A while ago, a patient in her 70s came to see me. I was alarmed to see her looking so frail. She had lost her appetite and had stopped going out because, she said, ‘I just don’t have the energy and I ache all over.’ I took a blood sample and when the results came back, the answer was clear: her vitamin D levels were abnormally low. I prescribed high-dose vitamin D tablets and arranged a follow-up appointment.
Vitamin D is made naturally in the body on exposure to sunlight, but deficiency is common, particularly during the dark winter months, if you always wear sunscreen or are almost fully covered. Having dark skin, being elderly or obese also increases your risk.
Should you be supplementing? Official advice is that during the winter most people should, because of lack of strong sunlight. If you are not deficient it is probably not necessary; a recent study of 53,000 people concluded that only those with low vitamin D levels get bone benefits from supplements.
8 signs that you may be lacking in vitamin D
- Your bones ache. Vitamin D increases absorption of calcium, so is important for strong bones. With severe deficiency, bones can become thin, brittle and even misshapen (rickets). Shockingly, rickets is making a comeback, usually as a result of our indoor lifestyles; I have even seen children with it in my surgery.
- You fracture a bone after a minor fall. Thinning of the bones (osteoporosis) is a particular problem for women during and after menopause, when bone loss speeds up and there’s a greater risk of fractures.
- Wounds take longer to heal – some types, such as leg ulcers, have been shown to reduce by 28 per cent after taking the vitamin.
- You’re less able to fight off infections.
- Your hair is thinning or falling out.
- You have unexplained aches and pains. In one study, 71 per cent of people with chronic pain were found to be deficient in vitamin D.
- You feel low and even depressed. In winter, this can present itself as seasonal affective disorder. Some studies have shown improvements in mood with vitamin D.
- You’re tired all the time. This non-specific symptom is often overlooked by doctors and patients.
Hero or villain? Dark chocolate
I recommend a few squares of dark chocolate as part of the healthy Mediterranean-style diet, because cocoa is surprisingly good for you. An excellent source of minerals and antioxidants, it has a beneficial effect on the cardiovascular system. People often say they only eat dark chocolate, ‘not the sugary rubbish’, unaware thatit can be high in sugar; if it’s flavoured, sugar content might be as high as 60 per cent. So choose dark chocolate with a cocoa content of more than 70 per cent. I like Green & Black’s Dark 70% or 85% Chocolate. Try my recipe for a healthy chocolate treat.
Chilli chocolate thins with pistachio crunch
Delicious scattered over strawberries.
75g dark chocolate (at least 70 per cent cocoa), chopped
1 pinch chilli powder
2 tbsp toasted pistachio nuts, chopped
1. Line a baking tray with a silicone baking sheet.
2. Melt chocolate in a bowl over a pan of simmering water, stirring often.
3. Mix in a pinch of chilli, then pour over the tray base. Tilt the tray so the chocolate spreads to form a layer 1mm-2mm thick. Immediately scatter the pistachios over and allow to cool, ideally in the fridge. Break into pieces to serve.
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