Vitamin D helps the body absorb calcium and keep bones and muscles strong. Most vitamin D is made in the skin from sunlight, so people who spend most time indoors or whose skin is mostly covered are at risk. Deficiency is common in Afghanistan, especially in women and young children. It can cause rickets in children and weak, painful bones in adults, but it is easy to prevent and treat.
Symptoms
Often no symptoms when mild
Tiredness and general aches
Bone pain, especially in the back, hips and legs
Muscle weakness and difficulty climbing stairs or getting up
In children: bowed legs, delayed walking, slow growth and late teeth
Muscle cramps or twitching from low calcium
Causes
Little time in sunlight, staying mostly indoors
Clothing that covers most of the skin when outdoors
Darker skin needs more sun to make vitamin D
Babies who are only breastfed without vitamin D drops, especially if the mother is deficient
Diet low in eggs, fish and fortified foods
Obesity, kidney or liver disease, and some medicines such as for epilepsy
Prevention
Get sunlight on the face, arms and hands for 15 to 30 minutes most days, for example in a private courtyard
Take babies and children outside in the sun regularly, avoiding the hottest midday sun in summer
Eat eggs, fish, milk and yoghurt
Vitamin D supplements for babies, pregnant and breastfeeding women when advised by a health worker
Do not take high-dose vitamin D injections or drops without a doctor
Treatment
Vitamin D tablets, drops or capsules at the dose a doctor prescribes, often higher for a few weeks then a lower daily dose
Calcium from food or supplements if a doctor advises
Regular safe sunlight
Blood tests to check levels when needed
Too much vitamin D can be harmful, so do not take more than prescribed
Common questions
Does sunlight through a window give vitamin D?
No. Window glass blocks the part of sunlight that makes vitamin D. The skin needs direct sunlight, for example in a private courtyard.
Can I take vitamin D injections to feel more energetic?
Only if a doctor finds you are deficient. High doses taken without need can raise blood calcium and harm the kidneys.
