Liv Hospital Internal Medicine and Geriatrics Specialist Assoc. Dr. Birkan İlhan talked about the importance of vitamin D deficiency and sources of vitamin D in elderly individuals.
Dr. Birkan İlhan talked about vitamin D deficiency as follows: “Vitamin D is synthesized in the skin with the help of sunlight. For this reason, it is also known as the sun vitamin among the people. Direct sunlight contact with the skin is required for synthesis. It can only be taken with food in very small amounts. Vitamin D, which is synthesized in the skin and taken with food, is transformed into a more effective form by undergoing changes in the liver and kidney.
Vitamin D ensures the absorption of calcium and phosphorus taken from the intestines with food. Thus, it provides the mineralization of the bone, that is, its hardness. It is also necessary for the health of the muscles. In vitamin D deficiency, bone weakness, increased bone fragility, muscle weakness, increased risk of falling and fractures can occur.
Decreased mobility with aging, prolongation of the time spent indoors, decreased capacity of the skin to produce vitamin D, inadequacy of dietary intake of vitamin D, decreased intestinal absorption and low kidney activity cause vitamin D deficiency to be seen more frequently in older ages. ”
Birkan İlhan informed that vitamin D deficiency seen in advanced ages causes softening of bones (osteomalacia), decrease in bone mass and increase in bone fragility (osteoporosis). İlkan said, “Since it causes deterioration in balance and decrease in muscle strength, falls are more common and fractures may occur in the bones, especially in the hip. In addition, pain, muscle cramps, muscle spasms, especially in the hands and legs are seen. The pain usually starts in the lower back and can spread to the hips, back and ribs. In vitamin D deficiency, the ability to walk and move decreases. In fact, some studies have shown that vitamin D deficiency is associated with forgetfulness, depression, immunity, cancer and diseases related to the cardiovascular system.
Only 10-20 percent of the vitamin D need can be obtained with food, while 80-90 percent is met by synthesizing the skin with the effect of sunlight (UVB). In other words, the main source of vitamin D for many people is direct contact with sunlight. The sun rays taken from the clothes or behind the glass are not effective in the synthesis of vitamin D. The sunscreens used also prevent the production of vitamin D in the skin. Fatty fish (salmon, sardines, swordfish, mackerel, tuna…), fish oil, egg yolk, milk, butter, oats, sweet potatoes, oil and liver contain vitamin D from foods. Plants such as parsley, alfalfa and nettle contain vitamin D.
Ilkan said, “The appropriate dose should be determined by the doctor according to the vitamin D measurement results and the targeted vitamin D values.” Adequate amount of calcium should be taken with it for bone and muscle health. Calcium intake should be 65 mg per day. For example, each 1200 mg of white cheese contains 100 mg of calcium, 169 mg of cheddar cheese contains 100 mg of calcium, and 350 mg of plain-low-fat yogurt contains 100 mg of calcium.
It is important that the doses of vitamin D are adjusted by the physician, because high doses of vitamin D are also harmful, such as low vitamin D. Vitamin D poisoning can cause blood calcium levels to rise too high, causing kidney stones, kidney failure, and other life-threatening conditions. In the treatment, mostly drops, capsules or tablets containing vitamin D are used. Since vitamin D in ampoules contains very high doses, it is used only in a limited patient group and is almost never preferred in elderly individuals.
In elderly individuals, vitamin D supplementation in appropriate doses helps to reduce hip and spine fractures. It is also known to reduce falls, help strengthen bones, improve muscle strength, and reduce aches and cramps. It also has positive effects on the cardiovascular system, forgetfulness, depression, and cancer.”
Dr. İlhan concluded his speech by saying: “Older-aged individuals are more vulnerable to heat. Because the ability to detect and correct changes in body temperature decreases with age. In addition, many elderly people have more than one chronic condition and many different drugs they use. Some of the drugs increase the loss of water from the body and thus can cause the body to become dehydrated in hot weather. This adversely affects many organs, especially the kidneys. Dehydration is one of the health problems associated with sunstroke. Therefore, it is important to drink plenty of water in the nutrition of the elderly. Alcoholic or caffeinated beverages should be avoided as they can increase water loss from the body.
Wearing wide hats to protect the head area and strenuous activities such as exercising outdoors during very hot times of the day should be avoided. When there is high humidity in the air, the body's ability to absorb itself through sweating becomes more difficult. Headache, dizziness, nausea, rapid heartbeat, chest pain, fainting, and difficulty breathing can all be indicators of overexposure to heat and sun. Caution should be exercised when such symptoms are observed.”