Vitamin D and Women's Health [autosaved]

1Copyright © 2014 Well Woman Clinic. All rights reserved.
Impact of Vitamin D Deficiency on
Women’s Health
Dr Nupur Gupta, Director Obstetrics & Gynecology

Sunshine Vitamin: Everyone Needs
 One of the most controversial nutrients
Strong bones, body,
coordination of nerve &
muscles
Healthy teeth &
Robust immune system

Synthesis (25 hydroxy Vitamin D)
 Skin epidermis
(sunlight UVB Rays &
dehydrocholesterol)
 Types: D2
(ergocalciferol) & D3
(cholecalciferol)

Why is Bioavailability low?
 GI liquids – chemical instability, poor solubility,
slow absorption & first pass metabolism
 Less exposure – lack of time & lack of open
spaces

What is the daily requirement?
Recommended Daily Allowance
Infants – 200-400 IU
Adult - 600 IU
Elderly - 800 IU
Normal: 30-100 ng/ml

How can we fulfill our daily requirements?
 Best time 11am – 3pm
 Minimum 40 min daily exposure
 20% body parts

Are there any Risk Factors
for deficiency?
 LIFESTYLE – use of sunscreen, time sent outdoors
 GEOGRAPHICAL LOCATION
Less – higher altitude, North India (Himalayas)
More – equator, South India
 AGE – less in elderly
 OBESITY – lower levels

Who is Deficient?
 Almost everyone
 Fat malabsorption, anticonvulsant use, chronic
kidney disease, & obesity
 Dark-skinned people, women using sunscreen
lotions, & those areas with thick layer of ozone
 People from urban & polluted areas

Who is more Deficient?
 Children (growing age)
 Women (pregnancy & menstruation)
 Elderly (less cholesterol in the skin)

How do we suspect deficiency?
 Tiredness, laziness
 Joint pains, constant pain in body
 Weakness of joints & muscles
 Poor immunity
 Hair loss
 Mood swings
 Infertility
 Irregularity of bones (frequent fractures)

You might be at risk
 Milk allergy or poor
intake
 Shun the sun
 Vegan diet

Five Common Signs & Symptoms
of Vitamin D deficiency

FIRST……………….
 Bone pain & muscle
weakness

SECOND………….
Constant Fatigue &
Tiredness

THIRD………….
 Mood swings,
feeling of sadness &
Depression

FOURTH………….
 Rickets &
osteomalacia
 Osteoporosis

How do you get Vitamin D?
 Sun
 Food
 Supplements

What are the Rich Sources?
 Cod liver oil
 Fish – Salmon, sardines
 Fortified milk, egg yolk
 Fortified yogurt, mushrooms
 Fortified soy products,
 Oysters & fortified cereals

Vitamin D3 & Calcium
 Ca & bone mineral metabolism
 Works with PTH
 Calcium & phosphorous homeostasis

CALCIUM

Vitamin D in Gynaecology
 Endometriosis (improves dysmenorrhoea)
 Assisted reproduction (improves conception rate)
 Ovarian & breast cancer (protective effect)

Vitamin D & Pregnancy
 Prevents Gestational Diabetes Mellitus (dec IR & inc
Insulin production)
 Prevents preeclampsia (helps is placental invasion,
implantation & angiogenesis)
 Prevents low birthweight & risk of severe PPH
 Increases risk of preterm birth

Emerging Role
 Immunity & immune disorders (rheumatoid
arthritis, multiple sclerosis)
 Diabetes (regulates insulin levels),
metabolic syndrome, skin disease
(psoriasis), hair loss

Emerging Role
 Prevention of cancer, osteoporosis
 Lung function, Hypertension
 Cardiovascular health & disease,
 Management of obesity,
 Psychiatric diseases

Vitamin D & Weight Loss
Weight Loss Plateau
Decreases serotonin levels
Increases Cortisol levels
Alters storage & formation of fat cells

MYTHS

Myth 1
 I can get enough Vitamin D from
Sunlight

Myth 2
I eat plenty of Vitamin D rich foods

Myth 3
 Only “at risk” groups need a supplement

Myth 4
 I take a multivitamin containing vitamin D so
I already get all I need

SUPPLEMENTS
Soft gelatin Capsule, Sachet, Drops

What is a healthy level of Vitamin D?
 Less than 30: DEFICIENT
 30-50: INADEQUATE
 More than 50: ADEQUATE
 More than 125: HIGH

Who should get Vitamin D levels
checked?
 Gastrointestinal disorder (IBD)
 Weight loss surgery, osteoporosis
 On anti-convulsant medications;
 Children who are immobilized, not outside & active.
 If you’re over 70
 People whose cultural or religious beliefs require
them to be fully clothed,
 If dietary habits include little or no dairy

HOME REMEDIES
 Fenugreek seeds (methi dana soak 1 tsp overnight)
 Turmeric (haldi)
 Almond in milk
 Exercise

TOXICITY: HYPERVITAMINOSIS/
Hypercalcemia
Mild – Nausea, vomiting, weakness, frequent
urination
Severe - brittle bones - bone pain and kidney
problems (formation of calcium stones), irregular
heart beat & heart attack

SUN RAYS can be harmful too…….
 Damages skin cellular DNA
 Creates genetic mutations
Skin cancers (90% nonmelanomas, 80%
melanomas)
 Premature aging

RECOMMENDATIONS
 Kids should play in sun daily (20% body
uncovered)
 Adults > 30 years, need monthly sachet
 Pregnancy & breastfeeding
 Elderly

Vitamin D and Women's Health [autosaved]

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