Vitamin D Deficiency
Overview
Vitamin D isn’t a single chemical – in fact, technically it’s not actually a vitamin at all – but rather a group of fat-soluble hormones responsible for enhancing intestinal absorption of calcium, iron, magnesium, phosphate, and zinc.
Your body makes vitamin D when direct sunlight (specifically UV rays) converts a chemical in your skin into an active form of the vitamin. Calcium, the primary component of bone, can only be absorbed by your body when vitamin D is present.
You can also get Vitamin D through dietary intake. Though not found in many foods, it can be obtained through ingestion of fortified milk, fortified cereal, and fatty fish such as salmon, mackerel and sardines.
In addition to bone health, getting enough vitamin D may also play a role in protecting against the following conditions (and increasing vitamin D levels may help to treat them). These conditions can include:
- Heart disease and high blood pressure.
- Diabetes.
- Infections and immune system disorders.
- Falls in older people.
- Some types of cancer, such as colon, prostate and breast cancers.
- Multiple sclerosis.
Persons commonly at risk for vitamin D deficiency include those with inadequate sun exposure, limited oral intake via diet, or impaired intestinal absorption (as seen with Crohn’s disease, Celiac disease, or in those who have had weight loss surgery).
Other factors that contribute to vitamin D deficiency:
- Age: The skin’s ability to make vitamin D lessens with age.
- Mobility: People who are homebound or are rarely outside (for example, people in nursing homes and other facilities) are not able to use sun exposure as a source of vitamin D.
- Skin color: high-melanin (dark) skin is less able to make vitamin D than low-melanin (fair) skin.
- Medications:
- Laxatives.
- Steroids (such as prednisone).
- Cholesterol-lowering drugs (such as cholestyramine and colestipol).
- Seizure-control drugs (such as phenobarbital and phenytoin).
- A tuberculosis drug (rifampin).
- A weight-loss drug (orlistat).
Symptoms
Severe lack of vitamin D in children causes rickets, showing up as incorrect growth patterns, weakness in muscles, pain in bones and deformities in joints. This is rare in developed countries due to fortification of milk and other foods with Vitamin D
Lack of vitamin D is not quite as obvious in adults. Signs and symptoms might include:
- Fatigue.
- Bone pain.
- Muscle weakness, muscle aches, or muscle cramps.
- Mood changes, like depression.
Diagnosis & Treatment
Diagnosis
A simple serum (blood) level can be drawn – most commonly the 25-hydroxyvitamin D, known as 25(OH)D for short.
A “normal” level varies depending on the lab’s reference values, but is generally considered to be 32 to 100 ng/ml.
Treatment
Adequate intake:
Vitamin D consists of 2 bioequivalent forms.
Vitamin D2, also known as ergocalciferol, is obtained from dietary vegetable sources and oral supplements.
Vitamin D3, also known as cholecalciferol, is obtained primarily from skin exposure to ultraviolet B (UVB) radiation in sunlight, but can also be obtained via ingestion of food sources such as oily fish and variably fortified foods (milk, juices, margarines, yogurts, cereals, and soy), and oral supplements.
Supplements:
D2 – Can be had via prescription from your health provider
D3 – better absorbed than D2, this is typically an over the counter supplement
How much you would require depends on your serum level.
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Disclaimer: This is an informational post designed to foster discussion. It should not substitute for the advice of your doctor.