Key Takeaways
\nVitamin D deficiency can lead to bone pain and fractures.People who spend a lot of time indoors or have dark skin are at risk for vitamin D deficiency.Vitamin D deficiency is often treated with vitamin D3 supplements.<\/p>\n
Vitamin D is often referred to as the “sunshine vitamin” because it is produced by your body when your skin is exposed to the sun. Since vitamin D helps to keep your bones strong, a deficiency can lead to bone softening and subsequent bone pain and fractures.\n<\/p>\n
1. You May Not Have Any Symptoms <\/p>\n
Most people with vitamin D deficiency are asymptomatic. Only with a severe and prolonged deficiency do symptoms arise<\/a>.\n<\/p>\n 2. Bone and Muscle Symptoms in Severe Deficiency <\/p>\n The major role of vitamin D is to absorb calcium and phosphorus from the intestines in order to build and maintain bone mass. With vitamin D deficiency, this cannot occur adequately. With a severe deficiency, bone softening (a condition called osteomalacia<\/a> in adults and rickets <\/a>in children) may develop.\n<\/p>\n With osteomalacia and rickets, a person may experience throbbing bone discomfort and muscle weakness and pain. Osteomalacia also increases a person’s chances of developing bone fractures, falling, and experiencing walking problems.\n<\/p>\n 3. Fatigue and Depression <\/p>\n Besides bone and muscle symptoms, fatigue and depression are also associated with vitamin D deficiency.\n<\/p>\n What Causes Vitamin D Deficiency? <\/p>\n Since you need sun exposure to make vitamin D, the most at-risk populations for vitamin D deficiency include anyone who spends a lot of time indoors (the elderly and the homebound, for example) and people with dark skin (as it produces less vitamin D from sunlight exposure).\n<\/p>\n Other populations at risk for vitamin D deficiency include:\n<\/p>\n Those who do not consume enough vitamin D-containing foods (e.g., canned tuna and fortified cow’s milk) Interesting Associations<\/p>\n Besides its primary function in calcium metabolism, vitamin D may play a role in reducing inflammation and moderating immune function in the body. This may be why research has found links between vitamin D deficiency and various autoimmune diseases like multiple sclerosis<\/a>, rheumatoid arthritis<\/a>, and type 1 diabetes<\/a>.<\/p>\n How Is Vitamin D Deficiency Diagnosed? <\/p>\n If you have one or more risk factors for vitamin D deficiency\u2014for example, if you live with obesity, or if you have chronic kidney disease or a gut malabsorption syndrome\u2014your healthcare provider should screen you for vitamin D deficiency.\n<\/p>\n Certain symptoms may also prompt your healthcare provider to test for vitamin D deficiency, such as an increased number of falls, especially if you are elderly.\n<\/p>\n However, screening for vitamin D deficiency in a person without symptoms is currently not recommended.\n<\/p>\n A simple blood test called 25-hydroxyvitamin D or 25(OH)D can be used to diagnose vitamin D deficiency.\n<\/p>\n While there is no definitive consensus about what a normal, healthy vitamin D level<\/a> is, the Institute of Medicine (IOM) defines it as follows:\n<\/p>\n Normal: 25 (OH)D level greater than 20 ng\/mLInsufficient: 25 (OH)D level between 12 to 20 ng\/mLDeficient: 25 (OH)D level less than 12 ng\/mLHigh enough to cause adverse effects: 25 (OH)D greater than 50 ng\/mL<\/p>\n How Is Vitamin D Deficiency Treated? <\/p>\n The treatment of vitamin D deficiency depends on a number of factors, such as the severity of the deficiency and whether certain underlying health problems exist.\n<\/p>\n That said, in the vast majority of cases, vitamin D deficiency is treated with a supplement.\n<\/p>\n Supplements <\/p>\n There are two major forms of vitamin D: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol), the latter of which is used in most supplements.\n<\/p>\n To date, there is no standard regimen for treating vitamin D deficiency. A typical plan, though, may include taking 50,000 international units (IU) of vitamin D2 or D3 by mouth once a week for eight weeks, or 6,000 IU daily followed by a maintenance dose of 1,500 to 2,000 IU of vitamin D3 daily.\n<\/p>\n Keep in mind that higher doses will be needed to treat people with medical conditions that affect vitamin D absorption in the gut, and those taking medications that affect vitamin D metabolism.\n<\/p>\n Vitamin D Toxicity<\/p>\n Excess vitamin D may cause symptoms related to high calcium levels in the blood<\/a>, such as muscle weakness, pain, heart arrhythmias, and kidney stones. This is why it is important to only take a vitamin D supplement as directed by your healthcare provider.<\/p>\n Food <\/p>\n Diet is an additional, although not robust, source of vitamin D, and therefore not usually recommended for treating a deficiency. That said, it can be useful for maintaining a healthy vitamin D level.\n<\/p>\n Foods that contain vitamin D include:\n<\/p>\n Fatty fish<\/a> (e.g., salmon and swordfish) Sunlight <\/p>\n Sunlight is the third source of vitamin D. As with diet, it is not usually recommended as a treatment for vitamin D deficiency. This is because of the increased risk of\u00a0skin cancer<\/a> associated with sun exposure.\n<\/p>\n How Can You Prevent Deficiency? <\/p>\n While the amount of vitamin D that a person needs varies based on factors like skin color and sun exposure, general recommendations from the IOM state that individuals ages 1 to 70 should take a supplement containing 600 IU of vitamin D daily. After age 70, a person should take 800 IU of vitamin D daily.\n<\/p>\n These vitamin D preventive recommendations are for the general population\u2014not for people with a diagnosed vitamin D deficiency. People who are deficient in vitamin D require therapeutic doses of vitamin D.\n<\/p>\n In addition to or in lieu of taking a supplement, your healthcare provider may recommend that you eat or drink foods that contain vitamin D and\/or that you get some sunshine (but not too much).<\/p>\n What Does Vitamin D Have to Do With MS? Nadeem S, Munim TF, Hussain HF, Hussain DF. Determinants of Vitamin D deficiency in asymptomatic healthy young medical students<\/a>. Pak J Med Sci. 2018 Sep-Oct;34(5):1248-1252. doi:10.12669\/pjms.345.15668<\/p>\n Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, et al., editors.\u00a0Dietary Reference Intakes for Calcium and Vitamin D<\/a>. Washington (DC): National Academies Press (US).<\/p>\n Cleveland Clinic. Osteomalacia<\/a>.<\/p>\n Roy S, Sherman A, Monari-Sparks MJ, Schweiker O, Hunter K. Correction of low Vitamin D improves fatigue: Effect of correction of low Vitamin D in fatigue study (EViDiF study)<\/a>. N Am J Med Sci. 2014 Aug;6(8):396-402. doi:10.4103\/1947-2714.139291<\/p>\n Wong SK, Chin KY, Ima-Nirwana S. Vitamin D and depression: The evidence from an indirect clue to treatment strategy<\/a>. Curr Drug Targets. 2018;19(8):888-97. doi:10.2174\/1389450118666170913161030<\/p>\n Nair R, Maseeh A. Vitamin D: the “sunshine” vitamin<\/a>. J Pharmacol Pharmacother. 2012;3(2):118-26. doi:10.4103\/0976-500X.95506<\/p>\n National Institutes of Health. Office of Dietary Supplements. Vitamin D fact sheet for health professionals<\/a>.<\/p>\n Cleveland Clinic. Vitamin D deficiency<\/a>.<\/p>\n Harrison SR, Li D, Jeffery LE, Raza K, Hewison M. Vitamin D, autoimmune disease and rheumatoid arthritis<\/a>.\u00a0Calcif Tissue Int. 2020;106(1):58-75. doi:10.1007\/s00223-019-00577-2<\/p>\n Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline<\/a>.\u00a0J Clin Endocrinol Metab. 2011;96(7):1911-1930. doi:10.1210\/jc.2011-0385<\/p>\n US Preventive Services Task Force, Krist AH, Davidson KW, et al. Screening for vitamin D deficiency in adults: US Preventive Services Task Force Recommendation Statement<\/a>.\u00a0JAMA. 2021;325(14):1436. doi:10.1001\/jama.2021.3069<\/p>\n Ross AC et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know<\/a>. J Clin Endocrinol Metab. 2011 Jan;96(1):53-8. doi:10.1210\/jc.2010-2704<\/p>\n Pilz S, Zittermann A, Trummer C, et al. Vitamin D testing and treatment: a narrative review of current evidence<\/a>. Endocr Connect. 2019;8(2):R27-R43. doi:10.1530\/EC-18-0432<\/p>\n
\nThose with diseases that affect the absorption of vitamin D in the gut (e.g., celiac disease<\/a> and Crohn’s disease<\/a>)
\nThose with diseases that affect the metabolism of vitamin D into its active form (e.g., chronic kidney disease or liver disease)
\nThose with obesity (extra fat tissue hides away vitamin D instead of releasing it into the bloodstream)
\nThose who take medications that enhance the breakdown of vitamin D (e.g., anti-seizure medications)<\/p>\n
\nCod liver oil
\nNuts
\nCereals and dairy products fortified with vitamin D
\nCheese
\nEggs
\nMushrooms
\nBeef liver<\/p>\n
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