Managing Vitamin D Deficiency

Deficiency of Vitamin D can affect people of all ages and is usually manifested as bone and muscle pain and weakness. The goal of treatment is to bring the levels to normal, prevent bone fractures and relieve the symptoms. Recent research and evidence shows that vitamin D deficiency is very common in general population. Average daily Vitamin D intake in the diet is usually inadequate to maintain normal blood levels.

Diagnosis Of Vitamin D Deficiency:
A low level of Vitamin D can be diagnosed with a blood test that checks the levels of 25 hydroxyvitamin D:

• A normal level is defined as a concentration greater than 30 ng/ml
• Insufficiency is defined as levels b/w 20-30 ng/ml
• Deficiency is defined as levels less than 20 ng/ml

Management:
The amount of vitamin D that is needed to correct the deficiency depends upon the severity of the deficiency.

Rule of thumb: for every 1 ng/ml increase in your blood level you need an additional 100 IU vitamin D per day.

• There are many different strengths and preparations of vitamin D supplements available to treat and prevent the deficiency.
• In patients with levels less than 20 ng/ml treatment consists of 50,000 IU of Vitamin D taken by mouth once or more every week for 6 to 8 weeks.
• In patients with levels b/w 20-30 ng/ml treatment consists of giving 800-1000 IU of vitamin D by mouth daily usually for a period of 3 months.
• Once a normal level is achieved 800 IU of vitamin D taken by mouth once daily is recommended.
• In infants and children with a deficiency and a level less than 20 ng/ml treatment is 1000-5000 IU vitamin D daily for 2 to 3 months.
• Patients who are obese, have a malabsorption syndrome or are taking medicines that can impair vitamin D absorption are recommended to take two to three times higher dose.

For optimal absorption it is recommended to take vitamin D with a meal that has high fat content as fat promotes absorption of vitamin D

Prevention:
The major source of Vitamin d comes from sun exposure. It is suggested that 10-15 minutes of sun exposure at least two times per week to the face, hands, arms, or back without sunscreen is usually sufficient to meet your needs.A few foods naturally contain vitamin D, and other foods are fortified with it. The amount found in food is not enough for treating a deficiency and may not be enough to maintain adequate levels unless combined with sun exposure. The food that are good source for vitamin D are fish, egg yolk, cheese liver etc.