Mar 23, 2018

Vitamin D Deficiency – A Serious Epidemic

Vitamin D plays an important role in our health and wellbeing. This particular vitamin is necessary for healthy bones, joints, muscles, immune system, and so much more. Deficiency in vitamin D levels are very common, and the vast majority are not even aware. Generally, symptoms and signs of mild to moderate vitamin D deficiency rarely present (and are non-specific such as lower back pain, bone pain, tiredness and fatigue, depression, impaired wound healing, loss of hair, muscle pain). Deficiency can be easily reversed, and health consequences of deficiency also. This makes tracking your vitamin D biomarker so important to avert health consequences from deficiency.

25-hydroxyvitamin D test

Before the body uses vitamin D, it is converted to a chemical 25-hydroxyvitamin D or calcidiol by your liver. The 25-hydroxyvitamin D test is used to assess the concentration of this micronutrient in the body.

The vitamin D test is used to determine whether bone weakness and fractures and joint pain are associated with a deficiency in this micronutrient. It can also help monitor parathyroid gland function, aid management of malabsorption disorders such as Crohn’s disease, osteoporosis, and other health conditions.

According to the Institute of Medicine report in 2011, the 25-hydroxyvitamin test can yield the following results:

  • Severe deficiency is <10 ng/mL, and could be associated with osteomalacia or rickets
  • Mild to moderate deficiency 10-19 ng/mL, and could be associated with increased risk of osteoporosis or secondary hyperparathyroidism. At these levels it is said to be insufficient rather than deficient
  • Optimum levels are 20-50 ng/mL in healthy population; patients with bone disease may benefit from higher levels within this range
  • High levels are 51-80 ng/mL associated with increased risk of hypercalciuria and kidney disease
  • Toxicity levels are >80 ng/mL,

Managing Vitamin D Deficiency

Vitamin D deficiency is considered a major public health problem worldwide in all age groups. It is estimated that over 41.6% Americans are deficient in this vitamin. The statistics for Malaysian population is less clear, but one study puts it at 23%, and another study in Malaysian adolescents (aged 13 years old) revealed that 80% are vitamin deficient. It is a serious issue. Principal causes of vitamin D deficiency are inadequate sun exposure and poor dietary intake of vitamin D. The importance of managing vitamin D deficiency lies in the fact it is associated with numerous health consequences such as osteoporosis in adults and rickets in children (and can lead to soft bones and skeletal deformities), fibromyalgia, chronic fatigue syndrome and high blood pressure.

Here are some useful tips to manage low vitamin D levels:

  • Get some sun, strive to spend 5-30 minutes in the sun between 10 am and 3 pm twice a week (without sunscreen); this is no reason to put yourself at risk of skin cancer though. Do not prolong sun exposure without sunscreen protection
  • Exercise regularly to lose weight
  • Eat vitamin D-rich foods such as cod liver oil, sardines, salmon, mackerel, tuna, raw milk, caviar, eggs, mushrooms
  • Look for fortified foods containing vitamin D: orange juice, cereals, dairy, soy milk
  • Take vitamin D supplements: both adults and children should take about 800 units of supplement daily which is a safe and adequate dosage. Particularly people with poor sun exposure (winter), children, elderly, and those who are obese.

Excessive vitamin D

Excessive vitamin D is referred to as hypervitaminosis D and it is a rare condition whose official statistics are still lacking. Although rare, high vitamin D is a serious condition with severe consequences. You’re not likely to get hypervitaminosis D from sunlight and nutrition. The primary cause of this problem is an excessive intake of vitamin D supplements. Tracking and managing vitamin D is particularly important if we bear in mind excessive levels are associated with hypercalcemia (high calcium), kidney damage, heart disease, certain cancers, excess bone loss, and hardening of the arteries.


Monitoring vitamin D levels is a practical and effective way to prevent deficiency and excessive levels of this vitamin. To avoid these problems, strive to consume recommended daily value of 15mcg vitamin D a day. Consult your doctor if you have problems with bones, kidneys, joints, muscles, and fatigue. Perform a 25-hydroxyvitamin D test. Perform the test as a screening measure even if you don’t have symptoms, as most people with vitamin insufficiency do not have any symptoms. It can be easily reversed, can cause serious health consequences which you can prevent. Start tracking for health!

If you’re interested in learning more about the importance of tracking your Vitamin D levels, read on more about it in our biomarker post here!


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