“ETIOPATHOGENESIS OF VITAMIN D3

DEFICIENCY IN AYURVEDIC
PERSPECTIVE”

THESIS SUBMITTED TO
BHARATI VIDYAPEETH
(DEEMED TO BE UNIVERSITY) PUNE (INDIA)

FOR THE DEGREE OF

DOCTOR OF PHILOSOPHY (Ph.D)
“AYURVED VARIDHI”
ROGA NIDAN EVAM VIKRITI VIGYAN

BY
Dr. PRIYA PADMANABHAN
Ph.D. (SCHOLAR)

GUIDE
Prof. Dr. ABHINANDAN. A. MUKE
M.D., Ph.D
Medical Superintendent,
Bharati Vidyapeeth, Bharati Hospital, Kolhapur

College Of Ayurved,
Pune Satara, Road Pune - 411043

YEAR 2024
 CERTIFICATE

This is to certify that the thesis entitled “Etiopathogenesis of Vitamin D3 Deficiency

in Ayurvedic Perspective” Submitted by Dr. Priya Padmanabhan for the award of Ph.D
Degree, in the subject of Roga nidan evam Vikriti Vigyan (Ayurved), of Bharati Vidyapeeth
College of Ayurved Department of Roga nidan evam Vikriti Vigyan is a record of the
research work done by herself during the period from 2019 to 2024 under the guidance of Dr.
Abhinandan A. Muke.

Signature of head of institute with seal

Place : Pune Dr Abhijit [Link]
Dean and Principal
Date : Bharati Vidyapeeth Deemed University
College of Ayurved, Pune
 CERTIFICATE

This is to certify that the thesis entitled “Etiopathogenesis of Vitamin D3 Deficiency

in Ayurvedic Perspective” Submitted by Dr. Priya Padmanabhan for the award of Ph.D
Degree, in the subject of Roga nidan evam Vikriti Vigyan (Ayurved), of Bharati Vidyapeeth
College of Ayurved Department of Roga nidan evam Vikriti Vigyan is a record of the
research work done by herself during the period from 2019 to 2024 under the guidance of Dr.
Abhinandan A. Muke.

Place : Pune Dr Sangram Mane

MD, Ph.D (Sch)
Date : Prof and HOD
Department of Roga nidan evam Vikriti Vigyan
Bharati Vidyapeeth, Bharati Hospital, Pune
 CERTIFICATION OF GUIDE

This is to certify that the work incorporated in the thesis entitled “Etiopathogenesis of
Vitamin D3 Deficiency in Ayurvedic Perspective” Submitted by Dr. Priya Padmanabhan
for the degree of 'Doctor of Philosophy' in the subject of Roga nidan evam Vikriti Vigyan
under the faculty of Ayurved has been carried out in the Department of Roga nidan evam
Vikriti Vigyan, Bharati Vidyapeeth Deemed University’s College Of Ayurved, Pune during
the period from 2019 to 2024 under my direct supervision / guidance.

Place : Pune Signature of Research Guide

[Link] A. Muke
Date : M.D., Ph.D. Medical Superintendent,
Bharati Vidyapeeth, Bharati Hospital, Kolhapur.
 DECLARATION BY THE CANDIDATE

I here declare that the thesis entitled " Etiopathogenesis of Vitamin D3 Deficiency
in Ayurvedic perspective " Submitted by me to the Bharati Vidyapeeth Deemed
University, Pune, India, For the degree of Doctor of Philosophy (Ph. D.) in Roga
nidan evam Vikriti Vigyan under the faculty of Ayurved is original piece of work
carried out by me under the supervision of Dr. Abhinandan A. Muke. I further
declare that it has not been submitted to this or any other university or Institution for
the award of any degree or Diploma.

I also confirm that all the material which I have borrowed from other sources and
incorporated in this thesis is duly acknowledged. If any material is not duly
acknowledged and found incorporated in this thesis, it is entirely my responsibility. I
am fully aware of the implication of any such act which might have been committed
by me advertently or inadvertently.

Place: Pune Dr. Priya Padmanabhan.

Date:
 LIST OF ABBREVIATIONS

1) Ch. – Charak
2) Su. – Sushruta
3) A.H. – Ashtanga Hridaya
4) A.S. – Ashtanga Sangraha
5) M.N. – Madhava Nidana
6) B.P. – Bhava Prakasha
7) Y.R – Yoga Ratankar
8) Sh.S – Sharangndhar Samhita
9) Hl.- Harit Samhita
10) Su-Sutra stan
11) Sa-Sareera stan
12) Vi-Viman Stan
13) Chi-Chikitsa stan
14) Ni-Nidan Stan

Other
1) Dr. – Doctor
2) Prof. – Professor
3) i.e. – That is
4) O.P. – Out Patient
5) I.P. – Inpatient
6) D.O.A. – Date of Admission
7) BP – Blood Pressure
8) NAD-No abnormalities detected
9) Vit-Vitamin
10) Pts-Patients
11) 25(OH)D-25-hydroxyvitaminD
12) GE –General Examination
13) PH-Personal History

In Tables
1) Sr .No. – Serial Number
2) No. – Number
3) Fig. – Figure
4) Pg. – Page
 ACKNOWLEDGMENT

With great delight, I take this opportunity to express my heartfelt gratitude to one and all
without whose guidance, cooperation and encouragements, the work I am submitting would
have no standing.

First, my sincere and revered obeisance to Lord Dhanvantari.

I am highly indebted to Hon. Dr. Patangrao Kadam, Founder chancellor of Bharati Vidyapeth
Deemed University, Dr. Shivajirao Kadam,, Chancellor of Bharati Vidyapeth Deemed
University,Dr Vivek Saoji Vice Chancellor of Bharati Vidyapeth Deemed University Dr.
Vishwajeet Kadam Pro Vice Chancellor and Dr Asmita Jagtap Excecutive Director for giving
me opportunity to fulfil my ambition.

I am very thankful to my guide professor and Medical Superintendent Dr. Abhinandhan A

Muke for his valuable guidance, support, encouragement and precious suggestions without
which I could not have completed my research work.

I express my deep sense of gratitude and thanks Dr. [Link], respected Dean and Principal
of B.V.D.U.C.O.A. Pune for encouraging and giving valuable cooperation at the different
stages of this massive work. I am Very thankful to Administrative vice principal, prof. and
HOD dept of Shalyatantra- [Link] kadam and Academic vice principal, prof, and HOD
dept of Dravyaguna [Link] Deshpande for their timely guidance and motivation.

I am very thankful to Dr S.M Mane HOD Roga vigyan evam Vikriti vigyan and other faculty
members Dr P S Adhikari,,Dr Latha Patil, Dr Advait Menon, Dr Ankita Pawar of Roga
Nidan Department.

I also thank to Statistician Mrs. Aswini Magalekar for valuable guidance.

I also thank to faculty members Dr Ninad Nangre, Dr Sanjay [Link] , for their valuable
support.

I also thank Mrs Asha Kanse for her timely support.

I thank to laboratory technicians Mr. Desai, Mrs. Desai, [Link], Mrs. Archana,
[Link], Miss Kavitha,Miss Maduri,Mr Santosh.
I express my sincere gratitude to most respected teachers Dr B V Prassanna, Dr Anand More,
Dr Nagaraj Poojari, Dr Prasanna Mogasale, Dr Naveen Chandra for their never-ending
guidelines, support and care throughout my studies.

I thank my seniors Dr Sachin Dev, Dr Nikhil Chandra, Dr Joel Antony for their timely
support.

Words are not enough to express my gratitude and indebt to my beloved & respected parents
and in-laws who were the guiding light throughout the study.

No words can express my feeling of immense appreciation, thankfulness, love and affection
to my beloved husband Dr Anand D A and my children Sreehari, Varun Suriya and Baby
Tanmaya for their wholehearted support, sacrifice and care in fulfilling my work.

I am indebted to all college staff, Library staff, Bharati Vidyapeeth Medical Foundation’s
Ayurved Hospital’s staff and all my students and friends for extending valuable co-operation
during this research work for their enormous help and contribution directly or indirectly, in
completing this research work.

I also thank my brothers and sisters for their continuous support throughout my study.

I offer my regards to all of those who are associated with each and every aspect of this work
and all those who helped me to materialize this work.

This Acknowledgement would be incomplete without expressing profound gratitude towards

the patients for their valuable co-operation, without which this work would not have been
completed.

Dr Priya Padmanabhan
 LIST OF TABLES

Table Page
Title of the Table
No number
1 Ashray Ashrayi Bhava 3
2 Amount of Vitamin D in Selected Food 9
3 Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health17 15
4 Age Wise Distribution 35
5 Gender Wise Distribution 36
6 Religion Wise Distribution 37
7 Education wise distribution 38
8 Occupation status wise Distribution 39
9 Socio economic status wise Distribution 40
10 Marital Status wise Distribution 41
11 Vitamin d3 level wise distribution 42
12 Gynecological history wise distribution 43
13 Obstetric history wise distribution 44
14 Infertility history wise distribution 45
15 Ahara wise distribution 46
16 Bowl wise distribution 47
17 Micturation wise distribution 48
18 Appetite wise distribution 49
19 Sleep wise distribution 50
20 Divaswapna wise distribution 51
21 Ratrijagarana wise distribution 52
22 Mental strain wise distribution 53
23 Excersice wise distribution 54
24 Rest wise distribution 55
25 Sex wise distribution 56
26 Atapaseva wsie distribution 57
27 Dress code wise distribution 58
28 Addiction wise distribution 59
29 Hobby wise distribution 60
30 Sunscreen cream wise distribution 61
31 Built wise distribution 62
32 Nourishment wise distribution 63
33 Pallor wise distribution 64
34 Icterus wise distribution 65
35 Cynosis wise distribution 66
36 Clubbing wise distribution 67
37 Lymphadenopathy wise distribution 68
38 Gait wise distribution 69
39 Height wise distribution 70
40 Weight wise distribution 71
41 BMI wise distribution 72
42 Pulse rate wise distribution 73
43 Temperature wise distribution 74
44 Respiratory rate wise distribution 75
45 Heart rate wise distribution 76
46 Respiratory wise distribution 77
47 CVS wise distribution 78
48 GIT wise distribution 79
49 CNS wise distribution 80
50 Integumentary wise distribution 81
51 Musculoskeletal wise distribution 82
52 Nadi wise distribution 83
53 Mutram wise distribution 84
54 Malam wise distribution 85
55 Jihwa wise distribution 86
56 Sabdha wise distribution 87
57 Sparsha wise distribution 88
58 Drik wise distribution 89
59 Akruthi wise distribution 90
60 Prakruti wise distribution 91
61 Hetu wise distribution 92
62 Vata wise distribution 93
63 Pitta wise distribution 94
64 Kapha wise distribution 95
65 Rasa wise distribution 96
66 Rakta wise distribution 97
67 Mamsa wise distribution 98
68 Medas wise distribution 99
69 Asthi wise distribution 100
70 Majja wise distribution 101
71 Shukra wise distribution 102
72 Ojo dusti wise distribution 103
73 Desha wise distribution 104
74 Kala wise distribution 105
75 Roga bala wise distribution 106
76 Rogi bala wise distribution 107
77 Sara wise distribution 108
78 Samhanana wise distribution 109
79 Satva wise distribution 110
80 Satmya wise distribution 111
81 Abyavaharana shkati wise distribution 112
82 Jarana shakti wise distribution 113
83 Vyayama wise distribution 114
84 Vaya wise distribution 115
85 Chakshu wise distribution 116
86 Grana wise distribution 117
87 Rasana wise distribution 118
88 Srotra wise distribution 119
89 Sparsha wise distribution 120
90 Vak wise distribution 121
91 Payu wise distribution 122
92 Upastha wise distribution 123
93 Mano pareeksha wise distribution 124
 94 Dominant rasa wise distribution 125
95 Dominant guna wise distribution 126
96 Association of rasa in vitamin d3 deficiency 127
97 Dietic habit wise distribution 128
98 Food items wise distribution 129
99 Bakery items wise distribution 131
100 Fruit and vegetable wise distribution 132
101 Nuts and dry fruits wise distribution 134
102 Association of vitamin d3 deficiency with nuts and dry fruits in daily life 135
103 Non veg diet wise distribution 136
104 Consumption of tea wise distribution 137
105 Consumption of coffee wise distribution 138
106 Consumption of horlick wise distribution 139
107 Consumption of ensure wise distribution 140
108 Consumption of poshan wise distribution 141
109 Consumption of boost wise distribution 142
110 Viharaj hetu wise distribution 143
111 Manisika hetu wise distribution 144
112 Agantuja hetu wise distribution 145
113 Vishesha lakshana wise distribution 146
114 Association of vishesha lakshana in vitamin d3 deficiency 147
115 Anupashaya wise distribution 148
116 Sadyasadyata wise distribution 149
117 Mamsa Varga 153
118 Viharaj Hetu 158
 LIST OF GRAPH
Grap Page
Title of the Graph
h No No
1 Age Wise Distribution 35
2 Gender Wise Distribution 36
3 Religion Wise Distribution 37
4 Education wise distribution 38
5 Occupation status wise Distribution 39
6 Socio economic status wise Distribution 40
7 Marital Status wise Distribution 41
8 Vitamin d3 level wise distribution 42
9 Gynecological history wise distribution 43
10 Obstetric history wise distribution 44
11 Infertility history wise distribution 45
12 Ahara wise distribution 46
13 Bowl wise distribution 47
14 Micturation wise distribution 48
15 Appetite wise distribution 49
16 Sleep wise distribution 50
17 Divaswapna wise distribution 51
18 Ratrijagarana wise distribution 52
19 Mental strain wise distribution 53
20 Excersice wise distribution 54
21 Rest wise distribution 55
22 Sex wise distribution 56
23 Atapaseva wsie distribution 57
24 Dress code wise distribution 58
25 Addiction wise distribution 59
26 Hobby wise distribution 60
27 Sunscreen cream wise distribution 61
28 Built wise distribution 62
29 Nourishment wise distribution 63
30 Pallor wise distribution 64
31 Icterus wise distribution 65
32 Cynosis wise distribution 66
33 Clubbing wise distribution 67
34 Lymphadenopathy wise distribution 68
35 Gait wise distribution 69
36 Height wise distribution 70
37 Weight wise distribution 71
38 BMI wise distribution 72
39 Pulse rate wise distribution 73
40 Temperature wise distribution 74
41 Respiratory rate wise distribution 75
42 Heart rate wise distribution 76
43 Respiratory wise distribution 77
44 CVS wise distribution 78
45 GIT wise distribution 79
46 CNS wise distribution 80
47 Integumentary wise distribution 81
48 Musculoskeletal wise distribution 82
49 Nadi wise distribution 83
50 Mutram wise distribution 84
51 Malam wise distribution 85
52 Jihwa wise distribution 86
53 Sabdha wise distribution 87
54 Sparsha wise distribution 88
55 Drik wise distribution 89
56 Akruthi wise distribution 90
57 Prakruti wise distribution 91
58 Hetu wise distribution 92
59 Vata wise distribution 93
60 Pitta wise distribution 94
61 Kapha wise distribution 95
62 Rasa wise distribution 96
63 Rakta wise distribution 97
64 Mamsa wise distribution 98
65 Medas wise distribution 99
66 Asthi wise distribution 100
67 Majja wise distribution 101
68 Shukra wise distribution 102
69 Ojo dusti wise distribution 103
70 Desha wise distribution 104
71 Kala wise distribution 105
72 Roga bala wise distribution 106
73 Rogi bala wise distribution 107
74 Sara wise distribution 108
75 Samhanana wise distribution 109
76 Satva wise distribution 110
77 Satmya wise distribution 111
78 Abyavaharana shkati wise distribution 112
79 Jarana shakti wise distribution 113
80 Vyayama wise distribution 114
81 Vaya wise distribution 115
82 Chakshu wise distribution 116
83 Grana wise distribution 117
84 Rasana wise distribution 118
85 Srotra wise distribution 119
86 Sparsha wise distribution 120
87 Vak wise distribution 121
88 Payu wise distribution 122
89 Upastha wise distribution 123
90 Mano pareeksha wise distribution 124
91 Dominant rasa wise distribution 125
92 Dominant guna wise distribution 126
 93 Dietic habit wise distribution 128
94 Food items wise distribution 130
95 Bakery items wise distribution 131
96 Fruit and vegetable wise distribution 133
97 Nuts and dry fruits wise distribution 134
98 Non veg diet wise distribution 136
99 Consumption of tea wise distribution 137
100 Consumption of coffee wise distribution 138
101 Consumption of horlick wise distribution 139
102 Consumption of ensure wise distribution 140
103 Consumption of poshan wise distribution 141
104 Consumption of boost wise distribution 142
105 Viharaj hetu wise distribution 143
106 Manisika hetu wise distribution 144
107 Agantuja hetu wise distribution 145
108 Vishesha lakshana wise distribution 146
109 Anupashaya wise distribution 148
110 Sadyasadyata wise distribution 149

LIST OF FIGURES

Page
Fig
Title of the Figure numbe
No
r
1 Structures of D2 and D3 vitamins. 8
2 Vitamin D production, bioactivation, and inactivation pathways 13
 INDEX

SR. PAGE
TITLE PAGE
NO. NO.

1 INTRODUCTION 1-6

2 REVIEW OF LITERATURE 7-31

3 AIM AND OBJECTIVES 32

4 MATERIAL AND METHODOLOGY 33-34

5 RESULTS AND OBSERVATIONS 35-149

6 DISCUSSION 150-166

7 CONCLUSION 167-169

8 SUMMARY 170-172

9 BIBLIOGRAPHY 173-180

ANNEXURE
Annexure I - Consent form
Annexure II - Case paper
10 181-194
Annexure III-Plagarism Report
Annexure IV-Final Ph.D. Registration
Annexure V- Master chart
 ABSTRACT

Vitamin deficiency is the lack of essential vitamins in our body and turns out to be matter
of major concern when it continues for long term causing various abnormal signs and
symptoms. Vitamin D is a group of fat-soluble prohormones known as sunshine vitamin. It
plays an important role in maintaining an adequate level of serum calcium and
phosphorus. Vitamin D has a great effect in forming and maintaining strong bones. Many
factors play an important role in giving raise to deficiency of essential supplements
necessary to the normal health. Vitamin D deficiency occurs when people do not have an
appropriate dietary intake or exposure to UVB rays. The Hidden secretes in the basic
principles of Ayurved are needed to be explained in terms of contemporary knowledge. In
Ayurved there is no any direct reference of Vitamin D3 Deficiency. Many systems in
human body is involved in pathogenesis of Vitamin D3 Deficiency. The signs and
symptoms of all these systems lead to a complex clinical picture of Vitamin D3
Deficiency. Thus various basic principles of Ayurveda have been studied in deep to
understand the concept of Vitamin D3 Deficiency.

In India, Vitamin D3 deficiency is widespread. It is necessary to understand the nidana,

purvarupa, rupa, samprapti of Vitamin D3 deficiency in Ayurveda along with
contemporary science for a better management. However, the clinically diagnosed cases
represent only the tip of the iceberg. With the knowledge of the multiple consequences, it
can lead to; we can imagine the burden. So Vitamin D3 deficiency needs to be addressed
with due attention and strong action.

Aim of the study was to understand the etiopathogenesis of Vitamin D3 deficiency in

Ayurvedic perspective and Objective of the study were to study the etiopathogenesis of Vit.
D3 deficiency according to both Ayurveda and contemporary science,Pathophysiology of
Vitamin D3 deficiency,Clinical evaluation of Vitamin D3 deficiency in Ayurveda and
contemporary science

Methodology:

200 patients of Vitamin D3 Deficiency were selected for study and comparative, Cross
Sectional Observational analysis of the newly diagnosed or known cases of Vitamin D3
Deficiency was performed with the help of a specialized case proforma designed for this
study. Statistical analysis of data was done using Frequency percentage tables,Chi-square
test- subjective parameters and Correlation test -objective parameters The observations are
presented in the form of tables and graphs. By using information collected through
statistical analysis results are discussed.

Conclusion:

Based on Statisticial finding it was accomplished that improper Dathu Poshana and Dhatu
Parinama are responsible for vitamin D3 Deficiency. Agnimandya is the major cause for
Vitamin D3 deficiency.

Key Words:

Vitamin, 25-hydroxy vitamin D test, Dhatu Parinama, Agnimandya, Asthi Kshaya.