Vitamin D holds central importance as it plays a crucial role in many acute and chronic diseases. It is a fat-soluble vitamin, which can be endogenously produced by UV rays from sunlight and can be synthesised by the skin. However, it is biologically inert, and it undergoes hydroxylation in the liver to get converted into an active form of 25-hydroxyvitamin D to 1,25 dihydroxy vitamin D in the kidney. Its deficiency is crucial as it promotes disorders related to the musculoskeletal system.
Role of Vitamin D3 in the musculoskeletal system
Vitamin D and Sarcopenia
It has been observed that vitamin D affects muscle strength, muscle size and neuromuscular activity. Evidence suggests that with increasing age, the muscle mass reduces and is associated with decreased circulating levels of vitamin D, which makes them weak. This happens due to the decline of vitamin D receptors on muscle cells with loss of muscle mass and function.
Patients with higher 25(OH)D levels have better postural control and a decreased number of falls. (Gendelman et al., 2015). Also, it benefits an athlete’s muscular strength if the level is 50 ng/mL. Certain studies have shown an association between the blood serum level of 25(OH)D and musculoskeletal pain as well as back pain (Health et al. 2006).
Vitamin D and Bone Health
Osteomalacia - A metabolic bone disease caused by the malfunction of vitamin D or phosphate metabolism, leads to reduced bone mineralisation in adults. It occurs due to insufficient levels of vitamin D i.e. less than (< 25 ng/mL), with symptoms of musculoskeletal pain, usually in the shoulders or the proximal part of the muscles.
Osteoporosis - It is a skeletal disease, in which the bones become porous with the decrease in bone mass elevating the risks of osteoporotic fractures.
Reduced Bone Strength - Vitamin D helps promote bone health, and it is evident that decreased vitamin D levels constitute a major risk factor which leads to the risk of bone diseases such as hepatic Osteodystrophy or diabetic osteopathy.
Deficiency of Vitamin D - It can lead to severe diseases and is supplied through cutaneous synthesis by sufficient sun exposure and regular consumption of certain food such as organ meat, mushrooms, organic eggs, Vitamin D fortified milk and milk products. These days, our food doesn’t contain the necessary quantities of micronutrients which leads to the need of depending upon supplements.
To conclude, Vitamin D is vital to sustaining health and quality of life. It influences many metabolic pathways essential for the musculoskeletal system.
- Gendelman, O.; Itzhaki, D.; Makarov, S.; Bennun, M.; Amital, H. (2015).A randomized double-blind placebo-controlled study adding high dose vitamin D to analgesic regimens in patients with musculoskeletal pain. Lupus, 24, 483-489.
- Heath, K.M.; Elovic, E.P. (2006).Vitamin D deficiency-Implications in the rehabilitation setting. Am. J. Phys. Med. Rehab. 85, 916-923.