Vitamin D and Covid
Our bodies create vitamin D because of our skins exposure to sunlight, although how much exposure we need depends on how dark or light our skin is and how much we cover ourselves up with clothes and or sun creams. Obviously, we will get the majority of our exposure during the summer and spring months from April to September and this should carry us through the rest of the year, in theory. We also get some Vitamin D from red meat, fish, eggs and when fortified in breakfast cereals or as direct supplementation from the health food shop.
Vitamin D is essential for healthy bones and is part of the bodily process of absorbing calcium and phosphate from our diets, which are then used for building and maintaining the structure of teeth, bones and muscles. In regard to Sars Covid-19, there has been discussion as to whether low Vitamin D levels may be related to more severe respiratory illness, although research is unlikely to be completed before the current lockdown is over. The following is from the UK government’s website:
‘In the UK during autumn and winter everyone is advised to take a supplement containing 10 micrograms (400 international units) of vitamin D a day to support general health and in particular bone and muscle health. This is because we cannot make vitamin D from sunlight at this time of year.
This advice is particularly important for those who have limited exposure to sunlight during the spring and summer, such as those in residential and nursing care homes and those in prisons; and those who usually wear clothes that cover up most of their skin when outdoors. These groups are more at risk of not having enough vitamin D. Those with dark skin (such as people who have an African, African-Caribbean or South Asian background) may also not get enough vitamin D from sunlight. All of these groups are advised to take a vitamin D supplement all year round in line with usual government dietary advice.
Vitamin D deficiency can cause bones to become soft and weak as in Rickets which then leads to bony deformities in children. In adults, it causes Osteomalacia (softening of bone) which causes pain in the joints and obviously, the bones themselves. Other Vitamin D Deficiency Symptoms include- weight gain, low bone density/ osteoporosis and history of fractures, fatigue and generalized weakness, muscle cramps and weakness, plantar fasciitis, joint pain (most noticeable in the back and knees), blood sugar issues, low immunity, low calcium levels in the blood, . Low levels of D are known to cause Sarcopenia (muscle weakness) and consequently instability and falls. The muscle weakness is interesting as the deficiency induces ‘muscle atrophy’ which is a loss of muscle bulk and power compromising its contractile abilities, producing weakness and a ‘swaying of posture when in movement’.
Some groups are at greater risk of deficiency such as expectant mothers, babies and children up to 4 years of age and people who are infrequently exposed to sunlight such as the infirm, the housebound (shielding), those in institutions or those who habitually wear clothes that cover a lot of their skin. For children and mothers there is a government scheme in operation to address this issue. Medications of certain types can also cause the condition, as can hypoparathyroidism and kidney disorders.
There is an increasing awareness among osteopaths and doctors regarding Vitamin D deficiency and the symptoms and signs of the conditions it can cause; there is also an increasing level of testing, it has yet to become common place among health professionals. How widespread the problem is well no one really knows, but from a reasonably recent paper in the BMJ ‘The increasing prevalence of disorders linked to vitamin D deficiency is reflected in the several hundred children with rickets treated each year in the UK. However, these children represent a small proportion of the individuals with a suboptimal vitamin D status in the UK population.
A recent nationwide survey in the United Kingdom showed that more than 50% of the adult population have insufficient levels of vitamin D and that 16% have severe deficiency during winter and spring; so common enough to be a concern.