Why taking vitamin D supplements could be critical

Case example:

Mr A is in his early 50s, Black British and lives an active lifestyle. He is fairly fit and often busy including commuting to work by train or by car in addition to DIY and gardening stints. He prides himself in his regular exercise routines  and dietary habits. He is a non-smoker and rarely drinks alcohol. However he observed it was getting rather  difficult to get started in the morning. He often needed extra motivation to get up and prepare for work most mornings. This on occasions has led to him tending to get stuck in the morning rush hour traffic. It was unusual for him to experience such lethergy. There were no other reasons to explain his tiredness such as associated mood symptoms.

He had not had a need to see his doctor for over a decade. Being male and now post 50, he decided to request for routine blood tests. He had specifically asked to do a PSA in addition to general blood tests including Vitamin D levels.

The test results returned indicating a slightly raised PSA which required further investigation. He was however surprised to find he was slightly Vitamin D deficient falling below the 30 nmol/l threshold by 3units. His GP commenced him on a 7 week course of Vitamin D3. By the end of the first week he felt dramatically revitalised. He was getting up more easily and no longer experienced the letherdy that seemed to slow him down in the mornings.

What is Vitamin D

Vitamin D or in its more active form Vitamin D3 is a steroid (Cholesterol derivative) which is usually produced in the skin of mammals by the action of ultraviolet light from the sun on its provitamin, 7-dehydrocholesterol.  Through a series of steps beginning in the liver and finally, in the kidney, Vitamin D3 is converted first to 25 hydroxycholecalciferol and subsequently to 1,25 dihydroxycalciferol hormone. Depending on the serum calcium levels, such as when it is high, 24,25 dihydrocholecalciferol may be produced instead.

What does Vitamin D do?

The main cellular processes vitamin D is involved in includes:

• It triggers the formation of specialised proteins that ensure Calcium can be absorbed from the guts and the kidneys to maintain normal blood levels
• It acts on the bone cells to ensure a normal process of bone formation and growth
• It stimulates the process of differentiation of immune cells and skin cells which is critical to help us fight infections and minimise skin diseases such as psoriasis or recurrent skin infections
• It can be involved in the regulation of growth through production of growth factors

How do we ensure adequate levels of Vitamin D

A healthy diet and copious amounts of sunlight as may be found in the tropics or in the Mediterranean during summer is all it takes to ensure adequate amounts of Vitamin D.

Communities in the temperate regions with long winters and short lasting summers are prone to vitamin D deficiency states and may require supplementation through diet or replacement pills. People with dark skins due to melanin, living in temperate regions of the world, may further have difficulty with achieving adequate vitamin D levels. This is because in the absence of the intense sunlight of the tropics, the protective barrier of the melanocytes become redundant and actually reduces the amounts of penetrating UV rays required to trigger production of vitamin D in the skin. The light skin of the Caucasian appear to be a phylogenetic adaptation to surviving in the cold wintery climates with less sun.