Vitamin D Deficiency

In this issue, we shed light on an important topic that affects a large portion of the population: vitamin D deficiency.  Vitamin D is a crucial nutrient that plays a significant role in maintaining overall health, and its deficiency can lead to various health issues.  Join us as we explore the causes, symptoms, and prevention strategies for vitamin D deficiency. 

Vitamin D, often referred to as the “sunshine vitamin,” is a fat-soluble vitamin that is primarily produced in the body when the skin is exposed to sunlight.  Vitamin D has some vital functions in the body, including¹: 

• Keeping the calcium and phosphate levels in the blood normal, thus promoting bone health. 
• Other possible benefits, such as improving muscle and immune function.

Vitamin D deficiency can happen when a person does not consume enough vitamin D, is unable to absorb or metabolize the vitamin D, or does not spend enough time in ultraviolet B (UVB) sunlight.  Various factors that can increase the risk of a deficiency include²:

• Diet – Not eating enough vitamin D-rich foods
• Lifestyle factors – Spending too little time outdoors
• Geographical factors – Living in areas with less sunshine  
• Pollution – Particles in the air can block UVB rays
• Absorption problems – Crohn’s disease, celiac disease, and other conditions can affect the absorption of nutrients
• Medications – Steroids, cholesterol lowering drugs, and others
• Smoking – Deficiency is higher among smokers
• Obesity – Body mass index of 30 or more
• Skin type – Darker skin needs more sunlight exposure to produce vitamin D
• Age – Vitamin D synthesis may decline with age due to decreased kidney function 
• Kidney and liver disease 
• Pregnancy – Vitamin D requirements may increase during pregnancy
• Breastfeeding – Human milk is low in vitamin D, breastfeeding infants are at risk of a deficiency 

Vitamin D deficiency may produce no symptoms, or symptoms may take several years to appear. Individuals may experience any of the following³:

• Bone pain or discomfort in the lower back, pelvis, or legs
• Muscle aches and weakness 
• Low back pain in women 
• Poor growth, irritability, and frequent respiratory tract infections in infants 
• Deformed bones and slow growth in children

In time, vitamin D deficiency may increase the risk of long-term health problems, including²:

• Osteoporosis – The bones become thin or brittle. 
• Osteomalacia – The bones become soft, resulting in bone deformities, short stature, dental problems, fragile bones, and pain when walking.
• Researchers are looking into whether other symptoms or conditions, such as depression, may result from low vitamin D levels.

To determine whether an individual has vitamin D deficiency, the healthcare provider may order a blood test. 

The specific need for vitamin D varies among individuals and is influenced by several factors, including age, UVB exposure, diet, and overall health.  While some individuals may require vitamin D supplements, it is crucial to consult with a healthcare provider before starting any supplementation, as certain supplements can have adverse effects.  A healthcare provider will also provide guidance on the appropriate dosage.  It is important to be aware that excessive intake of dietary supplements containing vitamin D can result in toxicity.  Symptoms of toxicity may include decreased appetite, weight loss, and irregular heartbeats. Furthermore, high levels of calcium in the blood due to vitamin D toxicity can lead to calcification in blood vessels and tissues, potentially causing damage to the heart, blood vessels, and kidneys².

The best ways to prevent a vitamin D deficiency are to eat foods that are rich in vitamin D and to spend some time outside each day. Good dietary sources of vitamin D include:

• Oily fish, such as mackerel or salmon
• Beef liver
• Cheese
• Mushrooms
• Egg yolks
• Fortified foods, including some breakfast cereals, orange juice, milk, soy drinks, and margarine

Sunlight is essential for boosting vitamin D, but inappropriate sun exposure increases the risk of skin cancer. For safe exposure to sunlight, a person should spend approximately 5–30 minutes between 10 AM and 3 PM at least twice a week to the forearms, hands, or lower legs without sunscreen³. When to do this and for how long will depend on the time of year, geographic area, and other factors. People should ask their healthcare provider about safe ways to increase sun exposure.

Some additional tips for avoiding a deficiency include:

• Maintaining a healthy body weight: Cycling or walking can provide both exercise and sensible exposure to sunlight.
• Treating medical conditions: People with health conditions that affect the absorption of nutrients may find that treating the underlying disease helps boost their levels of certain nutrients, including vitamin D.
• Being proactive about preventive health: People with a family history of osteoporosis or vitamin D deficiency may wish to consider speaking to their doctor about screening.
• Dietary supplements might be required to meet the daily need for vitamin D.

If you have concerns about vitamin D deficiency or would like more information on this topic, call your local health care provider to schedule an appointment.