Vitamin D deficiency can result from inadequate exposure to sunlight; malabsorption; accelerated catabolism from certain medications; and, in infants, the minimal amount of vitamin D found in breast milk. In children, vitamin D deficiency can result in rickets, which presents as bowing of the legs; in adults, it results in osteomalacia, which presents as a poorly mineralized skeletal matrix. Signs and Symptoms Vitamin D deficiency is often clinically silent. Manifestations are as follows: Children are often found to have started walking late or prefer to sit down for prolonged periods, bowing in the legs. Adults can experience chronic muscle aches and pains and periosteal bone pain, best detected with firm pressure on the sternum or tibia. Moreover the given symptoms: 1. Excessive sweating It's often difficult to tell if newborns are deficient, but a sweaty forehead is one of the first noticeable symptoms. The same rings true for adults, so if you're "glowing" while your activity level remains steady, your temperature is close to 98.6° and you're in a moderate temperature environment, you may want to consider avitamin Dtest. 2. Noticeable—and unexpected—weakness Muscle strength isn't just a matter of pumping iron. While having a vitamin Ddeficiency can leave you feeling overly exhausted, even when you're able to get enough shut-eye, propervitamin Dintake helps you maintain power in every fiber of your being, whether you're young or old. Harvard researchers have linkedvitamin Dsupplementation with increased muscle control, resulting in 20% fewer falls among adults around 60 years old. 3. Broken bones You stop building bone mass around age 30, and a lack ofvitamin Dcan speed up or worsen osteoporosis symptoms, according to research published in theAmerican Journal of Clinical Nutrition. Fortification, first introduced around 1930, almost eradicated the weak bone condition rickets, however, "it's nearly impossible for anyone to satisfyvitamin D needs through diet. It really requires a three-pronged attack: sun exposure, supplements, andfood. 4. Chronicpain It's often subtle, but some experience aches and pains in the bones, known as osteomalacia. Those who are diagnosed with arthritis or fibromyalgia may actually be shy of enough D, as a deficiency can cause joints and muscles to ache, too. 5. A down-in-the-dumps mood A depression diagnosis is often actually linked to a shortage of vitamin D. While the jury is still out about why, the Vitamin D Council says that the mineral may work in the same brain areas—and impact the same hormones, like serotonin—as those that affect mood. Diagnosis Measurement of serum 25-hydroxyvitamin D (25[OH]D) is the best test to determine vitamin D status. levels of 25(OH)D 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 Although not always required for the diagnosis of vitamin D insufficiency, measurement of the serum parathyroid hormone (PTH) level may help establish the diagnosis of vitamin D insufficiency. PTH levels are often elevated in patients with vitamin D insufficiency, indicating secondary hyperparathyroidism. Screening for vitamin D deficiency is recommended only in those individuals who are at high risk for vitamin D deficiency, including the following: · Patients with osteoporosis · Patients with a malabsorption syndrome · Black and Hispanic individuals · Obese persons (body mass index >30 kg/m2) · Patients with disorders that affect the metabolism of vitamin D and phosphate (eg, chronic kidney disease) Treatment & Management Recommended treatment for vitamin D–deficient patients up to 1 year of age is as follows: 2000 IU/day of vitamin D2or D3for 6 weeksor 50,000 IU of vitamin D2or D3once weekly for 6 weeks When the serum 25(OH)D level exceeds 30 ng/mL, provide maintenance treatment of 400-1000 IU/day Recommended treatment for vitamin D–deficient patients 1–18 years of age is as follows: 2000 IU/day of vitamin D2or D3for at least 6 weeksor 50,000 IU of vitamin D2once weekly for at least 6 weeks When the serum 25(OH)D level exceeds 30 ng/mL, provide maintenance treatment of 600-1000 IU/day Recommended treatment for vitamin D–deficient adults is as follows: 50,000 IU of vitamin D2or D3once weekly for 8 weeksor 6000 IU/day of vitamin D2or D3for 8 weeks When the serum 25(OH)D level exceeds 30 ng/mL, provide maintenance treatment of 1500-2000 IU/day Recommended treatment for vitamin D–deficient patients who are obese, have a malabsorption syndrome, or are taking medication that affects vitamin D metabolism, is as follows: At least 6000-10,000 IU of vitamin D daily When the serum 25(OH)D level exceeds 30 ng/mL, provide maintenance treatment of 3000-6000 IU/day Most dietary sources of vitamin D do not contain sufficient amounts of the vitamin to satisfy daily requirements. The following foods contain the indicated amounts of vitamin D, as reported by the US Department of Agriculture's (USDA's) Nutrient Data Laboratory: Fortified milk (8 oz) - 100 IU Fortified orange juice (8 oz) [5] - 100 IU Fortified cereal (1 serving) - 40-80 IU Pickled herring (100 g) - 680 IU Canned salmon with bones (100 g) - 624 IU Mackerel (100 g) - 360 IU Canned sardines (100 g) - 272 IU Codfish (100 g) - 44 IU Swiss cheese (100 g) - 44 IU Raw shiitake mushrooms (100 g) - 76 IU Most multivitamins (1 tab) - 400 IU Source
