Vitamone D: Rationalization vs Sensationalization

Vitamin D or cholicalciferol is a unique vitamin in the sense that apart from the dietary sources, it can be synthesized by our body through direct sun exposure. It is also recognized as pro-hormone or vitamone because it is synthesized in skin and transported to other sites for its action via vitamin D receptors present on various tissues. In the past decade, interest in this particular vitamin grown up due to identification of multi-systemic role played by it apart from calcium homeostasis. It led to increased interest in knowing the serum vitamin D levels globally in healthy individuals as well as with various systemic disorders. Through vast number of studies it has been proven that Vitamin D deficiency is associated with multiple systemic disorders viz. Cardiovascular Diseases, Metabolic syndrome, Diabetes, various Cancers, Autoimmune disorders, Materno-fetal outcomes etc. It has also been observed that vitamin D deficiency is quite prevalent in healthy population as well. In country like India, according to reference range of western countries more than 50% of the healthy population too is vitamin D deficient. There are numerous causes of vitamin D deficiency like decreased outdoor activity, environmental pollution, overclothing, injudicious use of sunscreen lotions with higher SPF, darker skin, old age, decreased dietary intake, genetic variations in various vitamin carrier protein and metabolizing enzymes etc. Even though popularly known that 90% of Vitamin D comes from sunlight exposure, vitamin D supplement have been widely advertised and practiced, in part to avoid complications like sun-burns, skin cancers and possible defect in vitamin D metabolism pathway. Supplementations with vitamin D have resulted in improved serum vitamin D levels. They have been widely used as supplements for prevention and aid in treatment of many disorders. Data related to their effect on disease outcome have started to come in past few years. Meta-analysis of various randomized controlled trials reveals that even though vitamin D supplementation result in improvement in vitamin D status, but there result in improvising the overall morbidity and mortality is not convincing. Results of Clinical trials are in there early stage, multiple shortcomings of these early trials needs to be identified. It will be keen to watch how fair vitamin D play its role in becoming a miracle drug.