Home » Vitamin D Deficiency in a Sunny Country: Why, Living in Tajikistan, Do We Suffer From It?
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Vitamin D Deficiency in a Sunny Country: Why, Living in Tajikistan, Do We Suffer From It?

Since childhood, we have been told that in order for a child to avoid rickets (lack of vitamin D), he needs to take sunbathing, but why doesn’t this work for us?

Vitamin D is called solar vitamin – it is produced in the skin when it is exposed to UV rays. But why in our sunny country then do children and adults have a deficiency of this vitamin? Why is it so important for the body?

Akmal Isakov, endocrinologist at Istiklol State Medical University, assistant at the Department of Endocrinology at the Tajik Medical University named after A. Abuali ibn Sino.

  • Why do residents have vitamin D deficiency in such a sunny country as Tajikistan?
  • There are two factors that contribute to a decrease in vitamin D synthesis.

1 – “Geographical coordinates”. It has been scientifically proven that UVR (ultraviolet rays) are capable of synthesizing vitamin D up to 35 degrees northern and southern latitude, and Tajikistan is located at 40 -41 degrees.

2 – “Global dimming” (the phenomenon of total darkening or reducing the amount of solar radiation falling on the surface of the earth.

This effect is caused by natural and man-made air pollution. From 1950 to 1990, the level of solar energy reaching the earth’s surface fell by 9% in Antarctica and by 30% in the United States. In Russia and Great Britain – by 16%.

This is why we often have vitamin D deficiency, despite the fact that Tajikistan is a sunny country.

Vitamin D is a unique biological substance that, in addition to its “classical” action (regulation of calcium and phosphate metabolism), has a lot of “non-classical” actions.

It is involved in the formation and adequate functioning of the immune system, cardiovascular, nervous and endocrine systems, maintains an adequate level of insulin production and secretion, promotes normal growth and differentiation of tissues, and so on. Vitamin D in humans is synthesized in the skin under the influence of ultraviolet rays. This is the largest source of cholecalciferol (vitamin D3) entering our body!

  • There is a statement that the sun in our country is useful only from 6 in the morning. But at this time it doesn’t really shine for us, which means there’s no benefit at all?
  • As I already noted, the intensity of ultraviolet rays in our region is not capable of synthesizing vitamin D, this is true.
    The human body receives 95% of vitamin D through ultraviolet radiation, so its deficiency plays a significant role in the development of deficiency of this vitamin in the body.
  • At what time of day does the sun not harm us?
  • From 11.00 to 15.00, during this period solar radiation reaches its maximum.

45% of adults in Tajikistan have vitamin D deficiency or deficiency

  • What are the main symptoms of vitamin D deficiency?
  • Bad mood,
  • prostration,
  • discomfort in bones and muscles,
  • decreased visual acuity,
  • increased sweating,
  • frequent colds and ARVI.

As you can see, the symptoms are commonplace – many associate them with fatigue, seasonal ailments, stress and, most often, do not pay due attention to them. However, the consequences can be significant.

  • What do the statistics say about the lack of vitamin D among the adult population of the country?
  • In 2017, we conducted a study under the guidance of Associate Professor of the Department of Endocrinology of TSMU named after. Abuali Ibn Sino, Nigina Azizovna Inoyatova, an outstanding endocrinologist.

As a result, the level of vitamin D was determined in 2,300 people (among children and adults). Among all those examined, 17% had insufficiency, 18% deficiency and 20% severe deficiency of vitamin D.

Among 18-year-olds and older, vitamin D insufficiency and deficiency is 45%.

You can learn more from our research by following this link.

  • Why do we need this vitamin at all?
  • Vitamin D is a prohormone that affects all organs and systems of our body. First of all, it helps the body absorb calcium and phosphorus. If it is deficient, we will not have strong bones, rickets will develop in childhood, osteoporosis in adults, and the risk of fractures increases manifold in the elderly.

The last 15 years have seen the era of vitamin D in endocrinology.

There are a lot of studies and discoveries; previously we associated vitamin D only with rickets, ultraviolet radiation and bone tissue, but now we are witnessing many discoveries in the field of vitamin D.

Today it is impossible to find a cell in our body without a vitamin D receptor.
There are now a lot of publications regarding the role of vitamin D deficiency on the development of various pathologies (endocrine diseases, cardiovascular diseases, skin diseases, autoimmune diseases, pathologies of the nervous system, etc.).

We are seeing Vitamin D slowly being renamed “D Hormone” as it appears to be a vitamin but presents itself as a hormone.

When and how to take vitamin D?

  • Let’s go back to the sun. Is it possible to replace it with artificial vitamin D?
  • The sun is very important for the human body, but if sun exposure is not enough, your doctor may prescribe vitamin D medications. Such preparations based on vitamin D3 and D2 can be considered natural.

Vitamin D is produced under the influence of ultraviolet waves of group B, which the sun produces from 11 a.m. to 3 p.m. Twenty minutes of sun exposure during this period is enough to produce a daily dose of vitamin D.
Unfortunately, from 11 a.m. to 3 p.m., adults are usually at work, and young people are in educational institutions. The smoke in the atmosphere of an industrial city also reduces the intensity of ultraviolet rays.

  • There are several types of vitamin D, which one is best? Which one is better absorbed and does not cause harm?
  • Vitamin D is synthesized in our skin in an inactive state and for full activation it is transported to the liver, then to the kidneys. Therefore, it is better to take the active form of vitamin D: Colecalciferol and Alfacalcidol.

But before taking vitamins, you should definitely consult a specialist.

  • When should you take this vitamin (under what conditions)?
  • First half of the day, since it actively affects the nervous system and can cause overexcitation and insomnia.
  • How to take this vitamin correctly? They say that many vitamins are useless without each other. What should I take this vitamin with?
  • It is better not to take vitamin D with vitamin E, since vitamin E interferes with the absorption of vitamin D.

It is recommended to take vitamin D together with calcium, phosphorus, magnesium, Omega-3, fatty acids, and vitamin K2.

Which vitamin D is the healthiest?

  • It often happens that you replenish the required level of vitamin D in the body, and after 2-3 months it falls again. Doctors say there is a lot of fake vitamin D on the market, which is why this is happening. Is this true or could there be other reasons?
  • To raise the level of vitamin D to the reference range, a loading dose of Colecalciferol is used, however, to maintain the vitamin in the reference range, maintenance therapy must be taken.
  • Are all vitamin D sold in pharmacies healthy? How to understand that you are buying a healthy vitamin?
  • Today, vitamin D is available in water, oil and tablet forms. Vitamin D is absorbed best in water and oil forms.
  • How often should you take this vitamin? They say that once every six months, for example, you can give an injection and it will last for 6 months.
  • It all depends on the level of vitamin D. It is wiser to monitor vitamin D (every 6-12 months) and then decide on the dosage and course.

It is better to take an injectable form of the vitamin in case of vitamin D deficiency (loading dose); in case of a maintenance dose, drops are best suited.

Source: Asia Plus TJ