Vitamin D for women: benefits and deficiency

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Vitamin D for women: benefits and deficiency

I. Introduction: The role of vitamin D in the female body

Vitamin D, often called “solar vitamin,” plays a key role in maintaining women’s health throughout life. Unlike other vitamins, vitamin D acts as a hormone, affecting numerous physiological processes. It is not just necessary for the health of bones; Its influence applies to the immune system, reproductive function, health of the cardiovascular system, and even mental well-being. Vitamin D deficiency is common among women, especially in certain age groups and geographical regions, and can lead to serious health consequences. Understanding the importance of vitamin D and awareness of risk factors of deficiency are critical for ensuring the optimal health and well -being of women.

II. Physiology of vitamin D: synthesis, metabolism and functions

A. Vitamin D:

  • Skin synthesis: The main source of vitamin D for humans is its synthesis in the skin under the influence of ultraviolet radiation of type B (UVB) of sunlight. The process begins with the transformation of 7-dehydrocholesterol (7-DHC) in the skin into previtamin D3. Previtamin D3 is rapidly isolated into vitamin D3 (cholecalciferol). The effectiveness of synthesis depends on many factors, including:

    • Time of day and year: The synthesis of vitamin D is effective only when the sun is high enough in the sky so that UVB-rays can penetrate through the atmosphere. In most regions, this means that the synthesis of vitamin D is almost impossible in the winter months.
    • Latitude: The farther from the equator, the less UVB-rays reaches the surface of the earth, especially in winter.
    • Cloud and air pollution: Clouds and air pollution absorb UVB ray, reducing the effectiveness of the synthesis of vitamin D.
    • Skin color: Melanin, the pigment responsible for skin color, absorbs UVB rays. People with darker skin need more time being in the sun to synthesize a sufficient amount of vitamin D.
    • Age: With age, the ability of the skin to synthesize vitamin D decreases.
    • Use of sunscreen: Sunscreen creams, even with low SPF, significantly block UVB ray and can reduce the synthesis of vitamin D.

  • Food sources: Vitamin D can also be obtained from food, although food sources are limited. The main food sources include:

    • Fat fish: Salmon, tuna, mackerel and herring are good sources of vitamin D.
    • Egg yolks: They contain a small amount of vitamin D, but its content can vary depending on the diet of chicken.
    • Enriched products: Some products, such as milk, yogurt, juices and flakes, are enriched with vitamin D.

B. Vitamin D metabolism:

  • The first hydroxylation in the liver: Vitamin D3 (cholegalciferol), obtained from leather or food, is first metabolized in the liver with a 25-hydroxylase enzyme (CYP2R1) up to 25-hydroxyvitamin D [25(OH)D]also known as calciol. 25 (OH) D is the main circulating form of vitamin D and is used to assess the status of vitamin D.
  • The second hydroxylation in the kidneys: 25 (OH) D is then transported to the kidneys, where it is subjected to the second hydroxylating by the enzyme 1α-hydroxylase (CYP27B1) with the formation of 1.25-dihydroxyvitamin D [1,25(OH)2D]also known as calcitriol. Calcitriol is the most active form of vitamin D and is a hormone that regulates the metabolism of calcium and phosphates.
  • Regulation 1α-hydroxylase: The activity of 1α-hydroxylase is strictly regulated by the level of parathyroid hormone (PTH), calcium and phosphates. The low level of calcium or phosphates stimulates the production of PTG, which, in turn, stimulates the activity of 1α-hydroxylasis, increasing the production of calcitriol.

C. Vitamin D:

  • Regulation of calcium and phosphate homeostasis: Calcitriol binds to vitamin D (VDR) receptors in the intestines, kidneys and bones, regulating the expression of genes involved in the metabolism of calcium and phosphates. It stimulates the absorption of calcium in the intestines, calcium reabsorption in the kidneys and mobilization of calcium from bones.
  • Bone health: Vitamin D is necessary to maintain bone health throughout life. It provides sufficient intake of calcium for bone mineralization and prevents the development of rickets in children and osteomination and osteoporosis in adults.
  • Immune function: VDR is expressed in various immune cells, including T cells, B cells and macrophages. Vitamin D modulates the immune function, enhancing congenital immunity and suppressing adaptive immunity. This can help protect against infections and autoimmune diseases.
  • Regulation of cellular growth and differentiation: Vitamin D is involved in the regulation of cellular growth and differentiation. It can inhibit the proliferation of cancer cells and stimulate their differentiation.
  • Cardiovascular health: Studies show that vitamin D deficiency can be associated with an increased risk of cardiovascular disease, such as hypertension, heart failure and stroke. Vitamin D can have a protective effect on the cardiovascular system, reducing blood pressure, improving the function of the endothelium and reducing inflammation.
  • Reproductive function: Vitamin D plays an important role in the reproductive function of women. VDR is expressed in ovaries, uterus and placenta. Vitamin D may affect the production of sex hormones, ovulation, implantation and development of pregnancy. Vitamin D deficiency can be associated with infertility, polycystic ovary syndrome (PCO) and pregnancy complications.
  • Mental health: Some studies associate the deficiency of vitamin D with an increased risk of depression, seasonal affective disorder (SAR) and other mental disorders. Vitamin D may affect the production of neurotransmitters, such as serotonin and dopamine, which play an important role in regulation of mood.

III. The prevalence of vitamin D deficiency in women

Vitamin D deficiency is a global healthcare problem that affects a significant part of the population, especially women. The prevalence of deficiency varies depending on the geographical region, age, ethnicity, lifestyle and other factors.

A. Determination of vitamin D deficiency:

The status of vitamin D is usually estimated by measuring level 25 (OH) D in blood serum. There are different definitions of deficiency, insufficiency and sufficient vitamin D level, but the most common criteria are as follows:

  • Deficiency: 25(OH)D < 20 нг/мл (50 нмоль/л)
  • Failure: 25 (oh) d 20-29 ng/ml (50-75 nmol/l)
  • Sufficient level: 25 (oh) d ≥ 30 ng/ml (75 nmol/l)

B. Factors affecting the prevalence of deficiency:

  • Geographical position: The prevalence of vitamin D is higher in regions with high breadth, where sunlight is limited over the course of most of the year.
  • Top of year: Vitamin D levels are usually lower in the winter months, when solar activity decreases.
  • Age: Elderly women are at greater risk of vitamin D deficiency due to a decrease in the ability of the skin to synthesize vitamin D and a decrease in the function of the kidneys necessary to activate vitamin D.
  • Ethnicity: Women with darker skin have a higher risk of vitamin D deficiency, since melanin absorbs UVB rays and reduces the synthesis of vitamin D in the skin.
  • Body mass index (BMI): Obesity is associated with the lower levels of vitamin D. Vitamin D is fat -soluble, and in people with obesity vitamin D can be secreted in adipose tissue, which reduces its accessibility for circulation.
  • Diet: Low consumption of products rich in vitamin D can contribute to deficiency.
  • Pregnancy and lactation: The need for vitamin D increases during pregnancy and lactation.
  • Some diseases: Some diseases, such as malabsorption, Crohn’s disease, cystic fibrosis and kidney disease, can affect the absorption of vitamin D.
  • Medicines: Some drugs, such as glucocorticoids, antifungal drugs and anticonvulsants, can affect vitamin D.’s metabolism.
  • Use of sunscreen: Regular use of sunscreen blocks UVB ray and reduces the synthesis of vitamin D in the skin.
  • Life: A limited stay in the sun, work in the room and wearing closed clothing can increase the risk of vitamin D. deficiency.

C. Called statistics in women:

Statistical data on the prevalence of vitamin D deficiency in women vary depending on research and population, but, as a rule, show that a significant part of women suffers from deficiency or insufficiency of vitamin D.

  • In the United States, studies have shown that a significant part of women, especially African Americanists and Latin American, has a low level of vitamin D.
  • In Europe, the prevalence of vitamin D is higher in northern countries, where there is less sunlight.
  • All over the world, the prevalence of vitamin D is higher among pregnant women and women in postmenopausa.

IV. Consequences of vitamin D deficiency for women’s health

Vitamin D deficiency can have serious consequences for women’s health throughout life, affecting bone health, immune function, reproductive function, cardiovascular health and mental well-being.

A. Bone health:

  • Osteomulation: In adults, vitamin D deficiency can lead to osteomination, a condition in which the bones become soft and weak due to insufficient mineralization. Osteomulation can cause bone pain, muscle weakness and increased risk of fractures.
  • Osteoporosis: Vitamin D is necessary to maintain bone density. The chronic deficiency of vitamin D can contribute to osteoporosis, a disease characterized by a decrease in bone density and an increased risk of fractures. Women, especially in postmenopausa, are susceptible to increased risk of osteoporosis due to a decrease in estrogen levels, which can aggravate the effect of vitamin D. Fractures associated with osteoporosis can lead to significant disability, pain and a decrease in quality of life.
  • Increased risk of fractures: Vitamin D deficiency increases the risk of falls and fractures, especially in elderly women. Muscle weakness caused by vitamin D deficiency can worsen the balance and increase the likelihood of falls.

B. Immune function:

  • Increased susceptibility to infections: Vitamin D plays an important role in the immune function. Vitamin D deficiency can weaken the immune system and increase susceptibility to infections such as respiratory infections, flu and pneumonia.
  • Autoimmune diseases: Some studies associate the deficiency of vitamin D with an increased risk of autoimmune diseases, such as multiple sclerosis (RS), rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Vitamin D can modulate the immune function and help prevent autoimmune reactions.
  • Inflammatory diseases of the intestine (BCC): Vitamin D deficiency can play a role in the development and progression of OKK, such as Crohn’s disease and ulcerative colitis.

C. Reproductive function:

  • Infertility: Vitamin D plays an important role in the reproductive function of women. Vitamin D deficiency can be associated with infertility, problems with ovulation and a decrease in the likelihood of conception.
  • Polycystic ovary syndrome (PCU): SPCI is a common endocrine disorder that affects women of reproductive age. Vitamin D deficiency is often found in women with PCO and can aggravate the symptoms of PCO, such as irregular menstruation, hyperandrogenia and insulin resistance.
  • Pregnancy complications: Vitamin D deficiency during pregnancy can be associated with an increased risk of pregnancy complications, such as preeclampsia, gestational diabetes, premature birth and low weight at birth.
  • Bacterial vaginosis: Some studies involve the relationship between the low level of vitamin D and bacterial vaginosis.

D. Cardiovascular health:

  • Hypertension: Vitamin D deficiency can be associated with an increased risk of hypertension (high blood pressure). Vitamin D can help regulate blood pressure, improving the function of the endothelium and reducing inflammation.
  • Heart failure: Some studies associate the deficiency of vitamin D with a high risk of heart failure.
  • Stroke: Vitamin D deficiency can increase the risk of stroke.

E. Mental health:

  • Depression: Some studies associate the deficiency of vitamin D with an increased risk of depression, seasonal affective disorder (SAR) and other mental disorders. Vitamin D may affect the production of neurotransmitters, such as serotonin and dopamine, which play an important role in regulation of mood.
  • Fatigue: Chronic fatigue can be a symptom of vitamin D. deficiency.

F. Other health consequences:

  • The risk of cancer development: Some studies suggest that vitamin D deficiency can be associated with an increased risk of developing certain types of cancer, such as breast cancer, colon cancer and ovarian cancer. However, additional studies are needed to confirm these results.
  • Muscle weakness and pain: Vitamin D deficiency can cause muscle weakness, pain and cramps.
  • Chronic pain: The low level of vitamin D can contribute to chronic pain, such as fibromyalgia.

V. Screening and diagnosis of vitamin D deficiency

A. Who should be screening:

Vitamin D screening is recommended for women at risk of deficiency, including:

  • Elderly women
  • Pregnant and lactating women
  • Women with darker skin
  • Women with obesity
  • Women with malabsorption
  • Women with chronic diseases such as kidney diseases, liver diseases and OKK
  • Women taking medications that can affect vitamin D metabolism
  • Women with osteoporosis or osteopenia
  • Women with inexplicable pain in bones or muscle weakness

B. Diagnostic methods:

The diagnosis of vitamin D deficiency is made on the basis of measuring level 25 (OH) D in blood serum.

  • Blood test for 25 (oh) d: This is a standard test for assessing the status of vitamin D. Level 25 (OH) D reflects the total amount of vitamin D obtained from sunlight, food and additives.

C. Interpretation of the test results:

The test results for 25 (OH) D are interpreted in accordance with generally accepted criteria:

  • Deficiency: 25(OH)D < 20 нг/мл (50 нмоль/л)
  • Failure: 25 (oh) d 20-29 ng/ml (50-75 nmol/l)
  • Sufficient level: 25 (oh) d ≥ 30 ng/ml (75 nmol/l)

The doctor may recommend treatment if the level of vitamin D is low.

VI. Treatment and prevention of vitamin D deficiency in women

Treatment and prevention of vitamin D deficiency includes a change in lifestyle, dietary interventions and additives of vitamin D.

A. Life change change:

  • Sun stay: Regular stay in the sun can help increase the synthesis of vitamin D in the skin. It is recommended to spend 10-15 minutes a day in the sun, several times a week, without sunscreen, especially in the summer months. However, it is important to remember the risk of skin damage and skin cancer associated with excessive sun stay.
  • Diet: An increase in the consumption of products rich in vitamin D, such as oily fish, egg yolks and enriched products, can help increase the level of vitamin D.

B. Dietary sources of vitamin D:

  • Fat fish: Salmon, tuna, mackerel and herring are good sources of vitamin D.
  • Egg yolks: They contain a small amount of vitamin D, but its content can vary depending on the diet of chicken.
  • Enriched products: Some products, such as milk, yogurt, juices and flakes, are enriched with vitamin D.
  • Mushrooms: Some mushrooms, such as Shiitake mushrooms, contain vitamin D2.

C. Vitamin D supplements:

  • Types of vitamin D additives: Vitamin D additives are available in two main forms: vitamin D2 (ergocalciferol) and vitamin D3 (cholegalciferol). Vitamin D3, as a rule, is more effective for increasing the level of 25 (OH) D in blood serum than vitamin D2.
  • Recommended dosage: The recommended daily dose of vitamin D varies depending on the age, state of health and level of vitamin D. General recommendations:
    • Adults: 600-800 IU (15-20 μg) per day
    • Elderly people: 800-1000 IU (20-25 mcg) per day
    • Pregnant and lactating women: 600 IU (15 μg) per day
    • People with vitamin D deficiency may require a higher dose to quickly increase the level of vitamin D. The doctor can prescribe a shock dose such as 50,000 vitamin D per week for several weeks, and then switch to a maintenance dose.
  • Safety and side effects: Vitamin D is usually safe in recommended doses. However, taking too much vitamin D can lead to toxicity of vitamin D, which can cause symptoms, such as nausea, vomiting, weakness, frequent urination and kidney problems. It is important not to exceed the recommended upper border of vitamin D consumption, which is 4000 IU (100 μg) per day for adults.

D. Monitoring of treatment:

After the start of treatment of vitamin D deficiency, it is important to regularly monitor the level of 25 (OH) D in blood serum in order to make sure that the treatment is effective and that the level of vitamin D is within normal limits.

VII. Special considerations for women in different periods of life

A. Teenagers:

Sufficient consumption of vitamin D is crucial for adolescents, since this is a period of rapid growth of bones. In adolescence, vitamin D deficiency can lead to a decrease in peak bone mass, which increases the risk of osteoporosis in further life.

B. Pregnant and lactating women:

The need for vitamin D increases during pregnancy and lactation to ensure sufficient vitamin D intake for both the mother and the child. Vitamin D deficiency during pregnancy can be associated with complications of pregnancy, such as preeclampsia, gestational diabetes, premature birth and low weight at birth. It is recommended that pregnant and lactating women receive at least 600 IU vitamin D per day. Some experts recommend higher doses, such as 1000-2000 IU per day.

C. Women in postmenopause:

Women in postmenopause are at risk of osteoporosis due to a decrease in estrogen levels. Vitamin D is necessary to maintain bone density and reduce the risk of fractures. It is recommended that women in postmenopause receive 800-1000 vitamin D per day.

D. Women from PCOM:

Vitamin D deficiency is often found in women with PCO and can aggravate the symptoms of PCO, such as irregular menstruation, hyperandrogenia and insulin resistance. Vitamin D additives can help improve glucose metabolism, reduce the level of androgens and adjust the menstrual cycle in women with PCOS.

E. Vegetarians and vegans:

Vegetarians and vegans can be attended by increased risk of vitamin D deficiency, since the main food sources of vitamin D, such as oily fish and egg yolks, are not included in their diet. It is important that vegetarians and vegans consume enriched products and consider the possibility of taking vitamin D.

VIII. The role of doctors in the management of vitamin D in women

Doctors play an important role in managing vitamin D status in women.

A. Risk assessment and screening:

Doctors must evaluate the risk of vitamin D deficiency in their patients and screening, if necessary.

B. Recommendations on lifestyle and diet:

Doctors must advise patients about lifestyle and diet, which can help increase vitamin D.

C. Purpose of vitamin D additives:

Doctors can prescribe vitamin D to women with vitamin D.

D. Monitoring and subsequent observation:

Doctors must monitor the level of vitamin D in their patients and conduct subsequent observation to make sure that the treatment is effective.

E. Direction to specialists:

Doctors can direct patients to specialists such as endocrinologists or nutritionists, for further examination and treatment, if necessary.

IX. Research and future areas

Studies of the role of vitamin D in the health of women continue. Future studies include:

  • Further study of the influence of vitamin D on the risk of cancer.
  • The study of the role of vitamin D in the prevention and treatment of autoimmune diseases.
  • Studying the optimal dose of vitamin D for various population groups.
  • The study of genetic factors affecting the status of vitamin D.
  • Development of new strategies to improve vitamin D in women.

X. Key conclusions and recommendations

  • Vitamin D plays a key role in maintaining women’s health throughout life.
  • Vitamin D deficiency is common among women and can have serious health consequences.
  • Screening for vitamin D deficiency is recommended for women at risk of deficiency.
  • Treatment and prevention of vitamin D deficiency includes a change in lifestyle, dietary interventions and additives of vitamin D.
  • Doctors play an important role in managing vitamin D status in women.
  • Additional studies are needed to fully understand the role of vitamin D in women’s health.

Note: This article is intended only for information purposes and should not be considered as a replacement for a professional medical consultation. Always consult your doctor before starting any new treatment plan or take any additives.

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