Vitamin D deficiency: What you need to know?
The following groups
are at a particularly high risk of vitamin D deficiency:
Infants and children aged <5 years
Pregnant and breastfeeding women, particularly teenagers and
young women
Older people aged >65 years
Individuals who have darker skin (e.g. people of South Asian
ethnic origin).
People who have no or limited sun exposure, including people
who:
- cover
their skin for cultural reasons
- are
confined indoors
- do not
ingest adequate amounts of foods that contain vitamin D
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Cholecalciferol is indicated for
the treatment of specific medical conditions like refractory rickets (or
vitamin D resistant rickets), hypoparathyroidism, and familial
hypophosphatemia.
Concurrently, Vitamin D3 (Cholecalciferol) is also very frequently used as a supplement in individuals to maintain sufficient vitamin d levels in the body or to treat vitamin D deficiency.
As well as various medical conditions that can be associated
directly or indirectly with vitamin d insufficiency like osteoporosis and chronic
kidney disease.
Severe lack of vitamin D causes
rickets, which shows up in Children as
- Incorrect growth patterns.
- Weakness in muscles.
- Painful muscles.
- Pain in bones and deformities in joints.
Lack of vitamin D is not quite as
obvious in Adults. Signs and Symptoms might include:
- Fatigue.
- Bone pain.
- Muscle weakness, muscle aches, or muscle cramps.
- Mood changes, like depression.
Measurement of serum D (25[OH] D)
is the best test to determine vitamin D status. Levels are interpreted as
follows:
- 21-29 ng/mL (52.5-72.5 nmol/L): Vitamin D insufficiency
- < 20 ng/mL (< 50 nmol/L): Vitamin D deficiency
Health professionals do not need to routinely test vitamin D status in asymptomatic people.
“Empiric vitamin D
supplementation without testing can be justified for patients who have no overt
risk factors or evidence of deficiency but are thought to have inadequate sun
exposure or dietary intake.”
To treat vitamin D deficiency, correct deficiencies of
calcium and phosphate and give supplemental vitamin D3 (Cholecalciferol).
The Endocrine Society recommends:
Child:
400 IU for children aged 0-1 year and
600 IU/day for children aged 1-18 years.
Adult:
1500-2000 IU for all men and women older than 18 years,
including lactating and pregnant women.
Higher doses of vitamin D, given either daily or weekly.
https://www.guidelinesinpractice.co.uk/nutrition/vitamin-d-deficiency-people-at-risk-need-access-to-supplements/352598.article
https://www.nice.org.uk/guidance/PH56
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/339349/SACN_Update_on_Vitamin_D_2007.pdf
https://emedicine.medscape.com/article/128762-overview
https://www.aafp.org/afp/2009/1015/p841.html
https://www.endocrine.org/clinical-practice-guidelines/vitamin-d-deficiency
https://my.clevelandclinic.org/health/articles/15050-vitamin-d--vitamin-d-deficiency
Note: For informational purposes only. Consult your
textbook for advising your patients.
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