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- Inadequate intake of vitamin D in the diet
Lack of sunlight due to:
- Having a darker skin color
- Wearing clothes that cover most of the skin
- Living in northern latitudes during the winter
- Not being exposed to direct sunlight—Sunlight through windows, clothes, or sunscreen-covered skin is not enough for the body to synthesize vitamin D.
- Conditions and procedures that affect the body’s ability to absorb vitamin D from the digestive tract (such as celiac disease, inflammatory bowel disease, bariatric surgery)
Conditions or medicines that affect the process of converting vitamin D to a form that the body can use, such as:
- Anti-seizure medicines such (such as phenobarbital, phenytoin, carbamazepine)
- Other medicines (such as rifampin, isoniazid, theophylline)
- Severe liver disease
- Chronic kidney disease
- Vitamin-D dependant rickets (an inherited condition)
- Hypoparathyroidism (underactive parathyroid)
- Nephrotic syndrome (kidney condition)
- Peritoneal dialysis
- Limited sun exposure
- Darker skin color
- Kidney disease
- Restricted activity (such as due to hospitalization)
- Injury due to a severe burn
- Malabsorption disorder (such as celiac disease)
- Certain types of diets (such as macrobiotic diet)
- Liver conditions
- Babies who are breastfed or do not consume enough formula that is fortified with vitamin D
- Bone and muscle pain
- Muscle weakness
- Hip pain
- Difficulty walking, walking up stairs, and getting out of a chair
- Blood tests to check vitamin D levels and kidney function
- Bone tests
- Vitamin D supplementation—High doses of vitamin D are given for 6-12 weeks. This is followed by a lower dose of the vitamin. The doses are continued until blood levels return to normal.
- Calcium supplementation—Calcium plus vitamin D supplements may be given to increase D levels. This can also improve bone strength in older women with low vitamin D.
- Light therapy—Exposure to sunlight or UV radiation can increase D levels. Vitamin D3 is produced in the skin when it is exposed to these light sources.
- Eat a healthy diet. Foods are not naturally high in vitamin D. Many foods are enriched with vitamin D, such as milk, juices, and cereal.
- Take a vitamin D supplement if recommended by your doctor. Your baby may need a supplement if he is breastfed or does not consume enough formula that is fortified with vitamin D. Children may also need to take a supplement if they are not getting enough vitamin D in their diets.
- Follow your doctor’s guidelines on getting enough sun exposure.
- If you or a family member has any of the above risk factors, talk to the doctor about other ways to avoid becoming deficient in vitamin D.
Celiac Sprue Association http://www.csaceliacs.org
Office of Dietary Supplements http://ods.od.nih.gov
Canadian Pediatric Society http://www.cps.ca
Health Canada http://www.hc-sc.gc.ca/index%5Fe.html
Allain TJ, Dhesi J. Hypovitaminosis D in older adults. Gerontol. 2003;49: 273-278.
American Academy of Dermatology. Position statement on vitamin D. American Academy of Dermatology website. Available at: http://www.aad.org/Forms/Policies/Uploads/PS/PS-Vitamin%20D.pdf. Published June 19, 2009. Accessed August 3, 2010.
Calvagna M. Vitamin D. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated April 5, 2010. Accessed July 13, 2010.
Dietary supplement fact sheet: vitamin D. Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/vitamind.asp#h4. Accessed March 16, 2008.
DynaMed Editorial Team. Vitamin D deficiency in adults. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 3, 2010. Accessed August 13, 2010.
Pfeifer M, Begerow B, et al. Vitamin D and muscle function. Osteoporosis Int. 2002;13:187-194.
Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003; 78:1463.
Tangpricha V, Pearce EN, et al. Vitamin D insufficiency among free-living healthy young adults. Am J Med. 2002;112:659-662.
Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122:1142-1152.
- Reviewer: Peter Lucas, MD
- Review Date: 12/2013 -
- Update Date: 01/13/2014 -