The deficiency of vitamin D, or hypovitaminosis D. Is a medical condition caused by the absence of appropriate vitamin D levels in the body; Appropriate levels of vitamin D are critical for good bone health and, according to recent studies, for good cardiovascular health. This article will give you a complete guide about vitamin d deficiency symptoms, causes, prevention & treatment.
Vitamin D deficiency can depend on various factors, including inadequate sun exposure. An insufficient dietary intake of the vitamin in question, the presence of kidney or liver disease, an increased requirement. And the intake of some specific drugs.
The main consequences of vitamin D deficiency in humans are rickets in young and very young subjects, osteomalacia, and osteoporosis in adults.
To diagnose vitamin D deficiency, doctors resort to measuring calcidiol’s blood levels, also known as 25-hydroxycalciferol.
The typical vitamin D deficiency treatment consists of causal therapy and therapy to immediately raise vitamin deficiency levels.
A brief review of vitamin D:
The ” sun vitamin, “vitamin D is a fat-soluble organic compound similar in chemical structure to steroid hormones. Which is responsible for fulfilling important functions in the human body, including:
- Promote the absorption of calcium in the intestine;
- Maintain normal blood levels of calcium and phosphorus ;
- Promote the reabsorption of calcium and phosphorus in the kidney ;
- Strengthen the bones through the deposition of calcium in the bone tissue ;
- Promote bone growth in children.
For humans, the natural supply of vitamin D depends on ‘ exposure to sunlight – which enables the conversion to level the skin of a specific precursor – and taking certain specific foods (e.g., the’ oil cod liver).
It should be noted that to have the above effects, vitamin D generated through exposure to sunlight and taken through the diet must undergo two hydroxylation reactions. Which makes it biologically active; these reactions take place in the liver and kidneys.
What is Vitamin D Deficiency?
Vitamin D deficiency is a condition resulting from the absence of adequate amounts of vitamin D in the body.
In other words, it is the situation that reflects an insufficient level of vitamin D to keep the human body healthy. In medicine, the lack of vitamin D is also known as hypovitaminosis D.
According to Harvard University, around one billion people are affected by vitamin D deficiency worldwide.
Vitamin D deficiency can have various causes; in fact, it can depend on:
- An insufficient dietary intake of the vitamin in question;
Inadequate exposure to the sun (especially UVB rays). This can be due to:
- Reduced physical activity in the open air;
- Dark skin ;
- Live in areas very far from the equator;
- Excessive sunscreen use (a sunscreen with protection 15 blocks about 99% of the skin’s vitamin D production).
- An increase in the need for vitamin D ;
- An altered intestinal absorption ;
- The presence of medical conditions. Such as liver disease or kidney disease. Which compromise the conversion of biologically inactive vitamin D into its biologically active form (NB: remember that liver and kidneys are the sites where the aforementioned conversion takes place) ;
- A therapy based on drugs that interfere with vitamin D’s normal metabolism (e.g., anticonvulsants, cholestyramine, glucocorticoids, antifungals, antivirals, anti-rejection drugs, etc.).
Several factors contribute to increasing the risk of vitamin D deficiency, including:
- Cigarette smoking (because it alters the metabolism of vitamin D);
- Advanced age (because, due to aging, the skin loses part of its productive efficiency);
- Obesity (because adipose tissue sequesters vitamin D and in this way reduces its bioavailability );
- Taking drugs that interfere with the metabolism of vitamin D (e.g., anticonvulsants, glucocorticoids, etc.);
- Dark skin (because a lower skin production efficiency accompanies it);
- Alcoholism (because it impairs the intestinal absorption of vitamin D);
- Presence of osteoporosis;
- Breastfeeding for long periods of time (because breast milk is a poor source of vitamin D)
- Presence of Crohn’s disease or celiac disease (because they compromise the absorption of vitamin D in the intestine);
- Presence of gastric bypass (because it reduces the absorption efficiency of vitamin D along the digestive tract ).
In addition to this, then, it is necessary to add (in some situations, it is a repetition) that the lack of vitamin D is more frequent among:
- Those who shy away from exposure to sunlight;
- Those suffering from kidney failure or liver failure ;
- Anyone suffering from sarcoidosis, tuberculosis, histoplasmosis, or some other granulomatous disease;
- People with lymphoma, a type of blood cancer.
- Patients with cystic fibrosis, chronic pancreatitis, or primary biliary cirrhosis.
Symptoms and consequences: Vitamin d deficiency symptoms dizziness
Vitamin D deficiency impairs bone mineralization in different ways, contributing to diseases. Such as rickets in children, osteomalacia, and osteoporosis in adults.
However, hypovitaminosis D is not limited to this: recently, experts have shown that its presence is associated with a not negligible increase in cardiovascular risk and predisposition to diseases, such as diabetes, hypertension, dyslipidemia, and metabolic syndrome.
Therefore, in light of this, it is possible to state that. If once vitamin D was associated exclusively with bone health, today – thanks to new scientific knowledge – it is also important for many organs and body tissues other than bone tissue, particularly at the cardiovascular level.
What symptoms characterize vitamin D deficiency?
Vitamin D deficiency is a rather subtle condition, as it tends to reveal itself (with some symptoms) only when the vitamin D levels are really very low.
That said, in an individual, symptomatic vitamin D deficiency can cause:
- Bone pain ;
- Pain in the joints ;
- Muscle weakness ;
- Muscle fasciculation disorders ;
- Brittle bones, which tend to deform in young people or break easily in adults;
- Difficulty thinking clearly
- Recurring fatigue.
There is a defect in bone mineralization in rickets. Over time, this leads to the collapse and deformation of the bones under a load of body weight and muscle tension. This explains why, in the stunted subject, the legs appear crooked, the jaw deformed, the rib cage sunken at the sternum level ( pectus excavatum ), the face particularly narrow and deformed.
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Fortunately, the progressive improvement of sanitation conditions and the increasing spread of vitamin prophylaxis since the neonatal period have greatly reduced, compared to several decades ago, the spread of this vitamin D deficiency disease.
In any case, it is good practice to start the baby, already shortly after birth, to a healthy life in the open air, exposing him frequently and regularly to sunlight, without swaddling him excessively in the winter months and protecting him with special creams in case of prolonged sun exposure.
Osteomalacia is a metabolic disease characterized by the macroscopic rarefaction of the bones, which are painful and more prone to fractures.
Equivalent to rickets in young humans, osteomalacia reflects a defect in bone mineralization, a defect. That may be due to an insufficient intake of vitamin D and calcium, and/or phosphorus.
Osteoporosis is a systemic skeletal disease that causes severe weakening of the bones. Responsible for a greater tendency to fractures, this weakening originates in the deterioration of the bone tissue’s microarchitecture and the consequent reduction in bone mineral mass.
Although it also involves greater bone fragility and a tendency to fractures, osteoporosis is notably different from osteomalacia. In fact, if in osteoporosis, the mineralization process occurs correctly, in osteomalacia – as stated in the dedicated sub-chapter – the same process is defective.
Vitamin D deficiency, cardiovascular risk, and more
At present, the role of vitamin D deficiency Symptoms in the onset of cardiovascular disease, hypertension, diabetes, dyslipidemia, and metabolic syndrome is still unclear. In fact, experts have yet to establish whether the vitamin deficiency in question acts directly in determining the aforementioned pathological conditions or should instead be associated with obesity (a proven risk factor for cardiovascular disease, hypertension, etc.).
Doubts about it (direct involvement of vitamin D deficiency or mediated by obesity?) Derive from the demonstration. That obese people have a greater tendency to have low circulating levels of vitamin D, compared to normal-weight subjects., essentially for two reasons: a sedentary lifestyle (which involves poor sun exposure) and vitamin sequestration in the adipose tissue.
In addition to compromising bone health and being a cardiovascular risk factor, vitamin D deficiency can have other consequences:
- It is a potential cause of periodontitis. Which is the bones’ inflammation that supports the teeth. If it degenerates, periodontitis can cause tooth loss;
- It has immunosuppressive effects; that is, it can reduce the efficiency of the immune system. Therefore, the individual with a vitamin D deficiency is more prone to infections;
- It can determine a state of insulin resistance, that is, the condition in. Which the body’s cells have a low sensitivity to insulin ;
- Feelings of depression. At present, studies are underway to investigate the relationship between vitamin D deficiency and mood decay.
To know the vitamin D levels present in a human, doctors measure the serum concentration of 25-hydroxycalciferol, also known as calcidiol or 25-OH-D.
25-hydroxycalciferol is the form in which vitamin D of solar and food origin circulates in the human being’s blood; in other words, in the blood, vitamin D takes the form of 25-OH-D. To express the concentration of 25-hydroxycalciferol, there are two measurement units: the nanomole per liter, more commonly written as nmol / l, and the nanogram per milliliter, usually identified as ng/ml.
An individual presents an adequate amount of vitamin D when the concentration of 25-OH-D is between 75 nmol / L (30ng / ml) and 200 nmol / L (80ng / ml). Therefore, doctors begin to speak of vitamin D deficiency when the 25-OH-D concentration is below 30 nmol / l (12 ng / ml).
What is the Vitamin D blood test called?
The test for measuring blood levels of vitamin D is called the 25-OH-D dosage. A simple blood sample is sufficient to collect a blood sample to be subjected to the 25-OH-D dosage.
Search for the causes: why is it important?
Once the presence of a vitamin D deficiency has been ascertained, the individual concerned will have to undergo a thorough medical history and other diagnostic tests used by the attending physician to trace the vitamin deficiency’s triggering causes in question.
Only thanks to the knowledge of the causal factors, it is possible to plan adequate therapy.
Therapy: Vitamin D Deficiency Symptoms
Vitamin D deficiency requires a causal therapy, i.e., time to counteract causes of the low levels of the vitamin in question and therapy aimed at restoring a normal level of the so-called “sunshine vitamin.”
The causal therapy varies from patient to patient, depending on the triggering factor (here is the importance of knowing the deficiency’s precise causes). The therapy aims to eliminate the deficiency; on the other hand, it generally consists of a diet rich in foods. Naturally high in vitamin D or foods fortified with the latter, and in the intake of specific supplements.
While causal therapy has long-term effects (therefore not immediate), therapy aimed at remedying the deficiency is designed specifically to act in the short term as the persistence of low levels of vitamin D is, as we have seen, dangerous for Health.
Causal Therapy Example
Suppose vitamin D deficiency is due to inadequate sun exposure. The causal therapy consists, quite simply, of changing your lifestyle and exposing yourself to the sun for at least 15-20 minutes a day without protective sunscreen.
What and what are foods fortified in vitamin D?
Briefly, a food fortified in vitamin D is food too, which vitamin D has been added to increase this nutrient intake by those who use it.
On the market, foods fortified in vitamin D include:
- Orange juice;
- Soy milk ;
- Yogurt ;
- Cereals for breakfast ;
Which foods contain the most vitamin D?
Good dietary sources of vitamin D, highly recommended to remedy a deficiency of the aforementioned vitamin, are:
- Cod liver oil ;
- The fish oils ;
- Fish such as salmon, trout, herring, swordfish, eel, mackerel, tuna, carp, etc.;
- The egg yolk ;
- The milk;
- The butter ;
- The mushrooms such as porcini and Spagnolo.
Beware of high vitamin D intakes.
It is necessary to remind readers that a high vitamin D intake can give rise to toxicity phenomena; therefore, before taking specific vitamin D supplements, it is important to consult your doctor and rely on his advice.
The consequences (i.e., symptoms and signs ) of a vitamin D overdose include:
- Mineralization of non-bone tissues with diffuse calcifications in the affected organs;
- Muscle twitching and spasms ;
- Muscle weakness
- Vomiting, diarrhea or constipation, and headache ;
- Loss of appetite and body weight loss ;
- Formation of kidney stones ;
- Confusion and disorientation;
- Heart problems.