Vitamin D is synthesized in our body by Sun rays falling on our skin. This is a fat soluble vitamin which gets collected in liver and other fat depots. This is only found in only some food items like meat and fish in natural form, otherwise it is artificially added to some food items like milk made foods, protein powder and other food items. This vitamin makes bones and muscles stronger and also do many other activities like managing brain activities, organize nerves and blood vessels, maintain immunity, affect insulin control over sugar. When our skin come in direct contact with ultra violet rays of sunlight then these rays synthesize Vitamin D in our skin which is converted to 25, hydroxy vitamin D in liver after reaching there through blood vessels. When it reaches kidney it gets converted to active 125 Vitamin D and this active vitamin D works in all the body organs.
Vitamin D increases absorption of calcium, magnesium, phosphorus and other minerals. Today deficiency of Vitamin D has become very common. Non exposure to Sun, covering whole body with cloths, less consumption of vitamin D containing food, lever and kidney problem are main reasons for this. Besides this in elderly, very fair skin people are also at risk of developing vitamin D deficiency. In small children it can be because of some hereditary problems. Vitamin D deficiency is investigated by blood investigation and X ray. In small children its deficiency is known as rickets. In rickets, child can develop proximal muscle weakness, irritability, soft skull bones, limb deformity, delayed development milestones, pot belly, and anorexia etc. Vitamin D deficiency in adult is called as osteomalacia.
In this problem, there is weakness, pain and fatigue in muscles and also there is chance of stress fracture of hip and spine. Besides this there is reduction of immunity in these persons. Vitamin D Supplements are needed in persons who are less exposed to Sun and are vegetarian. Today it comes in form of tablets, capsules, powder, and injection in different strengths. Every person who is either deficient in Vitamin D or at high risk, must take it with advice of a doctor. Vitamin D daily supplements of 400-800 unite is mandatory for all age group but requirement increases in growing children, pregnancy, lactating mothers and old age group. In very early age children with rickets, mild to moderate deformity correct spontaneously with vit D and calcium supplements. Children of more than 7 year and with sever deformity in all age group may need surgery. Usually deformity occurs around the joint so deformity can be corrected by growth modulation. But after the age of growth spurt they may need osteotomy to correct the deformity.
Sufficient vitamin D levels are essential for normal skeletal development. This is particularly important in children with
cerebral palsy or other neuromuscular disorders who are at an increased
risk of osteoporosis.
Dr. Jitendra Kumar Jain is a famous name in the field of childhood physical disability pediatric orthopedic problems in North India. He has been an MS Orthopedics, DNB Orthopedics, Pediatric orthopedic surgeon & also a cerebral palsy specialist for over 21 years.