Vitamin D Deficiency: Symptoms and Treatment

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Vitamin D is a group of fat-soluble secosteroids (a broken ring steroid) that is responsible for improving intestinal absorption of zinc, calcium, magnesium, phosphate, and iron in the body. Several vitamers, or forms of vitamin D exist. These include:

• Vitamin D₁ - A mixture of Vitamin D₂ and lumisterol.
• Vitamin D₂ - Known as ergocalciferol, it is made from ergosterol.
• Vitamin D₃ - Known as cholecalciferol, it is made from 7-dehydrocholesterol in human skin.
• Vitamin D₄ - Known as 22-dihydroergocalciferol.
• Vitamin D₅ - Known as sitocalciferol, it is made from 7-dehydrositosterol.

The two major forms of vitamin D are vitamin D₂ and vitamin D₃, collectively known as calciferol.

Related: 10 Vitamin D Foods You Should Be Eating Now

Vitamin D either enters the human body through food intake, or can be produced naturally through exposure to the sun.

Osteomalacia, also known as rickets, is a softening of bones caused by a vitamin D deficiency. While this extreme form of vitamin D deficiency is a rare condition, general vitamin D deficiency is very common in adult and children.

Symptoms of Vitamin D Deficiency

The National Health and Nutrition Examination Survey from 2005-2006 defined vitamin D deficiency as a serum 25-hydroxyvitamin D concentration of less than or equal to 20 ng/mL (50 nmol/L). ^[1] This survey found that 41.6% of adults had a vitamin D deficiency. Rates were more prevalent in overweight individuals, those lacking a college education, and individuals with poor health.

Individuals who do not drink milk or have hypertension tend to experience higher rates of vitamin D deficiency.

The highest rate of vitamin D deficiency, 82.1%, was seen in blacks. Hispanics came in at a rate of 69.2%. ^[1]

A vitamin D deficiency is linked to numerous risk factors that are tied in with some of the leading causes of death in America. For this reason, a deficiency should be taken seriously. Some of these conditions and problems include: ^[2]

• Advancement of cancer, including prostate, breast, colon, and ovarian. ^[3]
• Increase the risk of cardiovascular disease.
• Cognitive-related issues in adults.
• Muscle aches and muscle weakness. ^[4]
• Osteoporosis, with an increase in bone fragility and a decrease in bone mineral density.
• Erectile dysfunction. ^[5]
• Depression.

It should also be mentioned that a sunscreen of SPF 8 or greater is theorized to inhibit 95% or more of the vitamin D production done via the skin through sun exposure. ^[6] In reality, sunscreen application has been revealed to have a negligible impact on the skin's ability to generate vitamin D. ^[7][8]

Those with a vitamin D deficiency may experience the following symptoms, or have the following conditions or body/age characteristics.

• You feel down. Those with very low vitamin D levels are 11 times more likely to experience depression. ^[9] Sun exposure causes an increase in the rise of serotonin levels, which is the brain hormone that is connected to mood.
• You are over the age of 50. As you age, your skin's ability to produce vitamin D decreases. Also, with age, your kidneys become less efficient at converting vitamin D into a usable form.
• Your skin is darker. Dark-sinned individuals need 10 times the amount of sun exposure to generate the same amount of vitamin D.
• You're obese or overweight. Vitamin D is fat-soluble. Body fat acts as a collection point, or sink, for vitamin D.  Those with more fat require a larger amount of vitamin D.
• You carry extra muscle mass. There appears to be a tie-in between overall weight and the amount of vitamin D your body requires.
• Aching bones. This symptom of vitamin D deficiency is often misdiagnosed as chronic fatigue syndrome or fibromyalgia.
• A sweaty head. A classic, and often the first sign of vitamin D deficiency is a sweaty head. Physicians used to ask mothers if their newborn children had this condition to assess possible vitamin D issues.
• Stomach issues. A vitamin D deficiency may lead to conditions like Chron's disease, inflammatory bowel disease, and gluten sensitivity.

Vitamin D Deficiency Treatment

To treat a vitamin D deficiency you need to focus on a 3-pronged attack. Choose foods that are naturally high in vitamin D, spend more time in the sun each week, and consider using a vitamin D supplement.

The Institute of Medicine recommends a daily 800 IU of vitamin D for adults over the age of 70, The RDA recommends 600 IU for all individuals through the age of 70. The safe upper limit of vitamin D consumption is 4000 IU per day. Doctors have been known to prescribe more than this to combat a deficiency.

The following foods are high in vitamin D. Considering adding some of these choices to your weekly meal plan:

• Salmon, tuna, and tilapia
• Portabello and maitake mushrooms
• Lite silken tofu and soy beans
• Butter
• Vitamin D fortified milk
• Pork and spare ribs
• Turkey and pork sausage
• Eggs
• Spinach, kale, and collards
• Okra
• White beans
• Beef liver
• Cheese

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References

1) "Prevalence and Correlates of Vitamin D Deficiency in US Adults. - PubMed - NCBI."National Center for Biotechnology Information. N.p., n.d. Web. 11 July 2016.
2) Grant WB, Holick MF (June 2005). "Benefits and requirements of vitamin D for optimal health: a review" (PDF). Alternative Medicine Review 10 (2): 94?111. PMID 15989379.
3) Cherniack; Levis; Troen (2008). "Hypovitaminosis D: a widespread epidemic". Geriatrics. Retrieved 14 April 2015.
4) "Vitamin D deficiency in adults". Australian Prescriber (33): 103?6. 2010.
5) Low Vitamin D Levels Linked to Erectile Dysfunction, Study Says, Counsel & Heal: Physical Wellness Data on >3,400 men in the United States aged 20 and above without heart disease showed 30% deficient in vitamin D (<20 nanograms per milliliter of blood) and 16% had erectile dysfunction.
6) Sayre RM, Dowdy JC (2007). "Darkness at Noon: Sunscreens and Vitamin D3". Photochemistry and Photobiology 83 (2): 459?63. doi:10.1562/2006-06-29-RC-956. PMID 17115796.
7) Marks R, Foley PA, Jolley D, Knight KR, Harrison J, Thompson SC (1995). "The Effect of Regular Sunscreen Use on Vitamin D Levels in an Australian Population". Archives of Dermatology 131 (4): 415?21. doi:10.1001/archderm.1995.01690160043006. PMID 7726582.
8) Farrerons J, Barnadas M, Rodríguez J, Renau A, Yoldi B, López-Navidad A, Moragas J (1998). "Clinically prescribed sunscreen (sun protection factor 15) does not decrease serum vitamin D concentration sufficiently either to induce changes in parathyroid function or in metabolic markers". British Journal of Dermatology 139 (3): 422?7. doi:10.1046/j.1365-2133.1998.02405.x. PMID 9767286.
9) American Journal of Geriatric Psychiatry December 2006; 14(12): 1032-1040.