What is Vitamin D Deficiency?

Vitamin D deficiency is also known as hypovitaminosis D. It is the most common nutritional deficiency worldwide,^[1] affecting people of all age groups.^[2]

Vitamin D is one of the most important vitamins ‒ essential compounds on which the body’s cells rely for normal development. Nearly every cell in the body has a receptor for vitamin D.^[3]

Vitamin D levels in the body can be maintained in two ways:

1. The body can, itself, make vitamin D from its resources of cholesterol. To do this, it needs access to sunlight.
2. Vitamin D can be found in certain foods, such as fatty fish. (However, it is rare for a person to gain all the vitamin D that their body needs from food alone.)

Some of the most important functions of vitamin D include:

• Maintenance of normal calcium and phosphate levels
• Promotion of calcium absorption (essential for healthy bones and teeth)
• Growth of cells and bones
• Reduction of inflammation, such as can be caused by infection or injury

When a person has vitamin D deficiency, the body’s cells become less efficient at carrying out processes such as growth and regeneration.

Symptoms of vitamin D deficiency

If the body does not contain sufficient vitamin D, this can give rise to a variety of health complications. Problems arising from vitamin D deficiency include fatigue, depressed mood and bone and muscle pain.

Vitamin D is particularly instrumental in maintaining healthy bones. The development or worsening of skeletal disorders ‒ such as osteoporosis in adults and rickets in children ‒ are therefore often linked to vitamin D deficiency.

Read more about Osteoporosis ».

Read more about Rickets »

The most common signs that a person may be affected by vitamin D deficiency are:^[4][5]

• Bone pain, sometimes also felt as joint pain
• Fatigue
• Muscle pain
• Hair loss
• Being affected by frequent bacterial and viral infections
• Mood changes such as a depressed mood
• Wounds and injuries taking longer to heal
• Weaker and/or easily breaking bones

If you are experiencing symptoms that may be linked to a deficiency of vitamin D, use the Adoctor conditions and symptoms to carry out a symptom assessment.

Causes of vitamin D deficiency

The daily intake of vitamin D a person needs in order for their body to function optimally depends on factors such as age, weight, skin color, and overall health. People whose bodies require a greater intake of vitamin D are at greater risk of experiencing vitamin D deficiency.

Being an infant or an elderly person, being obese, having darker skin, and/or experiencing a health condition which compromises one’s ability to absorb vitamins properly (such as Coeliac disease or inflammatory bowel diseases) are all factors that may increase the daily quantity of vitamin D an individual requires.

Factors that increase the likelihood of being affected by vitamin D deficiency include:

• Living in countries where there is little sun all year round
• Having darker skin (the more pigmented a person’s skin is, the better it is able to produce melanin, which absorbs UVB radiation and reduces the synthesis of vitamin D)^[6]
• Wearing high-factor sunscreen
• Spending the majority of one’s time indoors
• Malabsorption as a result of conditions such as Coeliac disease which impede the normal uptake of nutrients
• Avoiding foods which provide a source of vitamin D such as fatty fish and dairy products
• Being obese
• Being elderly

The main source of vitamin D is exposure to solar UVB radiation (from sunlight.^[4] When the body is exposed to sunlight, it can manufacture vitamin D from cholesterol, a fatty substance synthesized by the liver and found in some foods. Anything that reduces a person’s access to solar UVB radiation will compromise the body’s ability to manufacture sufficient levels of vitamin D,^[4] therefore eventually causing vitamin D deficiency.

Lacking vitamin D in one’s diet

Vitamin D deficiency can be caused by failing to gain sufficient amounts of vitamin D from one’s diet, leading to insufficient levels in the body overall.

The recommended daily intake of vitamin D is:^[7]

• 400 IU (international units) for children under one year
• 600 IU for children, teens and adults up to age 70
• 800 IU for pregnant people and adults over the age of 71

To increase a person’s chances of meeting the vitamin D target for their age group, healthcare professionals advise everybody to ensure that their diet contains sources of vitamin D – which can be found in certain foods, especially in fatty fish, such as salmon or tuna, and certain dairy products, like milk and cheese.

However, most foods that contain vitamin D do not contain sufficient quantities to meet a person’s daily required intake. For this reason, many traditionally consumed sources of vitamin D (for example, formulated milk for infants, orange juice, and soy milk) are fortified with vitamin D.

Failing to eat regular or sufficient quantities of vitamin-D-containing food (for example, because of following a vegan diet) increases the likelihood of developing vitamin D deficiency. Even with a vitamin-D-rich diet, it is not usually possible for a person to maintain sufficient levels of vitamin D in their body from food alone. For this reason, vitamin D deficiency is a very common problem worldwide.

Failing to source additional vitamin D from sunlight

For some people, particularly those who ensure that their food contains vitamin D, exposure to sunlight will be sufficient for them to synthesize the rest of their recommended daily amount of vitamin D.

Many people – particularly those living far from the equator or whose lifestyles involve staying indoors and/or wearing clothes that cover most of the skin – may need to take supplements of vitamin D to meet their required daily amount. If they do not do so, this can cause vitamin D deficiency.

Diagnosis

If vitamin D deficiency is suspected, it is important to visit a doctor in order to confirm the diagnosis, so that one can begin treatment as soon as possible and redress any problems incurred as a result of the deficiency.

It is not standard medical practice to screen symptomless people for vitamin D deficiency. Therefore, it is common for people to be unaware that they are vitamin D deficient, or that they need to take supplements, until they begin to experience health problems related to their vitamin D deficiency, such as hair loss, bone and/or muscle pain, fatigue or depression.

To confirm a suspected diagnosis of vitamin D deficiency, one’s doctor will perform a blood test (called 25-hydroxy vitamin D test), measuring the serum 25(OH)D levels in the blood. This will determine whether a person has sufficient or insufficient levels of vitamin D.

Read more about Blood Test Results »

If an individual is suspected of having had long-term vitamin d deficiency, doctors will look for physical characteristics which are indicators of a long-term vitamin D deficiency.

Physical signs that a person may be affected by long-term vitamin D deficiency include:^[8]

• Widening of the ends of the bones
• Skeletal deformities including bow legs and expanded rib-cage
• Slow tooth development and/or early dental caries

In diagnosing vitamin D deficiency, a healthcare professional will also assess a person’s medical history, diet, and lifestyle to ascertain whether they have a history of health problems that could be related to vitamin D deficiency, like chronic liver or chronic kidney disease, and how likely they are to access sufficient sources of vitamin D on a day-to-day basis.

Treatment

People diagnosed with vitamin D deficiency must begin treatment as soon as possible to redress the health complications which may be caused by the condition. Treatment for vitamin D deficiency normally involves supplementing a person’s nutritional intake in order to ensure that they receive the quantity of vitamin D that they need for their cells to function healthily.

The correct course of vitamin D supplementation will be decided in relation to the age of the individual, their medical history, and any health conditions they may be experiencing.

Supplementation methods to treat vitamin D deficiency may include:^[9]

• Oral vitamin D3 (cholecalciferol) in the form of a liquid, capsules or tablets
• Oral calcium and vitamin D combined supplements (usually in the form of tablets)
• Intramuscular vitamin D replacement therapy (a course of injections)

Once a plan to restore a person’s vitamin D levels to a healthy score has been devised, the doctor will consider whether any additional treatments are necessary in order to manage and/or cure any additional conditions which may have arisen as a result of the vitamin D deficiency.

Prevention

In order to prevent vitamin D deficiency, doctors recommend getting as much access to sunlight as possible (with adequate precautions to prevent sunburn) and ensuring that one maintains a balanced diet which includes a regular intake of sources of vitamin D.

Foods that contain or are commonly fortified with vitamin D include:

• Oily fish. Trout, salmon, herring, sardines, pilchards, kippers, tuna.
• Cod liver oil. This contains a large amount of vitamin D and should not be taken in conjunction with supplements containing vitamin D.
• Fortified dairy products. Dairy-based spreads and cheese can be fortified with vitamin D. Check the nutritional information on the packet to ascertain the vitamin D content of individual products. Infant formula is generally fortified with vitamin D.
• Fortified soy products. Soy-based products such as soy milk and soy yoghurt can be fortified with vitamin D. Check the nutritional information on the packet to ascertain the vitamin D content of individual products.
• Natural animal products. Raw milk, meat and egg yolk are sources of vitamin D.

Good to know: It is important to note that the vitamin D content of animal products will vary according to the season. Animal products contain more vitamin D during the spring and summer months because the livestock – and the plant material they feed on – is exposed to more sunlight and thus has greater potential to synthesize vitamin D.

Vitamin D supplements

A recent evaluation of the treatment and prevention of vitamin D deficiency, undertaken on behalf of the Endocrine Society, found that most people do not achieve a sufficient intake of vitamin D from their diet and access to sunlight alone. It is therefore recommended that most people use vitamin D supplements as a means of ensuring that they reach their recommended daily intake, so as to prevent vitamin D deficiency.^[10]

The recommended daily intake of vitamin D supplements for each age group is:^[7]

• 400 IU (international units) for children under one year
• 600 IU for children, teens and adults up to age 70
• 800 IU for pregnant people and adults over age 71

Individuals should consult their doctor to establish the dosage that is appropriate for them.

People may need more potent supplements of vitamin D in order to reach their required intake if they:

• Live in countries far from the equator, for example, in Canada or middle or northern European countries which have little daylight in the winter months
• Have a lifestyle which involves spending the majority of their time indoors
• Usually wear clothing which covers the majority of their skin

In order to prevent hypervitaminosis D (vitamin D toxicity) which can occur if a person’s vitamin D levels are too high, it is also advisable to consult a healthcare professional before starting vitamin D supplements in order to ensure that one is not at risk of consuming too much vitamin D.

Vitamin D and UVB radiation protection: a warning

it is important to note that one should never become sunburnt in one’s efforts to spend time outdoors for the purpose of increasing one’s levels of vitamin D. Going without adequate sun protection carries significant health risks. For example, it increases the likelihood of developing severe forms of skin cancer such as melanoma.

Becoming sunburnt as a result of spending time in the sun is never recommended. One should ensure that one always takes care to wear appropriate sun protection for one’s skin type, as well as follow the general recommendations, such as wearing high-factor sunscreen and a wide-brimmed hat.^[11]

Complications of vitamin D deficiency

It is important to consult a healthcare professional if one suspects vitamin D deficiency because the condition increases the likelihood of developing certain problems. The most commonly experienced problems related to vitamin D deficiency are skeletal disorders; diseases related to the growth and strength of one’s bones.

In children, vitamin D deficiency can cause rickets, a condition involving the weakening and softening of the bones. In adults, the equivalent of rickets is known as osteomalacia (soft bones).

Being deficient in vitamin D can also render the body less robust and heighten the likelihood of accidents occurring:

• Vitamin D deficiency increases the likelihood of breaking a bone in people of any age
• Elderly people with hypovitaminosis D are more likely to fall, trip or stumble

Health complications that are associated with vitamin D deficiency include:^[12]

• Osteomalacia (softening of the bones in adults) and osteoporosis (increased fragility of the bones)^[13]
• Rickets (softening of the bones in children)
• Mental health conditions such as seasonal affective disorder (SAD) and depression^[14]
• Increased susceptibility to infections and illnesses
• Glucose intolerance^[15] and type 1 and type 2 diabetes^[12]
• Obesity^[16]
• Cardiovascular diseases (conditions affecting the heart) such as hypertension, heart failure and ischemic heart disease^[17][18]
• Cancer of the colon, breast or prostate^[19]
• Rheumatoid arthritis^[20]
• Multiple sclerosis^[20][21]
• Hair loss (alopecia)^[22]
• Tuberculosis^[23]

Complications of vitamin D deficiency in children

Rickets, a condition involving the softening of the bones, so that the skeleton develops deformities is a very common condition related to vitamin D deficiency and affects children worldwide.^[24]

In children, vitamin D deficiency primarily causes skeletal diseases because the growth of the skeleton demands certain levels of calcium, and lacking vitamin D impairs the body’s uptake of calcium. Vitamin D deficiency can therefore cause hypocalcemia (where the levels of calcium in the body are too low), which in turn can cause rickets and osteoporosis.

Children experiencing hypocalcemia as a result of vitamin D deficiency may exhibit additional symptoms and health problems, such as seizures or tetany (muscle spasms).^[25] If you are concerned that your child, or a child you know, maybe affected by vitamin D deficiency, . It’s always best to check with your doctor find a doctor.

Complications of vitamin D deficiency in pregnancy and infancy

Vitamin D deficiency is linked to a range of possible complications relating to pregnancy and the health of the pregnant person and the newborn. Complications that may arise for a pregnant person experiencing vitamin D deficiency include:^[26]

• Gestational diabetes and less efficient metabolism of glucose
• Bacterial vaginosis
• Preeclampsia
• Premature birth
• Increased likelihood of needing a cesarean delivery

The need of the developing fetus for vitamin D increases during the second half of pregnancy, when most of the bone growth prior to birth takes place. Because a developing fetus is entirely dependent on a passive transfer of vitamin D (from the pregnant person), it is important for pregnant people to ensure that their vitamin D intake is sufficient to support the needs of the fetus in addition to their own.

In newborns, vitamin D deficiency can lead to conditions including:

• Low birth weight
• Rickets
• Abnormal bone growth
• Increased likelihood of skeletal fractures

Breastfeeding and vitamin D deficiency

it is important to ensure that a breastfeeding person maintains adequate levels of vitamin D to support the healthy growth of a newborn in the postnatal period. For most newborns, breast milk is their primary source of vitamin D. However, not all breast milk will contain sufficient levels of vitamin D to provide an infant with their recommended vitamin D intake (400 IU per day). If the amount of vitamin D present in breast milk is not sufficient, It is possible for infants to develop vitamin D deficiency, particularly if they:

• Lack exposure to sunlight (because of staying indoors, wearing clothing which usually covers most of the skin or living far from the equator)
• Live in weather conditions with intense cloud covering
• Live in a highly polluted area

The American Academy of Pediatrics recommends) that a daily supplement of 400 IU should be given to all breastfeeding infants, to safeguard against vitamin D deficiency.

However, recent research indicates that if a mother takes a supplement with a sufficiently high concentration of vitamin D (around 6,400 IU), her breast milk will contain high enough levels of vitamin D to provide an infant with their recommended daily intake.^[27] This removes the need to give a supplement to an infant directly.

Risks of vitamin D deficiency in the elderly

People with vitamin D deficiency are likely to experience aging more rapidly than those with sufficient vitamin D intake.

In the elderly, a deficit of vitamin D is associated with an increased likelihood that the health problems one does experience may be difficult to treat and/or result in death more likely than without a vitamin D deficiency. Among other factors, this is because elderly people who have vitamin D deficiency are also more likely to experience cognitive impairment, compromised muscle function, and are more prone to falls.

Vitamin D deficiency FAQs

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1. “Vitamin D deficiency.” British Medical Journal Best Practice. November 2017. Accessed: 15 November 2017. ↩

2. “Is vitamin D deficiency a major global public health problem.” Journal of Steroid Biochemical Molecular Biology. 21 November 2013. Accessed: 15 November 2017. ↩

3. “Vitamin D.” Vitamins and Minerals. NHS Choices. 03 March 2017. Accessed: 15 November 2017. ↩

4. “Vitamin D deficiency: a worldwide problem with health consequences.” American Society for Clinical Nutrition. 01 May 2007. Accessed: 15 November 2017. ↩ ↩ ↩

5. “Vitamin D: an evidence based review.” Journal of the American Board of Family Medicine. 13 July 2009. Accessed: 15 November 2017. ↩

6. “Vitamin D and african americans.” The Journal of Nutrition. 2006. Accessed: 15 November 2017. ↩

7. “Vitamin D fact sheet for consumers.” National Institutes of Health. 15 April 2016. Accessed: 12 February 2018. ↩ ↩

8. “Vitamin D deficiency.” British Medical Journal Best Practice. November 2017. Accessed: 15 November 2017. ↩

9. “Management of vitamin D deficiency in adults.” General Practice Notebook. October 2017. Accessed: 15 November 2017. ↩

10. “Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.” The Journal of Clinical Endocrinology and Metabolism. 01 July 2011. Accessed: 15 November 2017. ↩

11. “How to get vitamin D from sunlight.” NHS Choices. 25 November 2015. Accessed: 15 November 2017. ↩

12. “Vitamin D and diabetes.” American Diabetes Association. 2011. Accessed: 15 November 2017. ↩ ↩

13. “Vitamin D and bone disease.” Biomedical Research International. 29 August 2012. Accessed: 15 November 2017. ↩

14. “Psychological consequences of vitamin D deficiency.” Psychology Today. 14 November 2011. Accessed: 15 November 2017. ↩

15. “The impact of vitamin D replacement on glucose metabolism.” Pakistan Journal of Medical Sciences. November 2013. Accessed: 15 November 2017. ↩

16. “Link between obesity and vitamin D clarified.” Science News. 05 February 2013. Accessed: 17 July 2018. ↩

17. “Vitamin D deficiency and risk for cardiovascular disease.” American Journal of Medical Science. July 2009. Accessed: 15 November 2017. ↩

18. “Vitamin D deficiency: an important, common and easily treatable cardiovascular risk factor.” Journal of the American College of Cardiology. 09 December 2008. Accessed: 15 November 2017. ↩

19. “The role of vitamin D in cancer prevention.” American Journal of Public Health. February 2016. Accessed: 15 November 2017. ↩

20. “Vitamin D and rheumathoid arthritis.” Therapeutic Advances in Endocrinology and Metabolism. December 2012. Accessed: 15 November 2017. ↩ ↩

21. “Study strengthens link between low vitamin D levels and risk of MS.” National Multiple Sclerosis Society. 14 September 2017. Accessed: 15 November 2017. ↩

22. “Serum vitamin D in patients with alopecia areata.” Indian Dermatology Online Journal. September 2016. Accessed: 15 November 2017. ↩

23. “Vitamin D deficiency and the risk of tuberculosis: a meta-analysis.” Drug Design, Development and Therapy. 28 December 2016. Accessed: 15 November 2017. ↩

24. “Epidemiology of nutritional rickets in children.” Saudi Journal of Kidney Diseases and Transplantation. March 2009. Accessed: 15 November 2017. ↩

25. “A review on vitamin D deficiency treatment in pedicatric patients.” The Journal of Pediatric Pharmacology and Therapeutics. October 2013. Accessed: 15 November 2017. ↩

26. “Vitamin D and pregnancy: 9 things you need to know.” OBG Management. Frontline Medical Communications Inc. 23 August 2011. Accessed: 15 November 2017. ↩

27. “Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial.” American Academy of Pediatrics. October 2015. Accessed: 05 November 2018. ↩

28. “Associations between 25-hydroxyvitamin D and weight gain in elderly women.” Journal of Women’s Health. October 2012. Accessed: 15 November 2017. ↩

29. “Does D matter? The role of vitamin D in hair disorders and hair follicle cycling.” Dermatology Online Journal. 2010. Accessed: 15 November 2017. ↩

30. “Vitamin D toxicity.” Post N Med 2016. 22 September 2016. Accessed: 15 November 2017. ↩

31. “Vitamin D toxicity.” Indian Journal of Endocrinology and Metabolism. March 2012. Accessed: 15 November 2017. ↩

**Question: What⁢ is Vitamin D Deficiency?**



**Answer:**



**Definition:**



Vitamin D deficiency is a condition characterized by insufficient levels of vitamin D, an essential nutrient that plays crucial roles ⁤in various bodily functions.



**Causes:**



* **Limited sun exposure:** ‍The primary source of ⁣vitamin D for‍ humans is sunlight. Inadequate exposure ‍to sunlight can lead to deficiency.

* **Dietary factors:** Vitamin D‍ is found in⁤ fatty fish, eggs, and fortified foods. Restricted intake of these foods can contribute ⁣to low levels.

* **Medical conditions:**⁤ Certain medical conditions, such as ⁢celiac disease, Crohn’s disease, ​and⁣ malabsorption disorders, can impair vitamin D absorption.

*‌ **Age-related factors:** The body’s ability to​ absorb and utilize vitamin D decreases with age.

* ‍**Certain medications:**​ Some prescription medications, like⁣ corticosteroids and ‍anticonvulsants,⁢ can reduce vitamin D levels.



**Symptoms:**



Vitamin D ‌deficiency often causes no noticeable symptoms in its early stages. However, as levels become more depleted,⁤ individuals may experience:



* Fatigue ⁢and weakness

* Muscle and bone ⁣pain

* Impaired immune function

* ‍Skeletal abnormalities, such as ⁤osteoporosis and rickets

*‌ Tooth decay

* Skin disorders



**Diagnosis:**



Vitamin D deficiency is diagnosed through a simple blood test that measures the‍ levels of 25-hydroxyvitamin D (25(OH)D), the main circulating form of vitamin⁢ D in the body.



**Treatment:**



Treatment involves increasing vitamin D levels through:



* **Sun exposure:** ​Controlled exposure to sunlight⁤ can be an effective way to boost vitamin D.

* **Vitamin D supplements:** Oral supplements in the form of pills, drops, or injections ⁢can correct ⁣deficiencies.

* **Fortified foods:** Consuming foods fortified with vitamin D, such as milk, cereals, and yogurt, can contribute to ⁤daily intake.



**Key Points to ‌Enhance SEO Visibility:**



* **Keywords:** Vitamin D ⁤deficiency, causes, symptoms, diagnosis, treatment, sun exposure, supplements, fortified foods

* **Headings:** Definition, Causes,⁢ Symptoms, Diagnosis, Treatment

*‌ **Subheadings:** Limited sun exposure, Dietary factors, Medical conditions, Age-related factors, Certain medications

* **Internal‍ linking:** Include links to relevant articles on related topics such as sunlight⁢ exposure‌ and vitamin ​D supplements



**Additional Information:**



* Vitamin D is essential for calcium absorption and bone health.

* Deficiency can have long-term consequences, including osteoporosis, increased ⁣risk of ‌fractures, and compromised muscle​ function.

* Maintaining adequate vitamin D levels is crucial for overall health and well-being.