The document discusses vitamin D deficiency in women's health. It notes that vitamin D is important for bone and muscle health, immune function, and other bodily processes. Risk factors for deficiency include lack of sun exposure, aging, obesity, and certain medical conditions or medications. The recommended daily intake is 600IU for adults, though deficiency is common. Symptoms include bone and muscle pain, fatigue, mood issues, and increased risk of osteoporosis and fractures. The document provides information on testing levels, food sources of vitamin D, supplements, and recommendations for intake.

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Impact of Vitamin D Deficiency on
Women’s Health
Dr Nupur Gupta, Director Obstetrics & Gynecology

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

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

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

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

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

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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

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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

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

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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)

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

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Five Common Signs & Symptoms
of Vitamin D deficiency

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

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SECOND………….
Constant Fatigue &
Tiredness

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

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

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

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

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

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CALCIUM

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

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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

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

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

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

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MYTHS

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Myth 1
 I can get enough Vitamin D from
Sunlight

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Myth 2
I eat plenty of Vitamin D rich foods

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

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

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SUPPLEMENTS
Soft gelatin Capsule, Sachet, Drops

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

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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

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

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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

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

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

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