Vitamin D deficiency: Difference between revisions

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In [[medicine]], '''vitamin D deficiency''' is "s nutritional condition produced by a deficiency of VITAMIN D in the diet, insufficient production of vitamin D in the skin, inadequate absorption of vitamin D from the diet, or abnormal conversion of vitamin D to its bioactive metabolites. It is manifested clinically as [[rickets]] in children and [[osteomalacia]] in adults."<ref>{{MeSH}}</ref>
In [[medicine]], '''vitamin D deficiency''' is "a nutritional condition produced by a deficiency of [[vitamin D]] in the diet, insufficient production of vitamin D in the skin, inadequate absorption of vitamin D from the diet, or abnormal conversion of vitamin D to its bioactive metabolites. It is manifested clinically as [[rickets]] in children and [[osteomalacia]] in adults."<ref>{{MeSH}}</ref>


Recommended serum levels are 20 ng/mL (50 nmol/L) according to the Institute of Medicine (IOM)<ref name="IOM2010">Committee to Review Dietary References Intakes for Vitamin D and Calcium. Ross AC et al., editors. (2010)  [http://www.nap.edu/catalog.php?record_id=13050 Dietary References Intakes for Calcium and Vitamin D]. Institute of Medicine.</ref> and 30 ng/mL (75 nmol/L) according to the International Osteoporosis Foundation and National Osteoporosis Foundation.<ref name="pmid20422154">{{cite journal| author=Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE et al.| title=IOF position statement: vitamin D recommendations for older adults. | journal=Osteoporos Int | year= 2010 | volume= 21 | issue= 7 | pages= 1151-4 | pmid=20422154 | doi=10.1007/s00198-010-1285-3 | pmc= | url= }} </ref>  
Recommended serum levels are 20 ng/mL (50 nmol/L) according to the Institute of Medicine (IOM)<ref name="IOM2010">Committee to Review Dietary References Intakes for Vitamin D and Calcium. Ross AC et al., editors. (2010)  [http://www.nap.edu/catalog.php?record_id=13050 Dietary References Intakes for Calcium and Vitamin D]. Institute of Medicine.</ref> and 30 ng/mL (75 nmol/L) according to the International Osteoporosis Foundation and National Osteoporosis Foundation.<ref name="pmid20422154">{{cite journal| author=Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE et al.| title=IOF position statement: vitamin D recommendations for older adults. | journal=Osteoporos Int | year= 2010 | volume= 21 | issue= 7 | pages= 1151-4 | pmid=20422154 | doi=10.1007/s00198-010-1285-3 | pmc= | url= }} </ref>  

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In medicine, vitamin D deficiency is "a nutritional condition produced by a deficiency of vitamin D in the diet, insufficient production of vitamin D in the skin, inadequate absorption of vitamin D from the diet, or abnormal conversion of vitamin D to its bioactive metabolites. It is manifested clinically as rickets in children and osteomalacia in adults."[1]

Recommended serum levels are 20 ng/mL (50 nmol/L) according to the Institute of Medicine (IOM)[2] and 30 ng/mL (75 nmol/L) according to the International Osteoporosis Foundation and National Osteoporosis Foundation.[3]

Institute of Medicine states:

  • Levels over 20 ng/ml are sufficient
  • Levels 12-20 ng/ml are at risk of deficiency.
  • Levels below 12 ng/ml are deficient.

The IOM based their recommendations in part on a prior systematic review by the Agency for Healthcare Research and Quality.[4]

Epidemiology and prevalence

About a quarter of older adults have levels below 20 ng/mL.[5]

Low levels of vitamin D are common in medical inpatients.[6]

Diagnosis

Symptoms

Vitamin D was reported to be associated with widespread musculoskeletal pain like fibromyalgia[7].[8] However, this was an uncontrolled study and more recent studies make the associated between Vitamin D and non-specific pain doubtful[9] and suggest that earlier recommendations[7] to screen patients with musculoskeletal pain for deficiency of vitamin D may not be justified.

Laboratory test

The serum level of 25-hydroxyvitamin D is the best metabolize to assay.[10][11]

Treatment

Clinical practice guidelines direct treatment.[12]

References

  1. ↑ Anonymous (2024), Vitamin D deficiency (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Committee to Review Dietary References Intakes for Vitamin D and Calcium. Ross AC et al., editors. (2010) Dietary References Intakes for Calcium and Vitamin D. Institute of Medicine.
  3. ↑ Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GE et al. (2010). "IOF position statement: vitamin D recommendations for older adults.". Osteoporos Int 21 (7): 1151-4. DOI:10.1007/s00198-010-1285-3. PMID 20422154. Research Blogging.
  4. ↑ Chung M, Balk EM, Brendel M, Ip S, Lau J, Lee J et al. (2009). "Vitamin D and calcium: a systematic review of health outcomes.". Evid Rep Technol Assess (Full Rep) (183): 1-420. PMID 20629479. [e]
  5. ↑ Orwoll E, Nielson CM, Marshall LM, et al (April 2009). "Vitamin D deficiency in older men". J. Clin. Endocrinol. Metab. 94 (4): 1214–22. DOI:10.1210/jc.2008-1784. PMID 19174492. Research Blogging.
  6. ↑ Thomas MK, Lloyd-Jones DM, Thadhani RI, et al (1998). "Hypovitaminosis D in medical inpatients". N. Engl. J. Med. 338 (12): 777–83. PMID 9504937. [e]
  7. ↑ 7.0 7.1 Plotnikoff GA, Quigley JM (2003). "Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain". Mayo Clin. Proc. 78 (12): 1463–70. PMID 14661675. [e] Cite error: Invalid <ref> tag; name "pmid14661675" defined multiple times with different content
  8. ↑ Hicks GE, Shardell M, Miller RR, et al (May 2008). "Associations between vitamin D status and pain in older adults: the Invecchiare in Chianti study". J Am Geriatr Soc 56 (5): 785–91. DOI:10.1111/j.1532-5415.2008.01644.x. PMID 18331295. Research Blogging.
  9. ↑ Warner AE, Arnspiger SA (February 2008). "Diffuse musculoskeletal pain is not associated with low vitamin D levels or improved by treatment with vitamin D". J Clin Rheumatol 14 (1): 12–6. DOI:10.1097/RHU.0b013e31816356a9. PMID 18431091. Research Blogging.
  10. ↑ Rosen, Clifford J. (2011-01-20). "Vitamin D Insufficiency". New England Journal of Medicine 364 (3): 248-254. DOI:10.1056/NEJMcp1009570. ISSN 0028-4793. Research Blogging.
  11. ↑ Pearce SH, Cheetham TD (2010). "Diagnosis and management of vitamin D deficiency.". BMJ 340: b5664. DOI:10.1136/bmj.b5664. PMID 20064851. Research Blogging.
  12. ↑ Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP et al. (2011). "Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline.". J Clin Endocrinol Metab. DOI:10.1210/jc.2011-0385. PMID 21646368. Research Blogging.
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