Vitamin D
Vitamin D deficiency is estimated to be present in around 90 per cent of the UAE population Image Credit: Pixabay

Abu Dhabi: Since residents in the UAE have been staying indoors for almost 60 days now due to movement restrictions in the country in view of the COVID-19 pandemic, resulting in negligible exposure to sunlight, they could well suffer from Vitamin D deficiency, medical practitioners have warned.

The global coronavirus outbreak has seen fewer people visit hospitals and clinics for ailments other than those related to COVID-19. As a result, hospitals and clinics have registered a significant drop in people seeking consultations for Vitamin D deficiency.

Research shows that 90 per cent of the population in UAE suffers from Vitamin D deficiency. Physicians in the country have advised residents to maintain the intake of supplementary dosages for Vitamin D, while staying indoors, and telecommunicate with their doctors as and when required.

Vitamin D level
A Vitamin D level of 20 nanograms/millilitre to 50 ng/mL is considered adequate for healthy people. A level less than 12 ng/mL indicates Vitamin D deficiency.

Speaking to Gulf News, Dr Satish Chandra Kini, specialist Internal Medicine at NMC Specialty Hospital, Al Ain, said: “We routinely receive patients with Vitamin D deficiency. But lately, the numbers are lesser as many patients refrain from visiting hospitals due to restrictions over COVID-19. We try to be in touch with patients through our teleconsultation services and advise them favourable treatment modules.”

He further said: “Definitely, the incidence of Vitamin D deficiency will increase amongst the residents while staying indoors for a long duration, coupled with lack of enough physical activity and a wrong dietary regime.”

Dr Kini added: “This will increase the risk of cardiovascular diseases, asthma, cancer and weakened bones. Vitamin D could also play a role in the prevention and treatment of a number of conditions, including Type 1 and Type 2 diabetes, hypertension, glucose intolerance and multiple sclerosis.”

Dr Ayesha Khaled, consultant, Family Medicine, from Burjeel Medical Centre in Abu Dhabi, said: “Our body can’t produce Vitamin D if we merely sit indoors by a sunny window because ultraviolet B (UVB) rays (needed by the body to produce Vitamin D) can’t get through the glass window pane.”

Vitamin D deficiency and COVID-19 link
Vitamin D is necessary for the proper functioning of the immune system, which is the first line of defence against infection and disease. A deficiency of this nutrient may compromise immune response.
British researchers recently found an association between low average levels of Vitamin D and high numbers of COVID-19 cases and mortality rates across 20 European countries. According to them, Vitamin D has been shown to protect against acute respiratory infections, and older adults, the group most deficient in Vitamin D, are also the ones most seriously affected by COVID-19.

She said: “It is not something that patients actively enquire about. A lot of patient focus has shifted towards coronavirus and how to prevent their family and themselves from contracting it. But we should also look after our general health.”

Dr Manoj Kumar Jangid, specialist, paediatrics at NMC Royal Hospital in Dubai, said: “With the current situation, we all are forced to stay indoors for our safety, but poor exposure to sunlight increases the risk of Vitamin D deficiency, which may lead to poor mental health including anxiety, depression and problems with immunity besides weaker bones.”

Vitamin D deficiency symptoms among children

Many people with low Vitamin D do not have symptoms, but children with low Vitamin D can get bone and muscle pain, he cautioned. “Low Vitamin D can lead to soft bones, causing rickets in children and osteomalacia in adolescents and adults. In rickets, bones can bend and cause ‘bow legs’ or ‘knock knees’. Low Vitamin D can also lead to low calcium levels, which can cause muscle cramps in children and even seizures (convulsions), particularly in babies,” Dr Jangid explained.

People in homes with balconies or those that receive direct sunlight should spend between 30 minutes and an hour to accumulate this vitamin. If one is prone to sunburn, opt for a shorter exposure period, Dr Jangid advised.

Vitamin D deficiency is estimated to be present in around 90 per cent of the UAE population, according to studies conducted by Dubai Health Authority (DHA) in 2017. This is expected to get worse during long days of staying indoors, he said.

Dr Yasser Nakhlawi, consultant in paediatrics and director of Clinical Affairs at Al Zahra Hospital in Dubai: “If left untreated over time, Vitamin D deficiency can lead to serious bone disorders. For example, severe and long-term Vitamin D deficiency may result in rickets or osteomalacia.

The recommended daily intake of Vitamin D is between 400 international units (IU) and 600 IU for most healthy individuals. Those in the high-risk category for Vitamin D deficiency may need to take a supplement, he said.

Dr Igbal Mubarak Sirag, specialist, internal medicine, at Bareen International Hospital in Abu Dhabi, said: “Staying indoors for 60 days may result in a significant decrease in a person’s exposure to sunlight. Accordingly, this may result in a significant reduction in the synthesis of Vitamin D in the body.”

Symptoms of deficiency

Symptoms vary from person to person. Most are asymptomatic. However, a few may have symptoms like body pain, bone and joint pain, back pain. Severe cases may lead to osteoporosis, osteomalacia. Vitamin D deficiency occurs when the body does not have enough Vitamin D to properly absorb the required levels of calcium and phosphate. Mild to moderate Vitamin D deficiency can lead to bone pain and weakening of the bones (osteoporosis). This could make you more prone to fractures in case of a fall. More severe levels of deficiency can lead to the development of rickets in children and osteomalacia in adults.

How to maintain optimum level of Vitamin D

Vitamin D is not easily found in all food items. It’s mostly found in animal, dairy products, oily fish such as salmon, mackerel, sword fish, herring, tuna and sardines, as well as in red meat, egg yolk, mushrooms and cod liver oil.

To ensure that the body generates enough Vitamin D, at least two-thirds of the human body should be exposed to sunlight for two-to-three hours daily.

However, this is not practical in the UAE considering the extreme weather conditions. Hence, taking supplements, as advised by health-care professionals, in the form of oral medications and injections is necessary.