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To Screen or Not - Has Sun Avoidance Gone Too Far?

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The sad case of Jayden Wray has drawn attention to what is probably the commonest malnutrition in UK - the lack of vitamin D or "sunshine" vitamin. It is difficult to believe that in this age of plenty where there is an epidemic of obesity, more than 50% of the population suffers from vitamin D deficiency! Despite surveys and reports revealing the extent of deficiency, when was the last time your doctor offered to check your vitamin D? Common symptoms include chronic fatigue, vague body ache, weakness and muscle cramps.

Increasingly more patients are presenting with rickets and osteomalacia - but don't have high expectations of your doctor's ability to diagnose the condition early as patients with mild deficiency may not show any symptoms. The reality is that the likelihood of deficiency is probably not even considered by most doctors including specialists, as the case of Jayden showed. Even some cancers, heart disease, diabetes and immunological conditions may be associated with vitamin D deficiency, but more often than not blood levels are not measured even by specialists!

A number of factors including sun avoidance, more people working in office than working in the fields, children preferring computers and television to playing outdoors, longer life and rising obesity may be contributing to the rising incidence. Patients who suffer from malabsorption and those who have undergone bariatric surgery like gastric band, sleeve gastrectomy, gastric bypass or duodenal switch are especially vulnerable.

Overexposure of sun may lead to melanoma but lack of exposure leads to vitamin D deficiency. Between April to September, only 20 minutes of daily exposure to direct sunlight will allow the body to make enough vitamin D, though people with darker skins need more as melanin contained in dark skin blocks sun. During the remainder of the year there is not enough sunshine in the UK, therefore food like eggs, oily fish, fortified cereals and liver in the diet can be helpful. Mother's milk is generally not high in vitamin D. Food will typically provide only 10% of daily requirement in adults - hence vitamin D supplements can be very important in the northern hemisphere. These supplements are widely available over the counter and do not require a prescription.

However, supplementation will not treat someone with deficiency. Therefore, if you are suffering from fatigue, pain or weakness then ask your GP if he has considered vitamin D deficiency and measured blood levels. And if you have a baby, especially one that suffers from irritability, poor growth, tooth decay, breathing difficulties, seizures or fractures then talk to your doctor about the need for measuring vitamin D levels and treating any underlying deficiency.

Around the Web

Jayden Wray death: Couple wrongly blamed for shaking their rickets ...

Baby Jayden case renews concerns over rickets and 'child abuse ...

BBC News - Parents cleared over Jayden Wray death of rickets

Vitamin D Deficiency: Symptoms, Causes, and Health Risks

Hypovitaminosis D - Wikipedia, the free encyclopedia

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