Vitamin D deficiency — when the level of vitamin D in your body is too low — can cause your bones to become thin, brittle or misshapen. Show Vitamin D also appears to play a role in insulin production and immune function — and how this relates to chronic disease prevention and cancer — but this is still being investigated. Although the amount of vitamin D adults get from their diets is often less than what's recommended, exposure to sunlight can make up for the difference. For most adults, vitamin D deficiency is not a concern. However, some groups — particularly people who are obese, who have dark skin and who are older than age 65 — may have lower levels of vitamin D due to their diets, little sun exposure or other factors. The Recommended Dietary Allowance (RDA) for adults is 600 international units (IU) of vitamin D a day. That goes up to 800 IU a day for those older than age 70. To meet this level, choose foods that are rich in vitamin D. For example, choose fatty fish, such as salmon, trout, tuna and halibut, which offer higher amounts of vitamin D, or fortified foods, such as milk and yogurt. Don't overdo it, though. Very high levels of vitamin D have not been shown to provide greater benefits. In fact, too much vitamin D has been linked to other health problems. If you're concerned about whether you're getting enough vitamin D, talk to your doctor about your diet and whether a vitamin supplement might benefit you. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. To provide you
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. Vitamin D deficiency is most commonly caused by a lack of exposure to sunlight. Some disorders can also cause the deficiency.
Two forms of vitamin D are important for nutrition:
Human breast milk contains only small amounts of vitamin D. Vitamin D is stored mainly in the liver. Vitamin D2 and D3 are not active in the body. Both forms must be processed (metabolized) by the liver and kidneys into an active form called active vitamin D or calcitriol. This active form promotes absorption of calcium and phosphorus from the intestine. Calcium and phosphorus, which are minerals, are incorporated into bones to make them strong and dense (a process called mineralization). Thus, calcitriol is necessary for the formation, growth, and repair of bones. Vitamin D may be used to treat
psoriasis Psoriasis Psoriasis is a chronic,
recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin. A problem with the immune... read more Requirements for vitamin D increase as people age. Vitamin D deficiency is common worldwide. Most commonly, it occurs when the skin is not exposed to enough sunlight. Natural (unfortified) foods alone rarely provide enough vitamin D to prevent deficiency. Foods that are fortified with vitamin D and supplements of vitamin D can help prevent deficiency when exposure to sunlight is inadequate. In vitamin D deficiency, the body absorbs less calcium and phosphate. Because not enough calcium and phosphate are available to maintain healthy bones, vitamin D deficiency may result in a bone disorder called rickets in children or osteomalacia in adults. In osteomalacia, the body does not incorporate enough calcium and other minerals into bones, resulting in weak bones. The most common cause of vitamin D deficiency is
Thus, vitamin D deficiency occurs mainly among people who do not spend much time outdoors: older people and people who live in an institution such as a nursing home. The deficiency can also occur in the winter at northern and southern latitudes or in people who keep their bodies covered, such as Muslim women. Because breast milk contains only small amounts of vitamin D, breastfed infants who are not exposed to enough sunlight are at risk of the deficiency and rickets. Some experts recommend that the arms and legs or the face, arms, and hands should be exposed to direct sunlight for 5 to 15 minutes at least 3 times a week, but some people, such as those who have darker skin or are older, may need more exposure to sunlight. However, many dermatologists do not recommend increased sunlight exposure because risk of skin cancer is increased. Vitamin D deficiency usually occurs in people who are not exposed to sunlight and who do not consume enough vitamin D in their diet. When the skin is exposed to enough sunlight, the body usually forms enough vitamin D. However, certain circumstances increase the risk of vitamin D deficiency even when there is exposure to sunlight:
Vitamin D deficiency can cause muscle aches, weakness, and bone pain in people of all ages. Muscle spasms (tetany) may be the first sign of rickets in infants. They are caused by a low calcium level in the blood in people with severe vitamin D deficiency. If pregnant women have vitamin D deficiency, their newborn may have spasms. The spasms may affect the face, hands, and feet. If the spasms are severe, they may cause seizures. In young infants who have rickets, the entire skull may be soft. Older infants may be slow to sit and crawl, and the spaces between the skull bones (fontanelles) may be slow to close. For older children and adolescents, walking is painful. Severe vitamin D deficiency can cause bowlegs or knock-knees. The pelvic bones may flatten, narrowing the birth canal in adolescent girls. In adults, the bones, particularly the spine, pelvis, and leg bones, weaken. Affected areas may be painful to touch, and fractures may occur.
Doctors suspect vitamin D deficiency in the following people:
Blood tests to measure vitamin D can confirm the deficiency. Levels of calcium and phosphate are measured. Levels of other substances may be measured to rule out other causes of decreased bone density. X-rays may also be taken. The characteristic changes in bone may be seen on x-rays before symptoms become noticeable. The diagnosis of rickets or osteomalacia due to vitamin D deficiency is based on symptoms, the characteristic appearance of bones on x-rays, and a low level of vitamin D in the blood. Many people need to take vitamin D supplements. Getting enough exposure to sunlight may be difficult, especially because the skin also needs to be protected from sun damage. Natural foods rarely contains enough vitamin D to compensate for lack of sunlight. Vitamin D supplements are particularly important for people who are at risk (such as people who are older, housebound, or living in long-term care facilities). To prevent deficiency, older people should usually take 20 micrograms [800 units] of vitamin D daily in supplements. Higher doses are rarely needed. Commercially available liquid milk (but not cheese or yogurt) is fortified with vitamin D in the United States and Canada. Many other countries do not fortify milk with vitamin D. Breakfast cereals may also be fortified. In breastfed infants, starting vitamin D supplements at birth is particularly important because breast milk contains little vitamin D. Supplements are given until infants are 6 months old, when they begin to eat a more varied diet. For formula-fed infants, commercial infant formulas contain enough vitamin D.
Treatment of vitamin D deficiency involves taking high doses of vitamin D, usually daily by mouth, for about 1 month. After 1 month, the dose is usually reduced gradually to the usual recommended dose. If muscle spasms are present or calcium is thought to be deficient, calcium supplements are also given. If phosphate is deficient, phosphate supplements are given. Usually, this treatment leads to a complete recovery. People with a chronic liver or kidney disorder may require special formulations of vitamin D supplements. Older people are more likely to develop vitamin D deficiency for several reasons:
Older people should take 20 micrograms [800 units] of vitamin D each day to keep their bones healthy. Vitamin D has not been shown to prevent cancer or other disorders or to prevent falls in older people. Research to look for other benefits of vitamin D is ongoing. Older people who take high doses of vitamin D supplements need to have periodic blood tests to check their levels of calcium, vitamin D, and parathyroid hormone.
What happens when your vitamin D is low?Vitamin D deficiency can lead to a loss of bone density, which can contribute to osteoporosis and fractures (broken bones). Severe vitamin D deficiency can also lead to other diseases. In children, it can cause rickets. Rickets is a rare disease that causes the bones to become soft and bend.
How can I check my vitamin D levels at home?"The overwhelming majority are self-collected blood tests including at-home finger prick options like imaware." Everlywell, Drop, and myLAB Box are other brands that offer at-home vitamin D tests. Each relies on a finger prick blood sample.
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What are the signs and symptoms of vitamin d deficiency
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