Potential implications of Vitamin D deficiency in Indians wide ranging : bone health , association with type 2 diabetes mellitus and pulmonary tuberculosis.
Optimal level of 25OH D to maintain skeletal health and maximal dietary absorption of calcium in the gut is accepted to be 30 ng/ml and is defined as vitamin D sufficiency . A value of <20 ng/ml is defined as vitamin D deficiency and values between 20 to 30 ng/ml is defined as vitamin D insufficiency.
Increased urbanisation, avoidance of sunlight, clothing practices, and greater atmospheric pollution may aggravate this problem. While severe vitamin D deficiency may be present with radiological features of rickets/osteomalacia, subclinical vitamin D deficiency or insufficiency may have adverse consequences on the bone because of secondary hyperparathyroidism. Adequate supplementation with vitamin D may increase the bone mass and decrease the risk of fractures .
The optimal amount of vitamin D required for treatment of vitamin D has been a matter of debate.
One potential source of variability in the clinical effectiveness of dietary supplements, which may also influence patient preference and adherence, is the delivery matrix used in the supplement; Common matrices include dry powder ,capsules, chewable tablets, and oil-emulsified drops.
Based on our clinical observation an attempt was made to ascertain the Efficacy and Efficiency of Vitamin D Supplementation from Four Different Forms in Vitamin D Deficient Subjects – Our study illustrates benefit of choosing a more efficient form to deliver the corrective effect at minimum dosage in short time .
Vitamin D supplemented as 60000 IU per day – 8 doses within a month to deliver 4.8 lac IU of Vit D helps correct severe deficiency state (<12ng/dl ). However it is strongly recommended that Evaluation of vitamin D status be done at baseline and at the end of 6-8 weeks of supplementation to assess need for further supplementation or maintenance therapy as a part of preventive strategy. Supplementation period shorter the better. Better compliance to supplementation helps achieve adequacy in Vitamin D status. The softgels were found to be most economic and efficient followed by micronized liquids, granules and tablets in descending order .
An imp fact most often overlooked in clinical practice is the need to strongly recommend in follow ups a maintenance therapy of 1500–2000 IU/day which can be easily done with one dose of 60000 IU per month .
Precaution , prevention and ethical supplementation without over or under doing it can surely make us all achieve a dense bone mass and ensure super bone health !