vitamin d deficiency
(Photo: Thomas Hawk. via flickr/CC Attribution)

How Does Vitamin D Work?

Vitamin D is really important for keeping our bones strong and healthy as it allows calcium and phosphorus to be absorbed into the body.

Vitamin D also benefits our muscles and general health and can help to protect against serious diseases such as diabetes, heart disease and cancer.

Best Sources of Vitamin D

We need Vitamin D to stay healthy, but many foods either contain no Vitamin D at all or contain only extremely low levels.

The foods with the highest Vitamin D concentration are oily fish and cod liver oil.

While liver, wild mushrooms and egg yolks also contain a small amount of Vitamin D.

Some foods are fortified with Vitamin D, these include infant milk formula and cereals – so keep a look out on packaging for products with added Vitamin D.

Individuals following a vegan or vegetarian diet tend to be those who are most at risk of not getting enough dietary Vitamin D.

Vitamin D Synthesis

But it’s not all doom and gloom, Vitamin D differs from other vitamins in that we do not have to rely on food to meet our needs as we produce Vitamin D in our skin through its exposure to sunlight.

Of course over-exposure to the sun, particularly if it burns the skin, should be avoided as, amongst other things, it increases the risk of cancer.

For many people however, not getting enough sun is the problem.

For example, during the winter months, the sunlight in much of Europe does not contain sufficient quantities of UVB to allow the body to create Vitamin D, meaning that diet once again plays an important role.

Sun Deficient Individuals

The location of individual is not the only factor that effects their ability to produce adequate amounts of Vitamin D from sunlight.

Housebound people, or those in hospital for prolonged periods are examples of people who may not be able to expose their skin to sunlight.

Another being individuals who cover their skin while outside, such as those who wear veils or use umbrellas.

People with pigmented skin too need to expose their skin to sunlight longer than those with fair skin to produce the same effect.

This is also true for the elderly, as they have thinner skin and therefore cannot produce as much Vitamin D as younger people.

Vitamin D Synthesis and Medication Conditions

Medical conditions such as Cystic Fibrosis, Coeliac Disease and Crohn’s Disease have an effect on the body’s ability to produce Vitamin D, as too does some liver and kidney diseases, and some medications, including some anti-HIV medication.

Obese individuals may also have problems with Vitamin D levels as the vitamin is extracted from the blood by fat cells.

Other Times Vitamin D Increased Intake is Needed

This is primarily the case for pregnant and breast-feeding women, particularly those who have had a number of children, or when there is only a short gap between pregnancies.

This can have a knock-on effect to the child who is being breast-fed with milk lacking in Vitamin D (although Vitamin D drops for infants are available should this be a concern).

Rates of Vitamin D Deficiency

With all these potential avenues for the disturbance in Vitamin D production and consumption it is potentially not surprising that in some north European countries, such as the UK, up to 50% of adults do not have enough Vitamin D, with around 16% experiencing severe deficiency over the winter months.

This percentage is raised still further if you look solely at individuals with pigmented skin living in these northern areas.

Vitamin D deficiency is very common, but what effect does it have?

Low Vitamin D Symptoms

Mild Vitamin D deficiency often goes undiagnosed as the symptoms are generally pretty vague, with general aches and pains being the most common, along with an overall sense of fatigue.

When the deficiency is more severe, individuals can experience strong pain and weakness in their limbs, all of which may lead to difficulties carrying out daily activities.

In addition, the bones themselves can feel painful and pressured and hairline fractures can occur.

This severe deficiency is called Osteomalacia.

All too often Vitamin D deficiency is only diagnosed when this pattern of bone pain and deformity is recorded.

Symptoms of Vitamin D Deficiency in Children

When children have Vitamin D deficiency their symptoms can be quite severe, rickets can develop as leg bones may be soft and become curved.

The bones are soft because they do not mineralize properly.

The leg bones, along with other bones and muscles, of individuals with rickets will also be weak and painful.

Rickets and Vitamin D Deficiency

If rickets are severe, Vitamin D deficiency can lead to low levels of calcium in the blood and can cause breathing difficulties, seizures and spasms.

In addition, due to low levels of calcium teeth may be late in developing teeth, and children’s growth may be slowed.

Some infants may also find it difficult to breathe due to weak ribcages.

If any of these symptoms develop, a blood test looking into levels of Vitamin D can be administered, along with tests for levels phosphate and calcium, as these differ depending on levels of Vitamin D within an individual.

Vitamin D Deficiency Treatment

For a problem that can cause such disastrous consequences, the treatment is pretty straightforward: take Vitamin D supplements.

There are a number of ways this can be administered depending on the individual’s specific circumstances and dosage will also depend on the severity of the deficiency.

An injection lasting six months can be given and is particularly useful for those who may forget to take medication.

High-dose liquids or tablets can be taken either daily, weekly or monthly and regular-dose tablets and liquids can be taken daily for up to one year.

Regular-dose medication is often prescribed for mild deficiency or to prevent deficiency in those at-risk.

It can take some months for the body to build up its reserves of Vitamin D and for all those having experienced a Vitamin D deficiency, preventing further episodes is vitally important.

This is particularly true for those in at-risk groups.

Preventative treatment will most likely involve a daily low dose of Vitamin D, often in a multivitamin tablet.

It is important to consult your doctor before starting a course of Vitamin D tablets as some other medical conditions and medications can cause interference.

For most people this form of treatment and prevention is extremely effective, for those who have developed rickets or osteomalacia as a result of their deficiency, the deformity in the bones can be permanent if not treated promptly.

Immediate Vitamin D Deficiency Treatment

Vitamin D deficiency can prove to be a serious, debilitating disorder.

It can also be easily prevented.

Although it is not as easy to get our recommended daily allowance when compared to other vitamins due to Vitamin D’s low availability in food products, meat-eaters can make attempts to eat oily fish regularly and those who eat dairy can incorporate egg yolk into their diet.

In addition to diet, time spent in the sun, even just 2-3 times per week for 20 minutes, can make a huge difference to your body’s ability to make its own Vitamin D.

Although of course caution must be taken – the goal is to expose your skin to the sun, not to damage your skin!

Final Thoughts

Lastly, taking a daily multivitamin that includes Vitamin D is an easy and effective aid, particularly for those who either need higher levels of Vitamin D or whose bodies do not, or cannot, produce as much Vitamin D as others.

Remember, consider your diet and lifestyle, and the possibility of a deficiency, should you notice any developing bone aches and pains – don’t pass it off as ‘just nothing’!