2023-11-28 09:36:08
Vitamin D exerts an important influence on the musculoskeletal system and, especially, on muscle function.
In Spain, it is estimated that 63.2 percent of the population has a vitamin D deficiency, a problem that has special consequences for menopausal women, as highlighted in the framework of the XXIII Continuing Training Course of the Study Group. for Menopause in Madrid, held at the Gregorio Marañón General University Hospital.
“In the menopausal stage, vitamin D deficiency is directly related to osteoporosis and the risk of fractures, with sarcopenia and the risk of falls, but it also increases the risk of suffering from chronic diseases such as obesity, cardiovascular diseases and high blood pressure. , metabolic diseases and the development of neoplastic processes,” highlighted the president of the Private Assistance Section of the Spanish Society of Gynecology and Obstetrics (SEGO), Manuel Marcos Fernández.
For this reason, this expert specifically advises women with postmenopausal osteoporosis undergoing treatment to “maintain optimal levels of vitamin D to optimize the response in terms of bone mineral density and fracture prevention.”
Vitamin D exerts an important influence on the musculoskeletal system and, especially, on muscle function. Its deficiency is related to a greater risk of falls (especially in the elderly), as well as a decrease in muscle volume and strength.
Furthermore, and given that it intervenes in muscle cell proliferation processes and in the musculoskeletal signal, people with vitamin D deficiency have a greater frequency and intensity of chronic muscle and joint pain, as well as lower tolerance to effort and exercise.
As summarized by the president of the Private Assistance Section of the Spanish Society of Gynecology and Obstetrics (SEGO), “vitamin D plays a crucial role in bone mineral metabolism, and maintaining an adequate level of this hormone improves bone mineral density results. in the hip, reducing the risk of fracture and improving the response to antiresorptive treatments.”
For years this influence of vitamin D on bone mineral metabolism has been assumed, but there is a resurgence of interest in knowing its extra-bone effects, trying to establish its relationship with autoimmune diseases, oncological processes, metabolic diseases, cardiovascular diseases and high blood pressure. with muscle pathology, and even with pregnancy and fertility.
“It has been shown to be of vital importance in the different stages of a woman’s life, since practically all cells in the body have specific receptors for vitamin D,” indicates the expert.
It has been proven, for example, how vitamin D improves insulin sensitivity in different types of cells (liver, muscle and fatty tissue), also stimulates the release of insulin and acts as a protective factor against diabetes. In fact, according to Dr. Marcos, “there is an inverse relationship between circulating concentrations of vitamin D and the risk of type 2 diabetes.”
Likewise, it is known that vitamin D can intervene in the process of oncological development through the activation of macrophages, cell proliferation and differentiation, apoptosis and angiogenesis. According to Manuel Marcos, “it has been observed that adequate levels of vitamin D are associated with a lower risk of breast, prostate, and colon and rectal cancer”; Specifically, he adds, “vitamin D has a key action in the regulation of various cellular mechanisms involved in the tumor transformation of cells.”
Currently, vitamin D deficiency is a “global pandemic” that affects more than a third of the world’s population. In Spain, despite the many hours of sunshine available, a similar situation occurs, and even with lower levels than those of Nordic countries with less sun exposure but which usually supplement and implement the diet.
“This is because only 10 percent of the vitamin D in our body is ingested through the diet and the rest through its synthesis in the dermis as a consequence of the incidence of UVB rays on the dermis,” says Marcos Fernández. Regarding what is provided by the diet, as he recalls, “only oily fish and dairy products are rich in vitamin D.”
However, the expert warns that in Spain there are a series of factors that will make this synthesis difficult, such as the existence of solar filters (ozone layer and clouds, pollution, glass, oblique incidence of solar rays depending on the latitude). , dark skin color, sun protection factors, etc.) “which make oral supplementation with vitamin D necessary to maintain adequate levels in the blood.”
On the other hand, melanin competes for the photonic energy of the sun’s ultraviolet rays at the skin level; Therefore, darker-skinned individuals need between three and four times more sun exposure to achieve the same levels of vitamin D as those with light skin.
There is an international consensus that the optimal needs for vitamin D are those that allow reaching a serum level of 25 OH vitamin D, greater than 30 ngr/ml, since it is with this level of vitamin D that maximum absorption is achieved. intestinal calcium and slow down the parathyroid gland to stop possible secondary hyperparathyroidism. RV. Ana Mera, pharmacist. Barcelona
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