With Covid 19 Vitamin D is coming again into lime light. Those with Vitamin D deficiency are the ones who develop ARDS is reported now. Vitamin D deficiency was observed by me in 1993, When I presented the hypothesis then doctors laughed at me, humiliated me. One endocrinologist even commented that as long as we get sunlight, we will never have Vitamin D deficiency in India. The research proposal submitted in 1994, was rejected too due to this attitude. Due to several reasons beyond my control, including financial, I could complete the study only in 1999, Finally the paper was sent for publication in 2000, but the journal hesitated to publish it, they thought it was a cooked up article, finally in 2002 April it was published in JAPI on its last page, still this was the first organised study on Vitamin D deficiency in the world as far as I know. It clearly said Vitamin D deficiency as an issue of malnutrition, but we are still debating on sunlight exposure alone. Sunlight helps only if we take a balanced diet with vitamin D containing proteins (meat, egg-yolk, curd, mushrooms, nuts etc) regularly in the diet; sunlight exposure alone will never give any vitamin D. Proper balanced diet gives some vitamin D, sunlight exposure gives an extra boost to the vitamin levels. Even then high melanin in the skin might interfere with cutaneous synthesis. Besides all these, the liver and kidneys have to be functioning optimally for the proper activation of the inactive vitamin D to 1,25 di-hydroxy form which is the metabolically active form of Vitamin D. Liver function is often poor in many these days due to overweight and fatty liver or alcohol or other diseases, kidney function is also poor in large numbers of people due to hypertension and diabetes and some toxins. The activation of Vitamin D in the kidneys depend also on parathyroid hormone- which is released from the glands only if there is enough Magnesium in the body. Magnesium we get mostly from vegetables and fruits and there should not be any Magnesium loss through kidneys and gastrointestinal tract as well. Vitamin D deficiency is thus multifactorial and hence it is common in almost all people everywhere in the world. The combinations of causes vary from person to person and place to place. Hence it is not testing the levels that is important, but consuming a balanced diet and avoiding wrong habits including, overeating and doing exercise and getting sunlight exposure. Vitamin D replacement with massive doses is not a good option, but regular consumption of 1000 to 2000 units every day can be resorted to even on a lifelong basis if needed. Very rarely only the tablets or sachets of 60,000 IU be used and that too under medical supervision.
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