Mar 23, 2018

5 Reasons to Track your Vitamin D Biomarker

The Biomarker Handbook is a curated series that seeks to provide readers with insights on each biomarker we cover in our blood test packages and its relation to our body.

In order to stay healthy and prevent a number of diseases and health conditions, we need to consume sufficient amounts of different macro and micronutrients. Micronutrients refers to nutrients that our body requires in relatively small amounts, such as vitamins and minerals. Abnormal levels of vitamins are a common occurrence and they can potentially cause undesirable health consequences.

What is Vitamin D?

Vitamin D or the ‘sunshine’ vitamin is a complex micronutrient, a fat-soluble vitamin that cannot be produced by the body, and has to be consumed through our diets. On the other hand, when sunlight reaches the skin our body can synthesize vitamin D. An important function of vitamin D is to promote absorption of calcium in the gut and maintain adequate concentrations of both calcium and phosphate. The micronutrient is also required for bone growth, modulation of cell growth, reduction of inflammation, and neuromuscular and immune function. Normal levels of vitamin D are between 50nmol/l (20ng/ml) and 125 nmol/l (50ng/ml).

Importance of Tracking Vitamin D Levels

We get vitamin D through our diet as well as through sun exposure. Estimates show that sun exposure on bare skin two to three times per week for 5-10 minutes can produce sufficient amounts of vitamin D. Since this micronutrient breaks down quickly, the stores can easily deplete, especially during winter (when there is less sun exposure).

Tracking vitamin D levels is important mainly because unlike other micronutrients, this vitamin isn’t found in many foods. As a result, it is easy to become deficient. In rare circumstances, people can have excessive levels of vitamin D in the body due to over-supplementation. Testing vitamin D levels is also recommended for adults and children with weak bones, older adults, babies who were breastfed only, obese individuals, and to patients prior to their start with treatment for osteoporosis. People with kidney disease also should check their vitamin D levels.

Reasons to track this biomarker called Vitamin D:

  1. Vitamin D deficiency is very common, where studies show have 41% of general population can be deficient, particularly elderly, children and adolescents (one study in Malaysia found that 80% of 13 year olds are deficient);
  2. Generally, when the deficiency is mild or moderate, symptoms are either absent or non-specific. This results in many being clueless about deficiency unless a blood test confirms it. But why would you do a blood test if you do not have any symptoms? This is called screening tests, part of a larger preventative healthcare.
  3. There are health consequences associated with vitamin D deficiency if left untreated.
  4. It can be reversed. Vitamin D deficiency can be easily treated and reversed. Track your levels regularly and see.
  5. Consequences of vitamin D deficiency can be prevented if diagnosed and treated early.

Signs and Symptoms to Watch Out For

Many people are deficient in vitamin D (hypovitaminosis D) while few have excessive levels of this micronutrient (hypervitaminosis D). Both hypo- and hypervitaminosis D are characterized by different signs and symptoms that tell you something is wrong. Keep in mind that for mild to moderate deficiency it is rare to have any symptoms at all, and as you can see they can be non-specific. The majority of people who have vitamin D deficiency do not know it, and carry this condition for years.

Symptoms and signs of vitamin D deficiency are:

  • Back and bone pain
  • Bone loss
  • Depression
  • Fatigue
  • Hair loss
  • Muscle pain
  • Slow wound healing
  • Weakened immune system

Signs and symptoms of excessive levels of vitamin D are:

  • Constipation
  • Dehydration
  • Disorientation and confusion
  • Dizziness
  • Excessive thirst
  • Excessive urination
  • Fatigue
  • Heart arrhythmia
  • Hypertension (high blood pressure)
  • Loss of appetite and weight loss
  • Muscle weakness
  • Nausea and vomiting
  • Nervousness and irritability
  • Tinnitus (ringing in the ear)

Consequences of Having Abnormal Vitamin D Levels

Hypo- and hypervitaminosis D carry a number of health consequences which only emphasize the importance of testing and checking the concentration of this micronutrient.

Vitamin D Deficiency

Insufficient levels of vitamin D are caused by insufficient sunlight exposure and poor dietary intake of it. People at risk are those who stay indoors, have dark skin, obesity, type 2 diabetes, malabsorption syndromes such as Crohn’s disease, and an inadequate intake of vitamin D. Keep in mind that many people who are healthy, slim, and exposed to adequate amount of direct to skin sunlight can be vitamin D deficient.

Consequences associated with a deficiency in this micronutrient are:

  • Osteoporosis – a condition which occurs when the body loses too much bone, produces too little bone, or a combination of the two. As a result, bones become weak, brittle, and break easily. It is estimated that 200 million women worldwide have osteoporosis. About 1 in 3 women older than 50 experience osteoporotic fractures. Vitamin D deficiency impairs absorption of calcium and makes your bones vulnerable.
  • Rickets: a disease of children caused by vitamin D and/or calcium deficiency, characterized by imperfect calcification, softening, and distortion of the bones typically resulting in bow legs.
  • Diabetes – low vitamin D status can contribute to insulin resistance
  • Hypertension – vitamin D indirectly modulates blood pressure and deficiency in this micronutrient may contribute to hypertension, which increases the risk of cardiovascular events such as heart attack and stroke
  • Fibromyalgia – a condition indicated by widespread musculoskeletal pain followed by fatigue, mood issues, and memory problems. It is estimated that 10 million Americans and 3% to 6% of world population have fibromyalgia. Low vitamin D levels increase inflammation which aggravates symptoms of this condition
  • Chronic fatigue syndrome – a disorder characterized by extreme tiredness and fatigue that doesn’t go away even after a patient gets enough sleep. Vitamin D plays a role in the strength of your muscles, joints, and bones which explains why deficiency makes you feel tired

Hypervitaminosis D

Excessive vitamin D is a rare, but potentially serious condition. Hypervitaminosis D isn’t caused by diet or sun exposure, but by excessive consumption of vitamin D supplements. The primary consequence of hypervitaminosis D is hypercalcemia or an accumulation of calcium in your blood leading to nausea, vomiting, weakness, kidney stones, fatigue, bone pain. Hypervitaminosis D also is associated with kidney and heart disease, and certain types of cancer. Treatment of this is to stop taking the supplements and seek medical help. Doctor may give you intravenous fluids to reduce vitamin concentration and possibly corticosteroids.

Ways to Balance These Levels

As seen above, both low and high concentration of vitamin D can negatively affect your health and quality of life. What you can do is to balance levels of this micronutrient through a healthy lifestyle and adequate diet. If you have Vitamin D deficiency, start including vitamin D rich foods and fortified foods in your diet and strive to spend more time outdoors. You also need to exercise regularly to lose weight and keep it in a healthy range. Your doctor may also recommend taking vitamin D supplements.

On the other hand, persons with hypervitaminosis D will need to make some changes in their lifestyle too. For example, your doctor will recommend discontinuing use of supplements you’re taking and he/she may also suggest lowering calcium intake until vitamin D returns to a healthy range.

When to See a Doctor?

You should see your healthcare provider if you experience bone, joint, and muscle pain for a prolonged period. People who deal with fatigue, dehydration, constipation and other symptoms mentioned above for a few weeks should also schedule an appointment to see their doctor. Of course, if you already have problems with your bones, parathyroid levels, or have osteoporosis, you need to see your doctor regularly and consult regarding 25-hydroxyvitamin D test.

Further Testing to Check for Ailments Related to Abnormal Vitamin D Levels

Further tests are always practical for men and women with abnormal vitamin D levels. These tests may include:

  • Blood calcium test
  • Parathyroid hormone level
  • Bone markers
  • Urinalysis for kidney disease
  • Imaging tests (X-ray, CT scan) for osteoporosis


Vitamin D is vital for our health and wellbeing, and it is hard to get enough of it through diet or sun exposure alone. It is estimated that more than half of the population in many countries suffer from deficiency of vitamin D, and it is necessary to take supplements in conjunction with adequate sun exposure, dietary intake and exercise. It can have nasty consequences to our health and is easily preventable or reversed.

The first step is to be aware of it and track your biomarker. Live a healthy life and don’t put your health at risk, because the odds of suffering from vitamin D deficiency are high.

If you want to find out more about Vitamin D and its importance, read more about it in our lifestyle post here!

Interested in other biomarkers? Check out the rest of The Biomarker Handbook.

For more information, drop us a message and we will get back to you.


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