A Tropical Paradox

I thought I was just tired, but sometime in mid-2024, I began to feel exhausted all the time. I was walking with friends for just a short distance and discovered I was the only one panting and I was the youngest amongst them. Shior! Fatigue had become my constant companion, not the ordinary end-of-day exhaustion […]

I thought I was just tired, but sometime in mid-2024, I began to feel exhausted all the time. I was walking with friends for just a short distance and discovered I was the only one panting and I was the youngest amongst them.

Shior!

Fatigue had become my constant companion, not the ordinary end-of-day exhaustion that a busy physician, mother, and woman in Nigeria might expect. This was different. I went to bed tired and woke up tired. I dragged myself out of bed each morning, whispering silent prayers for strength before heading to work. By the time I returned home, I would collapse on my couch, unable to lift even a finger. I attributed it to stress, responsibility to work, to the relentless demands of modern-day life and to old age. To my oversabi type A personality. I was burnt out! That was it.

I exercised more. I disciplined myself to get seven hours of sleep religiously. I cleaned up my diet, more fruits and smoothies, more vegetables, more water. I checked my haemoglobin levels. Normal. I checked my thyroid function. Normal. I took a vacation and when my symptoms did not disappear, I started to despair.

At some point, in the privacy of my thoughts, I wondered: Shebi this is not the fatigue of depression? Or was it something else? I began to blame my children. They were the ones making me talk too much, draining away my energy levels!

Surely, it had to be them.

It is a dangerous thing when a doctor begins to doubt her own body. And mind.

In December last year, I experienced a new symptom. The last two digits of my right toe would suddenly go numb and freeze in a certain position. This lasted for a few minutes and would normalise on its own.

The answer had finally come. I called my friend in chemical pathology and went for tests: serum calcium levels and something else.

Low calcium levels. Unrecordably low Vitamin D levels.

The result was sobering. I was deficient. Not mildly insufficient. Deficient.

Nigeria is bathed in sunlight almost all year round. We live in the tropics. The sun is not scarce. It is abundant, generous, relentless. In fact, for the past two years, we have not even had proper Harmattan. Just heat, heat and more heat!

And yet here I was, living under one of the brightest skies on earth, and deficient in the very vitamin that sunlight provides.

This is what researchers now describe as the tropical paradox. Nigerians call it ‘Village people’.

Equatorial regions receive year-round ultraviolet B (UVB) radiation necessary for Vitamin D synthesis. Yet many women here remain deficient. Why?

Because sunlight availability is not the same as sunlight exposure.

Many of us spend most of our days indoors, offices, clinics, classrooms, cars. Everywhere AC, and even when we step outside, cultural and religious dress often limits skin exposure in women. Studies have shown that women who wear fully concealing clothing such as hijabs or niqabs are significantly more likely to have Vitamin D deficiency. A meta-analysis found that women wearing fully covering garments were 2.28 times more likely to develop deficiency compared to those with more skin exposed.

Add to this the biology of melanin. Darker skin contains more melanin, which acts as a natural sunscreen. Remember Black don’t crack? However, while this protects against harmful UV damage and protects us from aging, it also reduces the skin’s ability to synthesise Vitamin D efficiently.

In simple terms the more melanin you have, the longer you need to stay in the sun to produce the same amount of Vitamin D as someone with lighter skin.

So here we are, covered, indoors, melanin-rich and silently deficient.

Fatigue, muscle aches, bone pain, low mood, generalised weakness.

These are all symptoms we normalise as women. We call it “stress,hormones,  perimenopause and menopause”. We call it “motherhood, we call it “life.” I was so angry and disappointed in myself. How could I have been so blind? In some studies, in Sudan, up to 82.6 per cent of women were found to be Vitamin D deficient. Eight out of ten women. How many women around us are walking through life exhausted, blaming themselves for what is in fact a biochemical deficiency?

Chronic deficiency in women is associated with severe fatigue, muscle weakness, increased risk of osteoporosis, and long-term skeletal fragility. In older women, it contributes significantly to fractures. In younger women, it quietly erodes quality of life.

How many women internalise blame for biological problems?

We live in a culture that celebrates endurance in women. We carry burdens quietly. We pride ourselves on resilience. But resilience should not mean ignoring symptoms.

My laboratory results were a relief not because deficiency is pleasant, but because it was treatable.

Within weeks of supplementation, something shifted. The fog began to lift, the heaviness eased. I did not realise how unwell I had been until I began to feel well again.

I even have a spring in my step!

Before the Ulama comes for me, this is not about questioning cultural dress. It is about recognising physiological realities and adapting health strategies accordingly and safe, modest sun exposure when possible. Dietary awareness. Supplementation when indicated, routine testing for high-risk women. We screen for hypertension, diabetes, anaemia and thyroid disease. Yet Vitamin D, so fundamental to musculoskeletal health, immune function, and mood regulation, often escapes attention.

As women in tropical Africa, we assume the sun protects us from deficiency. But sunlight does not help if it never touches the skin.

If you are persistently tired despite adequate sleep, if you feel muscle aches without explanation, if you wake up exhausted after a full night’s rest do not dismiss it.

Check your Vitamin D.

Not because it is fashionable, or trending, but because it might quietly be the missing piece.