If you shun the sun, suffer from milk
adhere to a strict vegetarian diet, you may be at risk for
vitamin D deficiency.
Known as the sunshine vitamin, vitamin D is produced by the body in response to
sunlight. It is also occurs naturally in a few
Vitamin D is essential for strong bones because it helps the body use calcium from the diet. Traditionally, vitamin D deficiency has been associated with rickets, a disease in which the bone tissue doesn't properly mineralize, leading to soft bones and skeletal deformities. But increasingly, research is revealing the importance of vitamin D in protecting against a host of health problems.
Symptoms and Health Risks of Vitamin D Deficiency
Symptoms of bone pain and muscle weakness can mean you have a vitamin D deficiency. However, for many people, the symptoms are subtle. Yet even without symptoms, too little vitamin D can pose health risks. Low blood levels of the vitamin have been associated with the following:
- Increased risk of death from cardiovascular disease
- Cognitive impairment in older adults
- Severe asthma in children
Research suggests that vitamin D could play a role in the prevention and treatment of a number of different conditions, including type1 and type 2 diabetes, hypertension, glucose intolerance, and multiple sclerosis.
Causes of Vitamin D Deficiency
Vitamin D deficiency can occur for a number of reasons:
You don't consume the recommended levels of the vitamin over time. This is likely if you follow a strict vegetarian diet, because most of the natural sources are animal-based, including fish and fish oils, egg yolks, cheese, fortified milk, and beef liver.
Your exposure to sunlight is limited. Because the body makes vitamin D when your skin is exposed to sunlight, you may be at risk of deficiency if you are homebound, live in northern latitudes, wear long robes or head coverings for religious reasons, or have an occupation that prevents sun exposure.
You have dark skin. The pigment melanin reduces the skin's ability to make vitamin D in response to sunlight exposure. Some studies show that older adults with darker skin are at high risk of vitamin D deficiency.
Your kidneys cannot convert vitamin D to its active form. As people age their kidneys are less able to convert vitamin D to its active form, thus increasing their risk of vitamin D deficiency.
Your digestive tract cannot adequately absorb vitamin D. Certain medical problems, including Crohn's disease, cystic fibrosis, and celiac disease, can affect your intestine's ability to absorb vitamin D from the food you eat.
You are obese. Vitamin D is extracted from the blood by fat cells, altering its release into the circulation. People with a body mass index of 30 or greater often have low blood levels of vitamin D.
Tests for Vitamin D Deficiency
The most accurate way to measure how much vitamin D is in your body is the 25-hydroxy vitamin D blood test. A level of 20 nanograms/milliliter to 50 ng/mL is considered adequate for healthy people. A level less than 12 ng/mL indicates vitamin D deficiency.
Treatment for Vitamin D Deficiency
Treatment for vitamin D deficiency
involves getting more vitamin
Guidelines from the Institute of Medicine increased the recommended dietary allowance (RDA) of vitamin D to 600 international units (IU) for everyone aged 1-70, and raised it to 800 IU for adults older than 70 to optimize bone health. The safe upper limit was also raised to 4,000 IUs.
If you don't spend much time in the sun or always are careful to cover your skin (sunscreen inhibits vitamin D production), you should speak to your doctor about taking a vitamin D supplement, particularly if you have risk factors for vitamin D deficiency.
WebMD Medical Reference
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Institute of Medicine: "Dietary Reference Intakes for Calcium and vitamin D."
Office of Dietary Supplements, National Institutes of Health; "Dietary Supplement Sheet: Vitamin D."
Melamed M. Archives of Internal Medicine, August 2008.
News release, Peninsula Medical School News.
WebMD Health News: "Low Vitamin D Linked to Severe Asthma."
Garland C.F. Annals of Epidemiology, July 2009.
MedlinePlus: "25-hydroxy Vitamin D Test."
Harvard School of Public Health: "Vitamin D: How Much Is Enough?"
Reviewed by Kathleen M. Zelman, MPH, RD, LD on May 04, 2012