Jayanti Acharya, 62, had never been ill in her life. She had never had an accident. So when she learnt that she had multiple fractures in her bones, she was shocked. The doctor who examined her was not. He ordered a blood test, and it confirmed what he had guessed: Acharya had Vitamin D deficiency.
Lasata Bajracharya, 17, began to feel pain in the hip late last year. She initially ignored the aches, and kept going to school. The pain did not subside, and she suffered unbearable muscle cramps. A blood test revealed she was suffering from Vitamin D deficiency.
Raj Shahi, 28, was passionate about martial arts, and always aspired to be an ace karate player. But a bone disorder caused by low Vitamin D forced him to give up the dream. Instead of practicing karate, he is now in physiotherapy.
Chandika Gurung, 42, was being treated for a thyroid disorder when she started suffering chronic joint pain. Soon, she could not even walk or stand up. A blood test showed it was due to a sharp drop in Vitamin D.
An increasing number of Nepalis are falling victim to a nationwide epidemic of Vitamin D deficiency as they adopt an urban life-style, stay indoors a lot and do not work or stay outdoors under the sun.
Exact data on the percentage of Nepalis suffering from low Vitamin D is not available, but doctors interviewed for this article all agreed that it is now becoming a national health emergency.
“Residents of Kathmandu Valley are at very high risk of Vitamin D deficiency, which leads to a host of medical complications,” says Sunil Poudel, an orthopedic specialist at Spark Health Home.
A research team found low Vitamin D levels in 74% of 2,158 patients at a medical lab in Pokhara in 2014-15 and published the finding in the Journal of Medicine and Medical Sciences in 2016. In Kathmandu, a study conducted seven years ago at a nursing home found that out of 50 patients who were treated, 78% had low Vitamin D.
Worryingly, Vitamin D deficiency is affecting under-five children more than other age groups, leaving them with life-long ailments. A study conducted by University of Oslo in 2013, examined 280 children below five in various parts of rural Nepal, and found that 91% had low Vitamin D. The same research showed that children who had been breast-fed had higher levels of vitamin D.
Decoding Vitamin D
Vitamin D is vital for humans as it enhances their capacity to absorb calcium, which protects bones from rickets, osteomalacia and other disorders resulting in thin, brittle, misshapen and broken bones.
Vitamin D is naturally found in very few food items like egg yolk, cheese and salmon. But 15 minutes of exposure to direct sunlight every day is enough to replenish Vitamin D levels in the body. Ultra-violet solar radiation allows the skin to generate Vitamin D which is then transported to the liver and kidney.
Depressed Vitamin D levels do not directly kill people, but it makes them susceptible to other deadly diseases like diabetes, asthma, cardiac arrest, paralysis, thyroid, dementia, Alzheimer’s, Parkinson’s and cancer.
However, despite its prevalence only a few Nepalis know about the importance of Vitamin D for good health. Most patients find out about it only when they go to hospitals to treat a different symptom caused by insufficient level Vitamin D in the blood.
A majority of kidney patients being treated at Grande International Hospital have been found to have low Vitamin D. Nephrologist Bishnu Pahari says: “This proves that there is a direct correlation between Vitamin D deficiency and renal failure.”
Vitamin D deficiency can also lead to depression, says psychologist Saroj Ojha: “If the body doesn’t get enough exposure to sunlight, it does not secrete enough of the hormone, serotonin. Vitamin D supplements are prescribed for some patients with signs of depression.”
What was once regarded as a condition confined to countries in the polar regions where the sun does not shine for 4-6 months in a year, is now a disease found all over the world as people move to cities and do not stay outdoor enough.
Says Poudel: “Those who mostly stay in shaded rooms, or apply sun block before stepping outside are more susceptible to Vitamin D deficiency.”
Nepali film actresses Keki Adhikari and Richa Sharma have recently found out that they have low Vitamin D, and both are on supplements. They said in an interview that since the film industry demands for fair skin, they could not expose themselves to the sun. Public health experts say, the stigma against dark skinned people and the increasing use of fairness creams is contributing to the Vitamin D crisis. Doctors usually prescribe Vitamin D capsules to patients, but nutrition expert Aruna Uprety does not endorse this: “If nature has blessed us with a bright sun, why do we need Vitamin D supplements. Just let the sun shine on you.”
(Some names have been changed)
Vitamin A: Important for vision and immune system. Found in carrots, vegetables and meat.
Vitamin B: Needed for cell metabolism. Found in nuts and berries.
Vitamin C: Helps prevent scurvy and heart disease. Found in citrus fruits.
Vitamin D: Helps absorb calcium and magnesium, prevents diseases. Found in sunshine, egg yolk, seafood.
Vitamin E: Prevents heart diseases and repairs damaged skin. Found in nuts, wheat germ and fruits.
Vitamin K: Promotes blood clotting and bone metabolism. Found in fruits, meat, dairy and fermented foods.