Vitamin D: role of vitamin D in human health beyond skeleton

Ambrish Singh, Ameet Soni, Mohit Changani, Harsh Choksi


Deficiency of vitamin D is now considered as epidemic in Indian subcontinent, with a prevalence of 70-94% in the general population. Like in US, Indian dairy products are rarely fortified with vitamin D. Socioreligious and cultural practices followed in India do not facilitate adequate sun exposure, thereby negating potential benefits of plentiful sunshine resulting in vitamin D deficiency.  Deficiency is highly prevalent in both urban and rural settings. Vitamin D deficiency can lead to rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections. In present review authors have revisited the details pertaining to vitamin D to increase the awareness on Vitamin D efficiency.


Extra-skeletal benefits, Hypovitaminosis D, Measurement, Secosteroid, Vitamin D deficiency

Full Text:



Ritu G, Gupta A. Vitamin D Deficiency in India: Prevalence, Causalities and Interventions. Nutrients. 2014;6(2):729-75.

Puri S, Marwaha RK, Agarwal N, Tandon N, Agarwal R, Grewal K, et al. Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle. Br J Nutr. 2008;99:876-82.

Marwaha RK, Puri S, Tandon N, Dhir S, Agarwal N, Bhadra K, et al. Effects of sports training and nutrition on bone mineral density in young Indian healthy females. Indian J Med Res. 2011;134:307-13.

Harinarayan CV, Ramalakshmi T, Venkataprasad U. High prevalence of low dietary calcium and low vitamin D status in healthy south Indians. Asia Pac J Clin Nutr. 2004;13:359-64.

Arya V, Bhambri R, Godbole MM, Mithal A. Vitamin D status and its relationship with bone mineral density in healthy Asian Indians. Osteoporos Int. 2004;15:56-61.

Pilz S, Zittermann A, Trummer C, Theiler-Schwetz V, Lerchbaum E, Keppel MH, et al. Vitamin D testing and treatment: a narrative review of current evidence. Endocr Connect. 2019;8(2):27-43.

Spustová V1, Dzúrik R. Vitamin D: synthesis, metabolism, regulation, and an assessment of its deficiency in patients with chronic renal disease. Vnitr Lek. 2004;50(7):537-43.

Rosen CJ, Adams JS, Bikle DD, Black DM, Demay MB, Manson JE et al. The nonskeletal effects of vitamin D: an Endocrine Society scientific statement. Endocrine Reviews. 2012;33:456-92.

Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC. Issues of trial selection and subgroup considerations in the recent meta-analysis of Zhao and colleagues on fracture reduction by calcium and vitamin D supplementation in community-dwelling older adults. Osteoporosis Intern. 2018;29:2151-2.

Wylon K, Drozdenko G, Krannich A, Heine G, Dölle S, Worm M. Pharmacokinetic evaluation of a single intramuscular high dose versus an oral long-term supplementation of cholecalciferol. PLoS One. 2017;12:0169620.

Murad MH, Elamin KB, Abu Elnour NO, Elamin MB, Alkatib AA, Fatourechi MM, et al. Clinical review: the effect of vitamin D on falls: a systematic review and meta-analysis. J Clin Endocrinol Metabol. 2011;(96):2997-3006.

Rejnmark L, Bislev LS, Cashman KD, Eiríksdottir G, Gaksch M, Grübler M, et al. Non-skeletal health effects of vitamin D supplementation: a systematic review on findings from meta-analyses summarizing trial data. PLoS One. 2017;12:e0180512.

Ish-Shalom S, Segal E, Salganik T, Raz B, Bromberg IL, Vieth R. Comparison of daily, weekly, and monthly vitamin D3 in ethanol dosing protocols for two months in elderly hip fracture patients. J Clin Endocrinol Metabol. 2008;93:3430-5.

Cashman KD. Vitamin D requirements for the future-lessons learned and charting a path forward. Nutrients 2018;10:533.

Cashman KD, Ritz C, Kiely M, Odin Collaborators. Improved dietary guidelines for vitamin D: application of individual participant data (IPD)-level meta-regression analyses. Nutri. 2017;9:469.

Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, et al. UK clinical guideline for the prevention and treatment of osteoporosis. Archives of Osteoporosis. 2017;12:43.

Khan HI, Aitken D, Zhai G, Ding C, Pelletier JP, Pelletier JM et al. Association between hip and knee cartilage measured using radiographs and magnetic resonance imaging: the Tasmanian Older Adult Cohort Study. Rheumatol (Oxford). 2013;52(11):2009-15.

Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabet Endocrinol. 2014;2:76-89.

Swart KM, Lips P, Brouwer IA, Jorde R, Heymans MW, Grimnes G, et al. Effects of vitamin D supplementation on markers for cardiovascular disease and type 2 diabetes: an individual participant data meta-analysis of randomized controlled trials. Am J Clin Nutrit. 2018;(107):1043-53.

Bolland MJ, Grey A, Gamble GD, Reid IR. Vitamin D supplementation and falls: a trial sequential meta-analysis. Lancet Diabet Endocrinol. 2014;2:573-80.

Khaw KT, Stewart AW, Waayer D, Lawes CMM, Toop L, Camargo CA, et al. Effect of monthly high-dose vitamin D supplementation on falls and non-vertebral fractures: secondary and post-hoc outcomes from the randomised, double-blind, placebo-controlled ViDA trial. Lancet Diabet Endocrinol. 2017;(5):438-47.

Pilz S, Verheyen N, Grübler MR, Tomaschitz A, März W. Vitamin D and cardiovascular disease prevention. Nature Reviews Cardiol. 2016;13:404-17.

Feneis JF, Arora RR. Role of vitamin D in blood pressure homeostasis. Am J Ther. 2010;17(6):e221-9.

Pilz S, Tomaschitz A. Role of vitamin D in arterial hypertension. Expert Rev Cardiovasc Ther. 2010;8(11):1599-608.

Judd SE, Nanes MS, Ziegler TR, Wilson PW, Tangpricha V. Optimal vitamin D status attenuates the age-associated increase in systolic blood pressure in white Americans: results from the third National Health and Nutrition Examination Survey. Am J Clin Nutr. 2008;87(1):136-41.

Rosen CJ, Adams JS, Bikle DD, Black DM, Demay MB, Manson JE, Murad MH, Kovacs CS. The nonskeletal effects of vitamin D: An Endocrine Society scientific statement. Endocrine Reviews. 2012;33:456-92.

Holick MF. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Reviews Endocr Metabol Disor. 2017;18:153-65.

Di Somma C, Scarano E, Barrea L, Zhukouskaya V, Savastano S, Mele C, et al. Vitamin D and neurological diseases: An endocrine view. International journal of molecular sciences. 2017 Nov 21;18(11):2482.

Van Groningen L, Opdenoordt S, van Sorge A, Telting D, Giesen A, de Boer H. Cholecalciferol loading dose guideline for vitamin D-deficient adults. Eur J Endocrinol. 2010 Apr;162(4):805-11.

An Endocrine Society Clinical Practice Guideline, J Clin Endocrinol Metabol. 2011, 96(7):1911-30.

Dalle Carbonare L, Valenti MT, Del Forno F, Caneva E, Pietrobelli A. Vitamin D: Daily vs. Monthly Use in Children and Elderly-What Is Going On? Nutri. 2017;9(7):652.

Goswami R, Gupta N, Ray D, Singh N, Tomar N. Pattern of 25-hydroxy vitamin D response at short (2 month) and long (1 year) interval after 8 weeks of oral supplementation with cholecalciferol in Asian Indians with chronic hypovitaminosis D. Br. J. Nutr. 2008;100:526-9.