Why So Many Indians Are Low on Vitamin D

It surprises many people that vitamin D deficiency is so common in a sunny country like India. Studies across Indian cities have found low levels in a large share of adults and children. The good news is that it is easy to test and usually simple to correct.

What vitamin D does

Vitamin D helps your body absorb calcium from food, which keeps bones and teeth strong. It also supports muscle function, and researchers continue to study its role in immunity and other body systems.

Why deficiency is common in India

Several factors work together:

• Indoor lifestyles, with long hours in offices, classrooms and vehicles
• Air pollution, which reduces the amount of sunlight reaching the skin
• Covering most of the skin with clothing
• Darker skin tones, which need more sun exposure to produce the same amount of vitamin D
• Diets that are naturally low in vitamin D, especially vegetarian diets
• Use of sunscreen, which is good for skin protection but reduces vitamin D production
• Older age, obesity, and some digestive, liver or kidney conditions

Signs you may be low

Many people with low vitamin D have no symptoms. When symptoms do appear, they can be vague.

• Tiredness and low energy
• Bone pain or lower back pain
• Muscle weakness, aches or cramps
• Frequent infections
• Slow healing of wounds
• In children, delayed growth or bowed legs in severe cases

These symptoms can have many other causes, so testing is the only way to know.

Testing your levels

The 25-hydroxy vitamin D blood test is the standard way to check your levels. It does not require fasting. Labs may use slightly different ranges, but as a general guide:

• Below 20 ng/mL is usually considered deficient
• 20 to 30 ng/mL is often considered insufficient
• 30 to 100 ng/mL is generally considered adequate

Your doctor will interpret the result based on your age, health and symptoms.

Getting more vitamin D

Sensible sun exposure helps. Exposing your face, arms and legs to sunlight for about 15 to 30 minutes, a few times a week, may support vitamin D production, though the right amount depends on skin tone, season and time of day. Avoid sunburn and take care during very hot afternoons.

Food sources are limited, but include:

• Oily fish such as salmon, sardines and mackerel
• Egg yolks
• Mushrooms exposed to sunlight
• Fortified milk, oils and cereals

About supplements

Doctors often prescribe vitamin D supplements to correct a deficiency, sometimes as weekly or monthly doses. Please do not start high-dose supplements on your own. Vitamin D is stored in the body, and taking too much over time can raise calcium levels and cause nausea, weakness, kidney problems and other harm.

• Take supplements only in the dose and duration your doctor advises
• Recheck your levels after a few months if your doctor suggests it
• Tell your doctor about other calcium or vitamin products you take

Who should consider testing

You may benefit from a test if you have bone pain, frequent fractures, muscle weakness, a mostly indoor lifestyle, or conditions affecting absorption, or if you are older, pregnant or breastfeeding. Please consult your doctor to decide whether testing and supplements are right for you.