Indians run low on vitamin D mainly because we don't get enough sun on enough skin. We work and study indoors, cover up outdoors, and darker skin needs longer in the sun to make the same amount. City pollution blocks some of the UV, and very little Indian food contains vitamin D. B12 is low mainly because so many of us eat little or no animal food, and B12 comes almost only from animal sources. Diabetes medicines, long-term acid-reducing tablets and getting older make it worse. The result: most Indian studies find 80–90% of people low in vitamin D, and B12 deficiency is common even among non-vegetarians.
- Low vitamin D in India
- 40–99% across studies, mostly 80–90%
- Low B12 (Pune studies)
- 47–66% of adults
- Biggest D3 reason
- Too little sun on skin
- Biggest B12 reason
- Little animal food in the diet
- Also raises risk
- Metformin, acid-reducers, age
- What helps
- Sun, fortified foods, dairy, testing
How big is the problem, really?
Big. A review by community medicine researchers at AIIMS pulled together Indian studies on vitamin D and found deficiency in anywhere from 40% to 99% of people. Most studies landed between 80% and 90%.1 That's across age groups, cities and villages, men and women.
B12 isn't far behind. In a study of 204 adults in Pune, 47% were outright deficient, and about three-quarters showed signs that their cells were short on B12.4 A separate Pune study of 441 men found 66% with low B12.5 These aren't small, unlucky groups. This is the normal state of things for a huge number of us.
So why? Let's take vitamin D first.
Why we're low in vitamin D
1. We don't actually get much sun
Yes, India is sunny. But think about a normal weekday. Out of the house early, into a car, bus or metro. Office or classroom till evening. Home after sunset. Weekends in malls. The strongest UVB, the kind that makes vitamin D, comes around the middle of the day, and that's exactly when most of us are indoors. Sitting near a sunny window doesn't help either, because glass blocks UVB.2
2. Not much skin is showing
Your body can only make vitamin D from skin the sun actually reaches. Full sleeves, dupattas, saris, burqas, long trousers: most traditional and office clothing in India covers most of the body. A bit of sun on your face and hands just doesn't add up to much.
3. Darker skin needs more time
Melanin, the pigment that gives skin its colour, absorbs UVB. That's useful protection, but it also means darker skin makes less vitamin D from the same amount of sun, so it needs longer exposure to get the same result.2 Add the cultural habit of avoiding the sun, carrying umbrellas and wearing sunscreen, which also cuts vitamin D production, and the effect stacks up.2
4. Pollution blocks the light
This one surprised a lot of people when it was first measured. Researchers compared toddlers in a heavily polluted part of Delhi with toddlers in a cleaner area. The children in the polluted area had average vitamin D levels of 12.4 ng/mL, less than half the 27.1 ng/mL seen in the cleaner area, and haze measurements confirmed less UVB was reaching the ground.3 Smog doesn't just hurt your lungs. It literally filters out the sunlight your skin needs.
5. Indian food has almost no vitamin D
Dal, rice, roti, sabzi and most of what we eat every day contain essentially no vitamin D. Oily fish is the main natural food source, and most Indians don't eat it regularly. Milk only has it if it's fortified. The AIIMS review put it plainly: the typical Indian diet fails to meet the daily vitamin D requirement.1
Some milk and edible oil brands in India add vitamin D under FSSAI's fortification standards, and mark the pack with a "+F" logo. If you're buying anyway, picking the fortified version is an easy win.
Why we're low in B12
1. A lot of us are vegetarian
This is the big one. B12 is made by bacteria, and it ends up in animal foods: meat, fish, eggs and dairy. Plants don't have it. So a vegetarian diet with not much milk or curd, and certainly a vegan one, makes deficiency likely over time. A review of 18 studies found high rates of B12 deficiency among vegetarians everywhere: 62% of pregnant women, 21–41% of teenagers, and higher still in vegans and people who'd been vegetarian since birth.6 With so many Indians vegetarian from birth, this hits us hard.
2. Non-vegetarians aren't safe either
Here's the part people don't expect. In that Pune study, poor B12 status showed up in non-vegetarians as well as vegetarians.4 Eating chicken on Sundays isn't the same as getting B12 every day. If meat, fish or eggs are occasional rather than regular, and dairy is limited, intake can still fall short.
3. Diabetes, and the medicine that treats it
India has a huge diabetes burden. The national ICMR-INDIAB survey found that 11.4% of adults have diabetes, and another 15.3% have prediabetes.7 Metformin, the most common diabetes medicine, lowers B12 levels with long-term use. In a trial that ran for about four years, people on metformin had a meaningfully higher risk of B12 deficiency than people on placebo.8 Metformin is a good, safe drug and nobody should stop it on their own. It just means B12 should be checked regularly.
4. Acid-reducing tablets
Pantoprazole, omeprazole and similar tablets: in India they're taken for gas and acidity almost like mints, often for years. Your stomach needs acid to release B12 from food. A large study found that using these medicines for two years or more was linked to a higher risk of B12 deficiency.9
5. Getting older
Older adults tend to absorb B12 less well, so parents and grandparents can slip into deficiency even on a diet that kept them fine for decades. Among older vegetarians, the review above found deficiency rates anywhere from 11% to 90%.6
The causes at a glance
| Cause | Affects | What helps |
|---|---|---|
| Indoor lifestyle, covered skin | D3 | Regular midday sun on arms and legs |
| Darker skin, sun avoidance | D3 | Longer exposure, or a supplement |
| Air pollution | D3 | Testing and supplements in polluted cities |
| Little vitamin D in food | D3 | Fortified (+F) milk and oil |
| Vegetarian or vegan diet | B12 | Daily dairy, eggs if you eat them, fortified foods or a supplement |
| Metformin | B12 | Regular B12 checks |
| Long-term acid-reducers | B12 | Review the need with your doctor; check B12 |
| Older age | Both | Test both every year or two |
So what can you do about it?
You can't change your skin colour or fix Delhi's air on your own. But a few habits make a real difference.
- Get some actual sun. A short walk around midday with your arms uncovered, a few times a week, beats sitting by a window.
- Make B12 foods a daily thing, not a weekend thing. Milk, curd, paneer and eggs every day if you eat them.
- Pick fortified when you can. Look for the +F logo on milk and cooking oil.
- Test if you're in a high-risk group: vegetarian or vegan, pregnant or planning to be, over 60, on metformin or long-term acid-reducers, or living in a heavily polluted city.
- Supplement sensibly if you're low, based on your report, not on a guess.
The rest of this series covers the details. Part 1 explains what low levels do to your body, part 2 covers symptoms and treatment, and part 3 explains why these vitamins matter and how much you need. If you're comparing products, our vitamin D comparison scores what's on Indian shelves.
India's D3 and B12 problem isn't a mystery. It comes from how we live, what we eat and the air we breathe. None of that changes overnight, but a little sun, daily dairy or eggs, fortified foods, and a blood test when you're at risk cover most of it.
Frequently asked questions
Why are Indians deficient in vitamin D despite so much sunlight?
Mostly because we don't get enough sun on enough skin. People work and study indoors during midday, clothing covers most of the body, darker skin needs longer exposure to make the same amount of vitamin D, and air pollution blocks some UVB. Indian diets also contain very little vitamin D.
Why is vitamin B12 deficiency so common in India?
B12 comes almost only from animal foods, and many Indians are vegetarian or eat little dairy, eggs or meat. Studies in Pune found B12 deficiency in about half to two-thirds of adults, including non-vegetarians. Diabetes medicine (metformin), long-term acid-reducing tablets and older age raise the risk further.
What percentage of Indians are vitamin D deficient?
A review of Indian studies by AIIMS researchers found vitamin D deficiency in 40% to 99% of people, with most studies reporting 80% to 90%. It was common across all age groups.
Do non-vegetarians in India also get B12 deficiency?
Yes. In a Pune study, poor B12 status was found in both vegetarians and non-vegetarians. Eating meat, fish or eggs only occasionally doesn't guarantee enough B12, especially if you eat little dairy or take medicines that lower absorption.
Does air pollution cause vitamin D deficiency?
It can contribute. A Delhi study found toddlers in a heavily polluted area had average vitamin D levels of 12.4 ng/mL, compared with 27.1 ng/mL in a cleaner area, because haze reduced the UVB reaching the ground.
Who in India should get tested for vitamin D and B12?
Vegetarians and vegans, pregnant women and women planning a pregnancy, people over 60, anyone on metformin or long-term acid-reducing tablets, people living in highly polluted cities, and anyone with symptoms such as bone pain, constant tiredness or tingling in the feet.
This article is general information, not medical advice. Don't stop or change any prescribed medicine without talking to your doctor.
References
Disclosures: No manufacturer provided funding for this article, and it contains no sponsored or affiliate links. The banner features an AI-generated presenter, not a real doctor or patient. Full policy: conflicts policy