Vitamin D deficiency is highly prevalent in India, almost in epidemic proportions. There are several reasons for deficiency of vitamin D. Lack of food fortification policies and more commonly our sociocultural practices, ‘sun-fleeing’ behavior, are major factors contributing to deficiency of this ‘sunshine vitamin’ in India which has abundant sunshine. Many people are unaware that they are vitamin D deficient.
Vitamin D, as we know, is essential for bone health. Evidence has also demonstrated its role in chronic diseases such as cardiovascular disease, cancer, diabetes, infertility, dementia and autism, among others.
There are two forms of vitamin D: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). D2 is plant-based and D3 is derived from animal sources.
Vitamin D levels below 20 ng/ml need to be treated and are an indication for vitamin D supplementation.
The question arises which one to choose: vitamin D2 or D3?
Several international guidelines have recommended either D2 or D3 for vitamin D deficient patients stating that the two forms of vitamin D are equivalent and are equivalent in their effectiveness in treating patients with low vitamin D levels.
However, findings of a new randomized-controlled trial from the UK have raised questions on these recommendations as the study found that vitamin D3 was twice as effective in increasing levels of serum 25-hydroxyvitamin D (25[OH]D) compared to vitamin D2 at a low dose of 15 μg daily.
In the study published online July 5, 2017 in the American Journal of Clinical Nutrition, vitamin D3 fortified foods (juice, biscuits) during winters led to higher serum 25[OH]D levels after 12 weeks of supplementation compared to D2 fortified foods (juice, biscuits) in healthy South Asian and white European women.
Vitamin D levels in women who received vitamin D3 via juice or a biscuit increased by 75% and 74%, respectively vs those who were given D2 through the same methods. Those given D2 saw an increase of 33% and 34% over the course of the 12-week intervention.
Therefore, D3 should be the preferred form when advising vitamin D supplementation as it is the most effective form of increasing vitamin D levels in the body.
Even low doses of vitamin D3 are effective in achieving the desired levels as demonstrated in this study.
Sources
1. University of Surrey, Eurekalert Press Release, July 5, 2017.
2. Tripkovic L, et al. Am J Clin Nutr. 2017 Jul 5. Epub ahead of print
Dr KK Aggarwal
National President IMA & HCFI
Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)
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