"I Live in India — How Can I Be Vitamin D Deficient?"
This is the question everyone asks when their report shows a level of 11 ng/mL. "I see the sun every day. This doesn't make sense."
But it does make sense. Despite abundant sunshine, 70-90% of Indians across all age groups are Vitamin D deficient. The story of Vitamin D deficiency in India is the story of how our lives have changed in the last 20 years.
The India Paradox
Here's something that surprises most people: India has one of the highest rates of Vitamin D deficiency in the world — despite being a tropical country with abundant sunshine.
The numbers are staggering:
- 70-90% of Indians across ALL age groups are deficient
- Urban Indians are more deficient than rural Indians
- Even doctors and medical students show similar deficiency rates
- Outdoor workers in construction still test deficient
How is this possible?
Why Your Grandfather Didn't Have This Problem
Think about how your grandparents lived. They woke before sunrise. They worked in fields or walked to local shops. Women sat in courtyards grinding spices. Children played outside until dark.
Now think about your day. You wake up, get in a car or metro, sit in an air-conditioned office, eat lunch at your desk, return home after sunset, and watch TV or scroll your phone until bed.
The sun hasn't changed. We have.
The Modern Indian Lifestyle
Here's why we're all deficient:
The Office Worker: Leaves home at 8 AM when the sun is low. Enters an office building with UV-blocking glass windows. Eats lunch indoors. Leaves at 7 PM when the sun has set. Total effective sun exposure: nearly zero.
The Homemaker: Cooks in the kitchen in the morning when sun is optimal. Runs errands in cars or autos with covered windows. Avoids the afternoon sun because of heat. Wears clothing that covers arms and legs.
The Student: Attends classes from morning to evening. Studies indoors. Plays video games instead of outdoor sports. Uses sunscreen when going out because of skin concerns.
The Senior Citizen: Stays indoors due to heat or health concerns. Reduced mobility limits outdoor time. Thinner skin produces less Vitamin D anyway.
This isn't a judgment — it's simply modern life. But our bodies are still running on ancient software that expects us to be outside for hours each day.
The Hidden Costs You're Already Paying
Vitamin D deficiency doesn't announce itself with dramatic symptoms. It whispers.
Symptoms you might be ignoring:
- That persistent tiredness you've blamed on work stress
- The joint pain you've dismissed as "just getting older"
- The frequent colds your child keeps catching
- The low mood that descends every monsoon season
What's Actually Happening Inside
Vitamin D isn't really a vitamin — it's a hormone. And it's doing far more than building bones.
Your Immune System: Vitamin D is like a conductor for your immune orchestra. When it's deficient, immune cells can't communicate properly. Illnesses become more frequent. Allergies worsen.
Your Muscles: Ever notice weakness when climbing stairs, even though you're not "out of shape"? Vitamin D receptors exist in muscle tissue. When levels drop, muscle function suffers.
Your Mood: There's a reason Nordic countries have high depression rates in winter. Vitamin D affects serotonin production. Some people whose "depression" improves significantly with Vitamin D supplementation.
Your Metabolism: Emerging research links Vitamin D deficiency to insulin resistance. In a country where diabetes is already epidemic, this connection deserves attention.
Reading Your Report: What the Numbers Mean
Your lab report shows 25(OH)D or 25-hydroxy Vitamin D. This is the storage form that reflects your true status.
| Your Level | Category | Interpretation |
|---|---|---|
| Below 10 ng/mL | Severe deficiency | Needs immediate attention — this is serious |
| 10-20 ng/mL | Deficient | Running on empty — explains the tiredness |
| 20-30 ng/mL | Insufficient | Better, but not optimal |
| 30-50 ng/mL | Optimal | The sweet spot — maintain this level |
| 50-80 ng/mL | High normal | Good levels — don't overdo supplements |
| Above 100 ng/mL | Excessive | Too high — reduce supplements |
Important: Most Indian labs mark 20 ng/mL as "normal." But that's like saying a 60% score is passing. Aim for 40-50 ng/mL — that's where research shows optimal benefits.
The Treatment Plan That Actually Works
Effective treatment based on years of clinical evidence:
If You're Severely Deficient (Below 20 ng/mL)
Loading Phase: 60,000 IU once weekly for 8-10 weeks
Take it with your fattiest meal of the week — perhaps Sunday lunch with ghee-laden parathas or a meal with paneer. Vitamin D needs fat to absorb properly.
After 8-10 weeks, retest. Most people reach the 40-50 range.
Maintenance Phase: 60,000 IU once monthly, or 1,000-2,000 IU daily
Common Mistakes to Avoid
Mistake 1: Taking Vitamin D without checking levels first
Some people start supplements because "everyone is deficient." But dosing depends on baseline. Someone at 15 ng/mL needs different treatment than someone at 35 ng/mL.
Mistake 2: Not taking it with fat
Taking Vitamin D every morning with black coffee for six months will barely budge levels. Switching to taking it with breakfast that includes ghee or butter can normalize levels within weeks.
Mistake 3: Stopping when you feel better
Vitamin D deficiency is a chronic condition for most urban Indians. Unless lifestyle dramatically changes, ongoing supplementation is typically needed. Think of it like charging your phone — you can't charge it once and expect it to last forever.
The Sunlight Solution: Why It's Harder Than You Think
In theory, 20-30 minutes of midday sun on your face and arms, 3-4 times per week, should produce enough Vitamin D.
In practice, here's what you're up against:
| Factor | Why It Matters |
|---|---|
| Melanin | Indian skin contains more melanin, reducing Vitamin D production by 50-90% |
| Timing | UVB rays only strong between 10 AM - 3 PM (when you're in office) |
| Pollution | Delhi, Mumbai smog blocks UVB rays significantly |
| Glass Windows | Office windows filter out the UVB you need |
| Sunscreen | SPF 30 blocks 97% of UVB rays |
| Clothing | Most Indians cover arms and legs, limiting exposed skin |
Practical advice: Sun exposure is a bonus, not a strategy. Enjoy the sun when you can, but don't rely on it.
Beyond Vitamin D: The Complete Picture
Vitamin D doesn't work alone. It's part of a team.
The Bone Health Team
Calcium — Vitamin D helps absorb it, but you need calcium to absorb:
- Ragi (finger millet) — the calcium king of Indian grains
- Sesame seeds (til) — add to everything
- Dairy if you consume it
- Moringa leaves (drumstick leaves)
Magnesium — Required to convert Vitamin D to its active form:
- Nuts and seeds
- Whole grains
- Bananas
- Dark chocolate (a happy excuse)
Vitamin K2 — Helps direct calcium to bones instead of arteries:
- Fermented foods
- Egg yolks
- Ghee (especially from grass-fed cows)
Special Situations
During Pregnancy
Vitamin D deficiency during pregnancy is linked to:
- Gestational diabetes
- Preeclampsia
- Low birth weight
- Poor bone development in baby
If pregnant or planning to be, check your levels. Most prenatal vitamins contain only 400-600 IU — often not enough if already deficient.
For Children
Yes, children can be Vitamin D deficient too. In fact, studies show Indian children have high deficiency rates. Signs to watch:
- Frequent respiratory infections
- Delayed milestones
- Bone pain or tenderness
- Unusual tiredness
If your child spends more time with screens than in sunlight, consider getting levels checked.
Common Questions About Vitamin D
"Can I get enough Vitamin D from food?"
Honestly? It's nearly impossible. The few foods with Vitamin D — fatty fish like salmon, egg yolks, fortified milk — contain such small amounts that you'd need unrealistic quantities. A vegetarian diet makes this even harder.
"My level is 15 but I feel fine. Do I really need to treat this?"
You might feel fine now. But deficiency is doing silent damage — weakening bones, affecting immunity, increasing inflammation. Think of it like high blood pressure: you don't feel it until something breaks.
"Is it possible to take too much?"
Yes, but it's rare with sensible supplementation. Toxicity typically happens at levels above 100 ng/mL, usually from taking extremely high doses for extended periods. Stick to the recommended protocol and retest periodically.
"How long until I feel a difference?"
Some people notice improved energy within 2-3 weeks of starting treatment. Others don't notice dramatic changes but see the benefit in lab values. Full replenishment takes 2-3 months.
Your Vitamin D Action Plan
Key steps:
- Get tested — If you haven't checked in over a year, add it to your next lab panel
- Don't assume you're fine — Even if you "get sun" or "drink milk," you're probably deficient
- Treat appropriately — Work with your doctor to determine the right dose
- Be patient — This isn't a one-time fix; most urban Indians need ongoing supplementation
- Think beyond the pill — Spend time outdoors whenever possible
A Final Thought
There's something poignant about Vitamin D deficiency in India. We live in one of the sunniest countries on earth, yet we've designed our lives to avoid the sun entirely. We've built glass towers that trap us. We've created schedules that keep us indoors during the only hours that matter.
This isn't meant to make anyone feel guilty — it's just an invitation to notice. To maybe take a 15-minute walk during a lunch break. To sit by a window. To let children play outside a little longer.
Vitamin D supplements will fix lab values. But they won't give you the other things sunlight provides — the reset to your circadian rhythm, the mood lift, the reminder that you're a biological being in a natural world.
Take the supplement. But don't forget to step outside sometimes.
Track your Vitamin D levels over time with ExaHealth. Upload your lab reports and see how your levels change with treatment.
