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What causes vitamin D deficiency?
Vitamin D deficiency - Who is most at risk?
Effects of vitamin D deficiency.
Symptoms of vitamin D deficiency.
Testing for vitamin D deficiency.
Treatment of vitamin D deficiency.
Vitamin D deficiency - correction dosage.
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Our bodies are adapted for obtaining vitamin D mainly from sunlight on our skin. Until a few thousand years ago (in evolutionary terms, just an eye blink) we spent much of our time in the sun, hunting and gathering. Vitamin D deficiency probably didn't exist.
Even fair-skinned races living in temperate zones would have obtained all the vitamin D they needed. At the end of summer, their vitamin D levels would have been optimum, then would have gradually declined to moderate levels during winter.
We have similar bodies to our ancestors, genetically speaking. But instead of occupying ourselves with hunting and gathering, most of us spend our daylight hours in offices, factories, houses, and we travel in cars, busses and trains.
When we do go outside, we are usually fully clothed. And those few square inches of skin that remain uncovered are often plastered with sunscreen or sunblock.
So it's not surprising that many of us are chronically deficient in vitamin D. Those with dark complexions who live in temperate or polar zones are worst affected. But, with our current lifestyles, even fair-skinned people these days can suffer from severe vitamin D deficiency.
Most likely to be deficient in vitamin D are:
Many of us are in fact deficient. In recent US surveys of serum 25(OH)D levels
were found to be vitamin D deficient, or insufficient.
Vitamin D deficiency has been associated with a large number of diseases, degenerative conditions and "genetic" conditions.
Vitamin D deficiency in pregnancy may affect the development of the unborn child. Low vitamin D levels in infants and children may affect their mental and physical development.
In adults, many degenerative conditions and disease processes are strongly associated with inadequate vitamin D levels. Just to take one single example, some scientists estimate that, with optimum vitamin D levels, first-world cancer rates could be halved.
Here are some of the conditions associated with vitamin D deficiency:
Acne
Adrenal insufficiency
Allergies
Alzheimer's disease
Asthma
Autism
Autoimmune disorders
Bones weak (easy to fracture)
Breast cancer
Cancer (all types)
Celiac disease
Crohn's disease
Chronic fatigue
Chronic pain
Colonic adenoma
Colorectal cancer
Cystic fibrosis
Dementia
Dental cavities and misaligned teeth
Depression
Diabetes (types 1 and 2)
Fatigue
Gluten intolerance
Graves disease
Heart disease
Hypertension
Kidney Disease
Low back pain
Lupus erythematosis
Melanoma
Mental illness and mood disorders
Multiple Sclerosis
Muscle weakness and pain
Obesity
Osteoarthritis
Osteomalacia (softening of bones)
Osteoporosis
Ovarian cancer
Parkinson's disease
Periodontal disease
Peripheral artery disease
Pelvic floor disorders
Psoriasis
Rheumatoid arthritis
Rickets
Seasonal affective disorder (SAD)
Tuberculosis
Urinary incontinence
Scary as it is, this list is not complete. Ill-effects from vitamin D deficiency are still being found, almost everywhere researchers look.
Vitamin D deficiency is involved somehow in just about every degenerative condition that affects us, even perhaps, the ageing process itself.
It sure seems as though the human body was designed to rely on plentiful supplies of vitamin D!
An association with vitamin D deficiency does not necessarily mean that vitamin D deficiency causes the condition. Most of the conditions in this list may have many causes. But it does imply that
Healthcare professionals are learning to look for vitamin D deficiency, and to restore optimum vitamin D levels, as an important part of their management of all these conditions.
Vitamin D deficiency doesn't happen overnight. If your vitamin D level was optimum at the end of autumn, you would then be able to coast all through winter and still have near-normal levels at the beginning of spring.
But if your vitamin D reserves are already low at the end of autumn, you will most likely be severely deficient by the end of winter if you rely entirely on food and sunlight to provide your vitamin D.
Being severely deficient in vitamin D for a few months may affect your well-being in areas such as: feeling depressed, poor resistance to infections, and increased pain and inflammation.
Vitamin D deficiency which persists for several years may chronically undermine your health and increase your chances of acquiring one (or more) of the serious degenerative conditions in the list above.
You can easily deal with vitamin D deficiency, before it leads to any of these conditions. Why wait until your health is compromised?
It's easy to get your blood vitamin D level tested. The most relevant test is for serum 25(OH)D, which can be performed at most pathology laboratories. A home test kit is also available.
The test indicates your vitamin D status. Results will either be quantified in nanograms per millilitre (ng/ml) or nanomoles per Litre (nmol/L) depending on which one your laboratory uses:
|
25(OH)D Blood test results |
||
|---|---|---|
|
Vitamin D Status |
ng/ml | nmol/L |
| Severely Deficient | 0-10 | 0-25 |
| Deficient | 11-20 | 26-50 |
| Low-normal | 21-32 | 51-81 |
| Normal | 33-49 | 82-124 |
| Optimum | 50-65 | 125-163 |
| High, but not toxic | 66-100 | 164-250 |
| Toxicity possible | above 100 | above 250 |
Not everyone agrees with these exact ranges, but most experts accept that below 25 ng/mL is insufficient for your body's needs. Ideally you should test above 40 ng/mL all year round.
If you want to assess your own vitamin D status before you take a blood test, see Estimating your own vitamin D status.
Fortunately, because certain foods contain vitamin D, we have the capability to absorb it through our digestive system. This means that we can increase our vitamin D levels by taking the right foods and supplements.
Treating a vitamin D deficiency involves restocking the body's vitamin D reserves, not just creating a momentary spike in blood levels. This is best done over several weeks, simulating how you would naturally recover from a vitamin D deficiency by sun exposure after a long winter.
The next table shows the daily amount (in IU) of vitamin D3 from all sources needed to rectify the deficiency over a period of 60 days. This is for an 80 kg adult person.
If you are making this calculation for a larger or smaller adult, or a child, then calculate an adjusted dose in proportion to that person's actual body mass. Give that adjusted dose for 60 days.
Using your current 25(OH)D blood level, read off the basic correction dose that applies to you from the table below:
|
25(OH)D Blood levels |
Correction Dose* | |||
|---|---|---|---|---|
|
Vitamin D Status |
ng/ml | nmol/L | D3 IU | Days |
| Severely Deficient | 0-10 | 0-25 | 7000* | 60 |
| Deficient | 11-20 | 26-50 | 6000* | 60 |
| Low-normal | 21-32 | 51-81 | 5500* | 60 |
| Normal | 33-49 | 82-124 | 0 | |
| Optimum | 50-65 | 125-163 | 0 | |
| High, but not toxic | 66-100 | 164-250 | 0 | |
| Toxicity possible | above 100 | above 250 | 0 | |
* The doses in this table are for an 80 kg adult. This dose must be adjusted as described below.
For example, if your blood level is 18 ng/ml currently, you fall into the Deficient range. You will see the correction dose for that category is 6000 IU of vitamin D3 each day. That is for an 80 kg adult.
Adjusted dose = correction-dose-per-table x body-mass-in-Kg / 80
Most people are getting about 150 IU of vitamin D every day from food. People who eat a lot of fatty fish (more than twice a week) may get slightly more.
See vitamin D sources for more information about vitamin D amounts in foods.
Now calculate your own correction dose using your body mass and vitamin D intake. See example calculation below.
Suppose you are a 72 kg adult whose vitamin D status is severely deficient. You estimate your food intake at 200 IU. You take a daily multivitamin containing 400 IU of vitamin D.
The table shows a correction dose of 7000 IU for the Severely Deficient category.
Adjust the dose for your body mass as described above:
7000 x 72 / 80 = 6300 IU
Now subtract your vitamin D intake from food (200 IU) and other supplements (multivitamin: 400 IU):
6300 - 200 - 400 = 5700 IU
That is the personalized correction dose for the person in this example, to be taken every day for 60 days.
It is quite common for medical doctors to prescribe 50 000 IU of vitamin D every week for up to 8 weeks for deficient patients. Some patients are alarmed at this high dosage, but it works very well and is completely safe (for an otherwise healthy person) for the purpose of treating a vitamin D deficiency.
It is wise to measure 25(OH)D blood levels before and after the course of vitamin D treatments. (Individual responses to high vitamin D doses vary.)
Ask your doctor if you can take vitamin D3 (cholecalciferol) which is identical to that which your own body would make, not the synthetic vitamin D2 (ergocalciferol) contained in most prescription forms of vitamin D.
Unless you expect to be getting a whole lot of sun exposure during the 60 day period, you can ignore vitamin D from sunshine.
You are probably not getting very much sun anyway, and if you do happen to get more during the coming 60 day period, then your vitamin D blood level may exceed the target 50 ng/ml at the end of 60 days, but it will still be within the optimum range (50 ng/ml to 65 ng/ml).
So take the personalized correction dose you calculated for yourself - every day for 60 days - to correct your vitamin D deficiency. Then change to the daily maintenance dose.
Also see these important considerations whenever you supplement vitamin D.