Symptoms

Vitamin D deficiency - causes, symptoms and treatment


Vitamin D deficiency is normal during the fall and winter months and leads to depressive symptoms. In the past, doctors thought vitamin D was only important for healthy bones and teeth, but recent research sees the substance to have more extensive functions: a lack of vitamin D plays a role in various health problems, including heart disease, depression, and even cancer.

Helena, a person affected, writes: “I have had a gradual decline in my performance over the past 2 years, which finally ended in massive memory, concentration problems, inner restlessness, exhaustion. I constantly felt irritated and increasingly overwhelmed, even in my private life. I was increasingly depressed. At the same time, I was chronically irritable. Back pain plagued me for many months. My colleagues were seriously worried so they approached my boss, who sent me on a forced break. I tried to recover. After a two-week phase in the sun, I felt better. ”

The sunny mind

Since time immemorial, people have known that the sun (in moderation) brings positive feelings, and many Germans flee to Spain in the cold season or to Thailand in the meantime. Popular clichés call “southern countries” a “heated temper”, while Russians and Scandinavians are considered moody and “cold”. These ideas inspired both obscure and dangerous race theories. The founder of the irrational “anthroposophy”, who allegedly suffered from schizophrenia, fantasized that “the negro” had black skin because “the heat was boiling in his blood”.

In fact, suicide rates are high in northern Russia and Scandinavia, as is alcohol abuse: Depression is widespread in countries where the sun has not been shining for months, and those living there today use UV rays from the solarium. Cod liver oil or cod liver are considered the aspirins of Norway and the Arctic - and not without reason.

The organism produces vitamin D primarily with the help of sunlight on the skin. Food also contains vitamin D, but this is only a fraction of what we get from the sun.

In a narrow sense, vitamin D is not a vitamin, because vitamins are organic substances that the body absorbs - but the body produces vitamin D. Few foods contain vitamin D, especially high-fat fish such as eel, herring, salmon and especially cod liver, but even dietary supplements cannot give us enough vitamin D to keep us healthy.

How much vitamin D the body needs varies with age, body weight, the percentage of body fat, skin color, latitude, the use of sun blockers, individual exposure to the sun, and basic illnesses or the general physical constitution.

Vitamin is fat-soluble and is stored in the liver and adipose tissue. Therefore people with a lot of body fat have the ability to store a lot of vitamin D and at the same time prevent it from being implemented in the body,

Ultraviolet rays in sunlight change cholesterol in the skin to vitamin D. For a light-skinned person, 20-30 minutes of sunlight a day on the face and forearms around noon two to three times a week is enough to be in the summer months in Germany or Great Britain to produce enough vitamin D. People with dark skin and / or older age, on the other hand, need a lot more time to have enough vitamin D.

A simple blood test can determine the level in the blood. Vitamins are measured in nanograms per milliter. 20 ng / mL to 50 ng / mL is an adequate level for bones and general health, while a level below 12 ng / mL implies a vitamin D deficiency. Many experts consider a higher level of 35-40 ng / mL necessary to stabilize health permanently. Higher levels have no additional benefit.

Vitamin D responsible for skin color?

George Chaplin and Nina G. Jablonski put forward the thesis in 2003 that the black and white skin of humans developed as an adaptation to too much and too little sun. This would have been a balancing act.

UV rays could have a devastating effect on bare skin, and reddish brown to black melanins are natural sunscreens and prevent skin cancer. People with fair skin in regions with strong sun exposure, such as Anglo-Australians, are particularly at risk of skin cancer.

However, people with fair skin also have low levels of folic acid in their blood after being exposed to strong artificial sunlight. If one irradiates human blood serum with artificial sunlight for one hour, the content of this B vitamin drops by half.

Folic acid deficiency in turn leads to severe physical disabilities in newborns, with sections of the spinal cord exposed, as well as the cleft lip and palate. To prevent this, pregnant women in the U.S. and Europe are advised to take folic acid supplements. B vitamin is mainly found in egg yolk, liver, wheat germ and leafy vegetables.

According to the pair of researchers, dark skin was created to protect the folic acid in the body from UV radiation. In the sun-poor north, however, UV-B hardly penetrated the skin anyway. This did not bring relief, but a problem, since UV-B rays are dangerous, but also vital because they trigger the synthesis of vitamin D and are therefore of fundamental importance for the calcium and phosphate metabolism, which in turn helps build bones controls.

The skin in the northern latitudes had to be light to absorb enough UV-B rays so that people could produce the vitamin. Without D vitamins, the body cannot absorb calcium from the intestines that make up the bones, and the skeleton cannot develop normally. Without calcium, the immune system also breaks down. Michael Hollick of the University of Boston (Massachusetts) and his colleagues have further substantiated these relationships with their medical studies over the past two decades. They also showed that sunlight in higher latitudes in winter is not sufficient for production because too little UV B rays reach the skin. North of the 50th parallel, meaning Frankfurt am Main, according to Chaplin and Jablonski, people would have to suffer from vitamin D deficiency for six months or longer, or compensate for it with food.

This is why people in the far north never really get brown because their skin should always catch as much sun as possible, whereas people in the middle latitudes turn dark in summer and their skin turns pale in winter, which means that there is little sunlight this season to store and protect from excessive sun in summer. In the tropics, however, the radiation is so strong that enough vitamin D is also produced with protected pigments.

Inuit in Alaska, Greenland and Northern Canada had darker skin, but had only migrated to the Arctic for around 5000 years, and on the other hand they had largely become independent of the sun: Traditionally, the Inuit ate extremely high-fat marine fish and thus the food with the highest concentrations of vitamin D

In Africa, the Khoisan, the Bushmen in southern Africa, had much lighter skin than the Bantu people near the equator, according to Chaplin and Jablonski, it is probably an adaptation to the lower UV radiation in South Africa.

Today, Chaplin and Jablonski say that people often do not adapt to the sun in a new home quickly enough, and this is usually due to ignorance. This leads to diseases from which the respective groups of people have not previously been affected. For example, many Indians who came to the UK as citizens of the Commenwealth in the north of England and Scotland suffered from rickets and other vitamin D-magma symptoms.

So the skin tones of people have nothing to do with biological races, but only with adaptations to different environments and are the least meaningful feature to recognize groups of people.

Pale nobles and coal children - vitamin D in modern times

The history of vitamin D is primarily called rickets, a disease in which the bones soften and deform and the cause of which our ancestors did not know.

The disease itself was described in England as early as the 17th century and was considered a disease of the fine people. At that time it was mainly high society who got this disease: the poor, if they did not work in the mining industry, worked outdoors and were therefore given enough vitamin D. However, the nobility defined itself precisely by not having to work physically and it was important to do so by a pale one To demonstrate skin color. As a result, her skin took in too little sunlight.

The industrial revolution made the deficiency, and with it rickets, a mass phenomenon - especially among children. Children were preferred to work in mines because they fit in the narrow tunnels. In addition there was poor hygiene and completely inadequate nutrition, which weakened the body.

Some of these child slaves buried underground did not see the sun for weeks in winter and pulled the coal carts up to twelve hours a day.

The rickets was then called "children's bone disease". Affected infants had “pits” on the back of their heads because the bones of the skull softened and widened hydrocephalus. If the disease progressed, the skull rounded off, it lost its oval shape and looked like a ball. The base of the skull rose due to the softening and the entire skull sank down. A typical symptom was a water head with increased intracranial pressure and an exceptionally broad face.

The axes of the legs bent, and a spherical belly developed, the chest deformed and the spine became crooked, as did the knees and joints. In the second year of life, the body weight had such an effect on the soft bones that the femoral neck lowered. The internal structure of the bones was rotten and incomplete, the hips without strength, the abdominal muscles could not function without the hips, and those affected suffered from chronic constipation.

The pull of the diaphragm on the soft chest created a “chicken breast”. The wrists swelled, especially the ends of the forearm bones - the growth zones. The distance between the neck and shoulders was shortened due to the diseased cervical spine. In the end, the children's bones broke regularly.

In 1822 the Polish doctor Sniadecki recognized that farm children were less likely to suffer from rickets than those in Warsaw. In the late 19th century, Theodore Palm, a missionary, also observed that children near the equator had no rickets and suspected sunbathing as a possible cure and contraceptive strategy.

In 1918, Sir Edward Mellanby successfully caused rickets in dogs by feeding them porridge only and keeping them indoors without the sun, while healing rachitic dogs with cod liver oil - the food that contains the most vitamin D. At that time this cod liver oil was known as a remedy for blindness and bone fractures.

McCollum recognized that the anti-rachitic effect in cod liver oil was a new substance and gave it the name Vitamin D. Hudshinsky discovered that the sun healed children with rickets. Steenbock and Black noted in 1924 that food exposed to UV rays could also cure rickets, which led to the great realization that UV light was able to convert a substance stored in food and skin into another form. The discoveries suggested a close relationship between sun exposure and vitamin D.

The importance of vitamin D for babies

Vitamin D deficiency in babies has the same causes as in adults: Inadequate vitamin D intake through food and lack of sun exposure, disorders that restrict vitamin D intake or impair the transmission of vitamin D to the liver and kidney.

A deficiency in babies can quickly have a worse impact than in adults because the first year of a child is characterized by rapid growth, bone structure and formation of the spine. They are therefore particularly affected by rickets.

Children with chronic diseases, especially those of the liver, and children who take seizure medication, can sometimes take vitamin D poorly and the risk of rickets increases. Vitamin D deficiency also makes babies more susceptible to infectious diseases.

Children who are breast-fed do not get vitamin D because their breast milk content is minimal. If a nursing mother has a vitamin D deficiency herself, it will be even more difficult for the infant to get enough of the substance. Children who receive commercial baby food usually do not need additional vitamin D, because this is already included in it.

Risks for vitamin D deficiency

People with dark skin are at higher risk than fair-skinned people. People who spend little time outdoors during the day lack vitamin D because they receive too little sunlight: For example, home workers, night workers or long-term patients in the hospital are affected.

People who cover their skin with sunscreen or clothing all the time are also at risk. This applies, for example, to women in Islamic countries who are forced to wear the niquab or the burqa.

People living in the far north can also build up little vitamin D - in Finland, northern Russia or Alaska. Their skin receives no sunlight at all for months.

Elderly people with muscle weakness can produce vitamin D poorly in the body, in general seniors are exposed to many risk factors: thin skin, little sunlight and limited absorption of vitamin D in the liver and kidneys.

Being overweight increases the risk of a low level, because the more weight a person has, the more vitamin D they need. Conversely, the vitamin deficiency increases the risk of becoming overweight. Vitamin D and calcium suppress the appetite.

Symptoms of vitamin D deficiency

Depression and anxiety disorders
Vitamin D receptors are found in many parts of the brain. These receptors are also in the parts of the brain where depression develops. That is why a vitamin D deficiency is also linked to depression and other psychological problems.

An additional problem arises when those affected and doctors do not know about the deficiency. They then logically look for psychological reasons for their psychological complaints: relationships, professional problems or mental disorders. However, if a vitamin D deficiency triggers depressive moods, it has very little to do with clinical depression. Those affected do not need behavioral therapy or psychoanalysis, but UV-B rays and vitamin D supplements.

Excessive sweating

One of the first signs of a vitamin D deficiency is a sweaty head. For this reason, doctors ask mothers of newborns whether they sweat profusely. Excessive sweating is also an indicator of an underproduction of the vitamin in infants themselves.

Bone pain

A lack of vitamin D shows itself as pain in the bones, as muscle spasms and suffering in the joints. People who don't have enough vitamin D can only eat 10 to 15% of their daily calcium intake, according to a study published in the American Journal of Clinical Nutrition.

But this is necessary for stare and healthy bones. The result of the lack of calcium is weak, soft and painful bones.

osteoporosis

This disease is characterized by low bone mass and a decrease in bone tissue - the bones become fragile and bone fractures are the result. The cause is considered to be insufficient calcium intake, but a vitamin D deficiency can result in insufficient calcium intake.

Osteoporosis is an extreme consequence of vitamin D deficiency and can rarely be traced back directly to it, but: Elderly people, women after menopause and people who do not exercise enough can prevent adequate levels of vitamin D and sufficient calcium to prevent osteoporosis .

Erectile dysfunction

The lack also leads to an increased risk of erectile dysfunction. Vascular problems cause approximately half of all erectile dysfunctions, and Vitam-D deficiency weakens the vessels. UV light is not only the main source of vitamin D, it also increases the concentration of nitric oxide in the blood, which in turn lowers the risk of erectile dysfunction.

Thyroid problem

Thyroid problems can go hand in hand with vitamin D deficiency, but there is a scientific controversy about cause and effect. In any case, genetic dispositions, nutrition and general health also play a role. Autoimmune diseases play a role in thyroid complaints, and vitamin D is just as inadequate as a genetic predisposition to not be able to produce them.

Common infections

Vitamin D plays a crucial role in the immune system. It strengthens the body's defenses to fight viruses and bacteria that cause illness. It interacts directly with the cells that are responsible for fighting infections. If someone gets sick often, especially if they have colds or flu infections, vitamin D deficiency can be the trigger. Several meta studies have shown that a deficiency is related to infections such as the common cold, bronchitis pneumonia.

anemia

Anemia occurs when the body does not produce enough red blood cells that transport oxygen to different areas of the body. The cause is probably vitamin D deficiency.

A study at the John Hopkins Children's Center found that people with low hemoglobin levels also had too little vitamin D. Although the exact role of vitamin S and anemia is under investigation, there is little doubt about the link between anemia and vitamin D deficiency.

infertility
Vitam D deficiency is linked to infertility, and couples who want to have children should have their levels examined. Research shows that women with sufficient vitamin D levels are more likely to get pregnant and produce healthier embryos. Low levels in men also mean that the desire to have children is often not fulfilled.

Two of the main parameters for sperm quality, namely movement and shape, could be influenced by vitamin D. If the sperm move slowly, it will be harder for them to get ahead and fertilize an egg. In a study with 300 men with high vitamin D levels showed a higher proportion of mobile sperm. Conversely, in men with low vitamin D levels, sperm were less rapid and more sperm were abnormally shaped.

cancer
Vitamin D appears to destroy cancer cells and prevent cell division. A study designed to test bone health found that post-menopausal women who took calcium and vitamin D supplements were 60% less likely to develop cancer.

Vitamin D slows cell growth, a factor that could reduce the risk of most cancers by up to 50%. A lack of this vitamin, on the other hand, suggests a 30 to 50% increased risk of prostate and breast cancer.

New research suggests that vitamin D is important for the body's immune system and gives certain genes the ability to work or not. That would be a logical explanation that vitamin D lowers the risk of cancer.

Heart disease
People with too little or too much of the vitamin in the blood have an increased risk of heart disease. Death from a heart attack or failure of the heart muscles doubles even if the vitamin D value falls below 50 nmo / L. Cardiac death also increases when the vitamin D level increases to over 100 nmol / L.

Too high a level can damage the heart as well as the blood vessels and kidneys.

Low levels of dietary vitamin D are associated with a greater risk for stroke, congestive heart failure and heart disease. On the flip side, high levels of vitamin D deficiency can cause toxicity and damage the heart, blood vessels, and kidneys.

Treatment of vitamin D deficiency

The deficiency can be compensated for with three methods: sunlight, artificial UV-B light and nutritional supplements.

How long someone has to be exposed to sunlight to produce significant amounts of vitamin D depends on a variety of physical and personal factors, and the environment also plays a role. In general, the duration of the sun bath to get a sufficient vitamin D level is below the limit at which the skin burns and turns red. This is why short stays in the sun help to increase the Vitam D value to the optimal level.

In temperate latitudes like Germany, it is therefore important in the cold season to leave the house in the few hours when the sun is shining. In other words: If you go for a walk with your dog, ride a bike or spend some time outside in the daylight in December, you will have fewer problems with your vitamin D balance or none at all. It should be borne in mind that in winter, full-body clothing means that less skin is exposed to the sun, which also shines less intensely. In order to “fill up” with vitamin D, it makes sense to take off your mittens in between and expose your hands to the sun and not to cover your face with a scarf.

Solariums cannot completely replace sunlight, and you should definitely consult a doctor about the artificial “sunbathing” or have your vitamin D level measured. Excessive use of artificial UV light poses health risks.

There is no ozone layer between the skin and the three wavelengths UVA, UVB and UVC. UVC rays are dangerous for the skin and weaken the immune system. A higher dose of UVA and UVB than the natural sun provides increases the risk of skin cancer.

Used in moderation, high-altitude sunshine can normalize the vitamin level and thus lower the risk of cancer - including skin cancer.

Vitamin D overdose

Vitamin D also has “too much of a good thing”. Too high a vitamin D level carries the risk of anxiety, excessive urination, cardiac arrhythmia and kidney stones. We can only get an overdose of vitamin D from preparations - even intense sunlight does not lead to an increased level.

The sun only enables the body to produce vitamin D. However, the organism stops its own production when a sufficient level is reached. Foods rich in vitamin D, such as cod liver, smoked eel or salmon, make it practically impossible to raise your level to a normal level.

Beware of epilepsy drugs

Anti-epilepsy medication can permanently lower vitamin D levels. Epileptics should check their vitamin D level regularly and, if it is too low, stabilize it with sunlight, sunlamps or preparations. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch

Swell:

  • Robert Koch Institute: www.rki.de (accessed: August 30, 2019), answers from the Robert Koch Institute to frequently asked questions about vitamin D.
  • Linsey Utami Gani; Choon How How: "Vitamin D deficiency", in: Singapore Medical Journal, Volume 56 Issue 8, 2015, NCBI
  • Opinder Sahota: "Understanding vitamin D deficiency", in: Age and Aging, Volume 43 Issue 5, 2014, Oxford Academic
  • K. Kruse: "Current aspects of vitamin D deficiency rickets", in: Monthly Pediatrics, Volume 148 Issue 6, 2000, Springer Link
  • Wolfgang Gerok (ed.) Internal medicine: reference work for the specialist, Schattauer Verlag, 2007
  • Francis Mimouni; Adi Huber-Yaron; Shlomi Cohen: "Vitamin D requirements in infancy: a systematic review", in: Current Opinion in Clinical Nutrition and Metabolic Care, Volume 20 Issue 3, 2017, Ovid


Video: 8 Signs and Symptoms of Vitamin D Deficiency (October 2021).