![Symptoms of a vitamin D deficiency include bone problems, muscle aches or cramps, muscle spasms, muscle weakness, fatigue, cognitive impairment (in older adults), severe asthma in children, and cancer.](https://images.medicinenet.com/images/article/main_image/benefits-of-vitamin-d.jpg?output-quality=75)
Vitamin D is a fat-soluble vitamin produced in the skin when it is exposed to sunlight. Vitamin D is also naturally occurring in certain foods such as fatty fish, cod liver oil, and eggs.
Vitamin D helps the body absorb dietary calcium and phosphorus from the intestines and suppresses the release of parathyroid hormone, a hormone that causes bone resorption. This helps keep bones healthy. Vitamin D is also believed to improve muscle and immune function.
Vitamin D deficiency is another term for low levels of vitamin D.
Symptoms of low vitamin D include:
- Bone problems
- Pain due to softening of bones (osteomalacia)
- Fractures
- Bone deformities such as rickets in children
- Abnormal bone growth in children aged 1 to 4 years, causing scoliosis, bowlegs, or knock-knees
- Muscle aches or cramps
- Muscle spasms
- Muscle weakness
- Fatigue
- Cognitive impairment in older adults
- Severe asthma in children
- Cancer
What Causes Low Vitamin D?
Low vitamin D may be caused by:
- Low levels of vitamin D in the diet along with inadequate sun exposure
- Human breast milk contains low levels of vitamin D, and most infant formulas contain inadequate levels of vitamin D
- Older adults may not consume enough vitamin D-rich foods, and when they do, absorption may be limited
- Certain conditions that result in an inability to absorb vitamin D from the intestines
- Crohn's disease
- Celiac disease
- Cystic fibrosis
- Surgery that removes or bypasses portions of the stomach or intestines such as gastric bypass
- An inability to process vitamin D due to kidney or liver disease
- Certain medications
- Laxatives
- Weight loss medications
- Cholesterol-lowering drugs
- Steroids
- Anti-seizure medications
- Tuberculosis medication
- Other factors
- Not going outside often, such as those who are ill or housebound
- Living in institutions such as nursing homes
- Wearing clothes that cover most of the skin when outdoors
- Having dark skin, because people with dark skin may not produce sufficient vitamin D from sunlight
- Obesity
What Is the Treatment for Low Vitamin D?
Treatment for low vitamin D includes:
- Vitamin D supplements
- Cholecalciferol (vitamin D3) - vitamin D3 is usually recommended because it is the naturally occurring form of the vitamin and it may raise vitamin D levels more effectively
- Ergocalciferol (vitamin D2)
- The recommended dose of vitamin D depends upon the nature and severity of the vitamin D deficiency
- Additional supplements
- Calcium
- 1000 mg of calcium per day for premenopausal women and men
- 1200 mg per day for postmenopausal women
- Calcium
Foods that are good sources of vitamin D include:
- Oily fish
- Trout
- Salmon
- Sardines
- Herring
- Mackerel
- Tuna
- Meat and poultry
- Red meat
- Beef liver
- Chicken breast
- Ground beef
- Vegetables
- Mushrooms – white and portabella
- Dairy products
- Milk, vitamin D fortified
- Cheddar cheese
- Other
- Cod liver oil
- Plant-based milks (e.g., soy, almond, oat), vitamin D fortified
- Egg yolks
- Ready-to-eat cereals, vitamin D fortified
Exposure to sunlight is a source for vitamin D but too much sun exposure can cause sunburns, premature skin aging, eye damage, heat exhaustion or heat stroke, or skin cancer. Exposure to the sun is not recommended as a source of vitamin D for infants and children because of the potential risks of skin cancer. Talk to your doctor about how much sun exposure you need and how to get sun exposure safely.
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https://www.uptodate.com/contents/vitamin-d-deficiency-beyond-the-basics?search=vitamin%20d%20deficiency&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
https://www.merckmanuals.com/home/disorders-of-nutrition/vitamins/vitamin-d-deficiency