Low Vitamin D levels – Significance beyond Bone Health: Metropolis Healthcare

Despite ample sunlight in India throughout the year, almost 80% of Indians are deficient in Vitamin D. Prolonged Vitamin D deficiency leads to a host of health issues. Recent studies link Vitamin D Deficiency with Diabetes, metabolic syndrome, blood pressure, heart disease, stroke and may even trigger symptoms of depression in a healthy population.

There are various studies that directly correlate Vitamin D deficiency to PTH levels in the blood which is studied further in detail here.

Vitamin D Deficiency& Parathyroid Hormone (PTH)

Vitamin D deficiency, simply put is having low levels of Vitamin D in body, which causes the bones to become thin, porous and brittle.Vitamin D helps the intestines absorb calcium. Once activated, Vitamin D acts to greatly increase the amount of calcium that the intestines can absorb from food. For patients with vitamin D deficiency, it is difficult for the body to obtain calcium from the diet. This often leads to a rise in the PTH level, since the parathyroid glands must increase the PTH production, in order to increase calcium levels they absorb it from bones. Therefore, people with a normal blood calcium levels and a high PTH level may have secondary hyperparathyroidism, which means that the high PTH level is a normal response of healthy parathyroid glands to another problem (like vitamin D deficiency or kidney failure).The sole purpose of the parathyroid glands is to control calcium within the blood in a very tight range between 9.0 and 10.1. In doing so, parathyroid glands also control how much calcium is in the bones, and therefore, how strong and dense the bones are.

Primary hyperparathyroidism

Primary hyperparathyroidism most of the times results due to a non-cancerous tumor of the parathyroid, called an adenoma. Because of the adenoma, the parathyroid can make too much PTH, which can cause calcium to be too high in the blood, and overtime, lead to poor bone health. Sometimes doctors decide to treat primary hyperparathyroidism surgically, by removing the adenoma. If you have primary hyperparathyroidism, you need to work with your doctor to see if you can take vitamin D. Since you may have high blood calcium, it’s important to make sure you’re under a doctor’s supervision if considering taking vitamin D.

Secondary hyperparathyroidism

Secondary hyperparathyroidism is caused by either long term vitamin D deficiency or kidney failure. With long term vitamin D deficiency, the body may not get enough vitamin D to absorb adequate calcium. This can be corrected by treating vitamin D deficiency. It is important to note that accurate diagnosis is important to get to the core of the disorder and decide course and dosage of treatment accordingly.

How does the Human body ensure that there is adequate amount of calcium in the blood?

The human body can produce Vitamin D3 from direct exposure to sunlight. 7-dehydrocholestrerol is converted to Vitamin D3 with the help of UV Rays. However a large population of India does not face the sun as over 80% of the population is deficient in Vitamin D

  • Poor/inefficient exposure to sunlight
  • Sunscreen, full sleeved clothes acts as an impediment
  • Dark colored skin requires longer exposure to sunlight
  • Poor dietary /supplementary intake
vitamins
blood-calcium

When you get enough vitamin D from good sun exposure and supplementation habits and enough calcium from your diet, this allows you to maintain a healthy calcium level in your blood and keep good amounts of calcium in your bones. Healthy vitamin D and calcium habits also help keep your PTH levels in check.

Prolonged Vitamin D Insufficiency or Deficiency leads to reflex increase in PTH levels in the blood. This is called secondary Hyperparathyroidism, in which PTH mobilizes bone calcium which leads to increased bone fragility and risk of fractures or increased level of calcium in blood. Secondary Hyperparathyroidism is commonly the result of compensatory over secretion of PTH in response to Vitamin D deficiency.

In a recent study done by the R&D team at Metropolis Healthcare, the following are the study results.

According to R&D team in Metropolis Healthcare, when the calcium level in the blood drops, due to Vitamin D deficiency, high levels of Parathyroid Hormone (PTH) are secreted by the parathyroid gland, which absorbs calcium from bones, leading it to become brittle and porous.

How it affects the people?

Many people with Vitamin D deficiency can have increased levels of Parathyroid Hormone (PTH) in the body. The main function of PTH is to maintain calcium levels in the blood stream. With the decrease in Vitamin D levels, there will be drop in the calcium levels, in order to balance the calcium level in the blood, parathyroid gland starts secreting high levels of parathyroid hormone. PTH starts to absorb calcium from bone replenishing the calcium level in the blood, which in turns leads to weakening of bones, making it more fragile or prone to fractures.

The Study

In an analysis of over 7,542 patients who underwent both Vitamin D and PTH tests, the following trends emerged.

table

Correlating Vitamin D deficiency with Hyper Parathyrodism, the following table can be drawn

table1

An increasing trend can be witnessed from 30 to 40 age group and above, indicating an increasing level of susceptibility with progression in age

table2

table3

Observations:

Elevated PTH levels were found in the age group of 20 – 50 years contributing to 24.11%. Such patients are at a high risk of developing High BP, Diabetes, Heart diseases.

Of these deficient samples 28.98% were of women.Vitamin D deficiency with PTH elevation can have several ill effects on bone and increased risk of high BP, Diabetes & Heart disease.

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