • Decreased outdoor activity - reducing sunlight exposure such as those in who are in residential care or housebound
  • Darker skin - darker skin reduces the penetration of UV light
  • Avoiding the sun due to medical conditions
  • Covering the body for cultural or religious reasons
  • Absorption issues - gastrointestinal diseases etc

Environment factors 

  • air pollution (reducing sunlight exposure)

UVB from sunlight is needed for activation of vitamin D synthesis from 7-dehydrocholesterol in the epidermis of the skin.

What is Vitamin D

Vitamin D is a group of fat-soluble steroids. Also known as ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3), vitamin D's are broken down to their active form, calcitriol in the body. Calcitriol increases the absorption of calcium and phosphorus from the small intestine and aids in the maturation of osteoclasts in the bone. Calcitriol aids reabsorption of calcium and phosphorus by preventing loss from the kidneys.

Vitamin D helps with

  • Bone development and strength 
  • Dental health
  • Cell growth
  • Maintaining a healthy immune system
  • Immunomodulation of inflammatory pathways
  • Hormone function
  • Nervous system regulation
  • Preventing skin aging

Where do we get vitamin D?

Dietary intake of components are needed to synthesise vitamin D in the body. These precursor  are obtained from animal sources (cholecalciferol D3) and vegetable sources (ergocalciferol D2).

We get most of our D3 through sunshine, by UVB-activated photochemical conversion of pro-vitamin D3 (7-dehydrocholesterol) to pre-vitamin D3 (cholecalciferol) in the skin.

Small amounts are obtained through the diet from eating foods such as: fatty fish; salmon, tuna, mackerel and herring; liver, egg yolks and some fortified products.

Vitamin D deficiency

In Australia having a mild, moderate and severe deficiency is common. Low levels can lead to bone and joint pain; risk of falls in the elderly; and impact on pregnancy and the neonate.

The main reasons for low levels of vitamin D

  • Lack of vitamin D in the diet
  • Inadequate sun exposure
  • Inability to absorb vitamin D from the intestines
  • Inability to process vitamin D due to kidney or liver disease

Could you benefit from more vitamin D?

Osteoporosis 

This disease affects both male and females throughout the world and can become a problem particularly after menopause in woman. Bone remodelling is a constant process throughout life but it is important to have the nutrients in adequate amount for this process to be successful. Calcium and vitamin D supplementation and exercise are some of the foundations of osteoporosis prevention.

Teeth

Vitamin D influences the formation and mineralization of teeth. Adequate levels of vitamin D during pregnacy is important for tooth formation in baby and timely eruption of teeth in early life.

Immune health

Vitamin D has been recently shown to increase antimicrobial responses through the production of antibacterial peptides (innate immune response), and stimulation of the autophagic activity in macrophages (the natural, regulated mechanism of the cell that removes unnecessary or dysfunctional components and allows orderly degradation and recycling of cellular components) - healthy immune cell function. Studies show a significant association between vitamin D deficiency and an increased incidence of several infectious diseases.

Adequate vitamin D levels can help prevent infection

Allergy

Calcitriol can block IgE-mediated mast cell degranulation in allergic disorders and many other inflammatory diseases.

Mast cells are the major cells that actively respond to stimulus and begin the symtomatic signs associated with an allergic reaction.

Adequate vitamin D levels can help prevent allergic reactions

Gastrointestinal disorders

Low vitamin levels have been found in people suffering from inflammatory bowel diseases, such as Irritable Bowel syndrome, Crohn’s disease and Ulcerative colitis and clinical studies have shown improvement through supplementation. It is thought low levels of vitamin D may lead to disruption of the tight junction’s integrity – leading to intestinal barrier dysfunction, damage to the mucosa linning the digestive system and increased susceptibility to infections.

Vitamin D is required for normal gut function, protection and gut-mediated immunity.

Chronic Disease

An increased level of intracellular reactive oxygen species (ROS) disrupting the normal function of cells is one reason believed to be responsible for the development of chronic disease. Vitamin D deficiency is thought to be associated a disruption of redox system homeostasis. The loss of this control is a factor for the onset of numerous age-related disorders.

Type 2 Diabetes. Observational studies support an association between a low blood 25-hydroxyvitamin D level and the risk of type 2 diabetes and most other insulin resistance related disorders.

Autoimmune Disease. Vitamin D insufficiency is an important factor in the development of some autoimmune diseases, thought due to its role in the immune system.

Cardiovascular disease. Numerous studies have showen low levels of vitamin D is inversely correlated with the incidence of cardiovascular disorders such as hypertension, Choronary Artery Disease(CAD)  and stroke.

Chronic Obstructive Pulmonary Disease (COPD). Patients with more severe disease tend to have lower serum Vitamin D levels.

Cognitive impairment, vascular dementia and Alzheimer’s disease 

Vitamin D levels have been shown to be  linked with the risk of developing vascular calcification, atherosclerosis and dementia. Severe deficiency in the elderly are associated with cognitive impairment, dementia and the development of Alzheimer’ disease.

Should you supplement

Vitamin D levels can be established through a blood test and your doctor can determine if you are at risk of deficiency. This might be due to your medical history and your level of sunlight exposure. Vitamin D levels are generally lower at the end of winter and higher at the end of summer. Your doctor wil determine the amount of supplementation needed. 

Getting your Vitamin D from Sunshine

Sunshine is the best way to increase levels of vitamin D other than supplementation. But this needs to be balanced with avoiding the damaging aspects of sunshine. Adequate sun exposure to create vitamin D is based on season, location, skin exposure and skin type. Poor health of skin and aging may also influence this. In summer mid-morning and mid-afternoon are best times, avoiding high UV times. Longer exposure is needed in other seasons. Check the UV index via the Cancer Council Website or myuv.com.au.

The Take Home

Vitamin D deficiency is common and may 

  • contribute to the development of osteopenia and osteoporosis
  • increase risk of falls in the elderly
  • be associated with chronic diseases
  • increase risk of infection and allergy
  • contribute to digestive dysfunction

www.superpharmacy.com.au  Australia’s best online discount chemist

References

Health Risks of Hypovitaminosis D: A Review of New Molecular Insights https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5877753/

[Current Topics on Vitamin D. The effects of vitamin D on the immune system]. https://www.superpharmacy.com.au/admin/blog/edit/5780

https://www.uptodate.com/contents/vitamin-d-deficiency-beyond-the-basics

https://www.medicinenet.com/vitamin_d-oral/article.htm#what_are_the_uses_for_vitamin_d-oral

Vitamin D status in irritable bowel syndrome and the impact of supplementation on symptoms: what do we know and what do we need to know? https://www.nature.com/articles/s41430-017-0064-z

Vitamin D deficiency promotes epithelial barrier dysfunction and intestinal inflammation. https://www.ncbi.nlm.nih.gov/pubmed/24755435

Medical Treatment for Osteoporosis: From Molecular to Clinical Opinions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540613/

The Associations of Maternal and Neonatal Vitamin D with Dental Development in Childhood https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435444/

https://www.health.gov.au/resources/pregnancy-care-guidelines/part-g-targeted-maternal-health-tests/vitamin-d-status - 47.2 Vitamin D status in pregnancy

https://www.osteoporosis.org.au/vitamin-d

https://jeanhailes.org.au/health-a-z/bone-health/vitamin-d

Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. https://www.ncbi.nlm.nih.gov/pubmed/20219962

Type 2 Diabetes Mellitus, Insulin Resistance, and Vitamin D. https://www.ncbi.nlm.nih.gov/pubmed/31506836

Vitamin D and autoimmune diseases https://www.sciencedirect.com/science/article/abs/pii/S002432051930671X?via%3Dihub

backBack to Blog Home