Quick answer
Vitamin D deficiency is common in India because many people spend little time in direct sunlight, cover most of their skin outdoors and eat few foods rich in vitamin D. It often has no symptoms, but can cause tiredness, bone pain and muscle weakness. A simple blood test confirms it, and a doctor can advise on sunlight, food and supplements.
Vitamin D helps your body absorb calcium and keeps bones and muscles healthy. Your skin makes vitamin D when exposed to the sun’s UVB rays, which is why deficiency in a sunny country can seem surprising. Studies across India have repeatedly found low vitamin D levels in large parts of the population, in cities and villages alike.
Why deficiency is common in India
- Indoor lifestyles: office work, schooling and commuting mean little sun exposure.
- Covered skin and sunscreen: less exposed skin means less vitamin D is made.
- Darker skin: more melanin means you need longer sun exposure to make the same amount.
- Air pollution: haze can reduce the UVB light that reaches the ground.
- Diet: few common Indian foods are naturally rich in vitamin D, especially in vegetarian diets.
- Other factors: obesity, older age, some digestive and kidney conditions, and certain medicines.
Signs and symptoms
Many people have no symptoms. When symptoms appear, they can include:
- Tiredness and low energy
- Bone or lower back pain
- Muscle weakness, aches or cramps
- In children, severe deficiency can cause rickets, which affects bone growth
- In adults, severe deficiency can cause osteomalacia, or soft bones
These symptoms have many possible causes, so do not assume vitamin D is the reason without a test.
How it is tested
A blood test called 25-hydroxyvitamin D measures your vitamin D level. Many laboratories treat levels below about 20 ng/mL as deficient, but cut-offs vary. Your doctor will interpret your result along with your symptoms and health history.
How to get enough vitamin D
Sunlight
Short, regular exposure of your arms and face to sunlight, without burning, helps your skin make vitamin D. Midday sun has the most UVB, but avoid long exposure in peak summer heat. Your doctor can advise what is sensible for you.
Food
- Fatty fish such as salmon, mackerel and sardines
- Egg yolks
- Fortified foods, such as some milk and edible oils. Look for the FSSAI “+F” logo on fortified products.
- Mushrooms exposed to UV light
Supplements
If you are deficient, your doctor may prescribe vitamin D supplements. Take them only as advised. Very high doses over time can cause vitamin D toxicity, which raises calcium levels and can harm the kidneys and heart. Nutrition guidelines in India and the US use about 600 IU (15 micrograms) a day as the requirement for most adults, but treatment doses for deficiency are decided by a doctor.
Frequently asked questions
Why is vitamin D deficiency common in India despite sunlight?
Indoor lifestyles, covered skin, darker skin tones, pollution and diets low in vitamin D all reduce the amount people get, even in a sunny country.
What is the test for vitamin D deficiency?
A blood test called 25-hydroxyvitamin D measures your vitamin D level. Your doctor will interpret the result.
Can I take vitamin D supplements without a prescription?
Some low-dose supplements are sold over the counter, but you should speak to a doctor first. High doses over time can be harmful.
Sources and further reading
- NIH Office of Dietary Supplements: Vitamin D fact sheet
- ICMR National Institute of Nutrition
- FSSAI: Food fortification
Featured image: Photo: Manish kumar talnia / Wikimedia Commons (CC BY-SA 4.0)
This article is for general information and is not medical advice. Speak to a qualified doctor about your own health.
