Vitamin D Deficiency |
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Vitamin D deficiency, when the level of vitamin D is too low, can cause bones to become thin, brittle or misshapen. This is most common nutritional deficiency worldwide, characterized by serum 25-hydroxyvitamin D <20 nanograms-mL. Vitamin D insufficiency is regarded as a serum 25-hydroxyvitamin D level between 21 and 29 nanograms-mL. Main causes include sun avoidance, using sun protection, increased skin pigmentation, inadequate dietary and supplemental vitamin D intake, malabsorption syndromes, obesity, and medication use. Acquired and inherited disorders that either reduce or prevent the metabolism of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D also present with biochemical and skeletal abnormalities seen with vitamin D deficiency, but in a more severe form. Both vitamin D deficiency and vitamin D insufficiency are corrected by giving vitamin D2 or vitamin D3 in treatment doses followed by lifelong maintenance doses; adequate sensible sunlight exposure should be encouraged. Most patients are asymptomatic. Severe prolonged vitamin D deficiency causes growth retardation and rickets in children and osteomalacia, osteopenia, and osteoporosis in adults. Additional replacement with 1,25-dihydroxyvitamin D or one of its active analogs is necessary for those with disorders of vitamin D metabolism. |
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Calcium |
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