Santo Domingo.- Although our bodies can naturally produce vitamin D through sun exposure, deficiency is surprisingly common—even in tropical countries such as the Dominican Republic. Despite the sunny climate, many people have low levels without realizing it.
What causes this deficiency? How can we detect it, and what are the consequences of not treating it in time?Dr. Alejandro Cambiaso, a specialist in Family and Preventive Medicine at Médico Express, answers these and other questions to help better understand this silent yet significant health condition.
Why is Vitamin D so important?
Vitamin D is a fat-soluble vitamin that functions like a regulatory hormone in many vital bodily processes. It is mainly produced in the skin after exposure to UVB rays from sunlight and is also obtained in smaller amounts through food or supplements.
The World Health Organization (WHO) and various scientific societies recognize its essential role in calcium and phosphorus absorption and metabolism, bone health maintenance, and the proper functioning of the immune, cardiovascular, muscular, and nervous systems. It’s also linked to the prevention of chronic diseases such as osteoporosis, respiratory infections, autoimmune disorders, type 2 diabetes, and certain types of cancer.
Why do so many people have a deficiency?
Globally, vitamin D deficiency is highly prevalent. According to the WHO and studies published in The Lancet and Endocrine Reviews, over one billion people have insufficient levels. The main causes include limited sun exposure (due to urban lifestyles, sunscreen use, or clothing), older age, obesity, darker skin (melanin reduces synthesis), digestive or kidney diseases that affect absorption or metabolism, and diets low in vitamin D-rich foods.
These factors explain why deficiency is common even in sun-rich countries like the Dominican Republic.
How can you tell if you have a deficiency?
Vitamin D deficiency can remain silent for a long time. When symptoms do appear, they may include:
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Fatigue, muscle weakness, and generalized pain
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Bone pain (especially in the back or legs)
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Increased susceptibility to respiratory infections
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Mood changes like irritability or depression
In children, signs include growth delays and bone deformities.Due to the vague nature of these symptoms, the only reliable way to confirm a deficiency is through a blood test measuring 25-hydroxyvitamin D levels.
What’s the recommended sun exposure for adults and children?
The WHO and the International Vitamin D Research Society recommend 10 to 30 minutes of direct sun exposure daily (without sunscreen), depending on skin type, age, latitude, and time of day.
It’s advisable to expose areas like the forearms, legs, and face during safe hours (before 10 a.m. or after 3 p.m.). If staying outdoors longer, sunscreen should be applied to prevent UV damage.
What foods are natural sources of Vitamin D?
Top natural sources include:
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Fatty fish (salmon, tuna, sardines)
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Beef liver
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Egg yolks
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Mushrooms exposed to UV light
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Fortified products: milk, cereals, juices, and plant-based drinks
Still, diet typically provides only a limited amount, making a combination of sunlight, balanced nutrition, and, when needed, tailored supplementation the most effective approach.
Can you have low Vitamin D even with a healthy diet and sun exposure?
Yes. Many people have suboptimal levels despite healthy lifestyles due to factors like genetics, sunscreen use, poor intestinal absorption, liver or kidney dysfunction, or excessive storage in fat tissue (in cases of obesity). That’s why lab testing is essential—especially for individuals with risk factors, fracture history, autoimmune diseases, or low sun exposure.
What health risks can arise from untreated deficiency?
Chronic deficiency can lead to:
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Osteomalacia or osteoporosis in adults
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Rickets in children
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Higher risk of falls and fractures
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Weakened immune system
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Worsening of autoimmune diseases
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Possible links to high blood pressure, metabolic syndrome, and neurological issues
Recent studies also connect low vitamin D levels with increased severity in infections like COVID-19.
Are Vitamin D supplements reliable? How is the right dose determined?
Supplements are safe and effective when properly prescribed. The preferred form is vitamin D3 (cholecalciferol) due to its better absorption. Doses can be taken daily, weekly, or monthly. The correct dosage depends on the person’s blood levels, age, weight, medical conditions, and underlying health status. Therefore, supplementation should not begin without prior evaluation and should always be medically monitored.
Guidelines from the U.S. Institute of Medicine (IOM), the Endocrine Society, and the WHO recommend maintaining blood levels between 30 and 50 ng/mL for most adults.