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VITAMIN D DEFICIENCY AND TREATMENT

Updated on December 6, 2011
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Vitamin D Deficiency

Vitamin D deficiency is a growing concern and may be more frequent than you think. To make matters worse, unlike other conditions, the damage to your bones often goes unnoticed until it is too late. Studies have indicated that up to 60% of nursing home residents and 57% of patients in hospitals are deficient in Vitamin D.

But Vitamin D deficiency is also a problem among the younger and healthier populations. Studies done in Boston not long ago determined that 2 of 3 adults had insufficient vitamin D levels by the end of winter (we get a significant amount of Vitamin D from the sun).

Why is Vitamin D deficiency so serious? Here is part of the answer: we need vitamin D to help maintain a proper level of calcium in our blood. When we are low in Vitamin D, we cannot absorb enough calcium and our body begins to take calcium AWAY from our bones and into our blood. This weakens our bones over time and can lead to osteoporosis.

Not only does deficiency in Vitamin D cause bone loss, but it is also an underlying cause in many cases of otherwise unexplained muscle and bone pain. A study at a Minnesota Hospital looked at over 150 patients complaining of muscle pain and bone ache. The reviewers discovered that 90% of these patients were severely deficient in Vitamin D.

Vitamin D is essential for the function of many different cells and organs as well. It plays a role in insulin production, regulation of blood pressure, heart disease and possibly cancer prevention. It is hard to over-estimate the importance of maintaining adequate levels of Vitamin D.

The SUNSHINE Vitamin

Vitamin D has earned the nickname: "The Sunshine Vitamin" due to the fact that the radiation from the sun converts substances in our skin (specifically a precursor to cholesterol) into Vitamin D3.

The other source of Vitamin D (known as Vitamin D2) comes from food. Food sources tend to have only minimal amounts of Vitamin D, thus the "sunshine" tends to be our primary resource for Vitamin D.

WHAT CAUSES VITAMIN D DEFICIENCY?

Vitamin D deficiency may be due to several reasons.

Infants fed only breast milk may have lower levels of Vitamin D, since Vitamin D is only poorly absorbed into breast milk. Supplementation with vitamin D for breast-fed infants after 2 months of age is generally recommended.

For adults, the most common cause is limited sun exposure. The sun promotes the production of Vitamin D in our skin, which then supplies the Vitamin D to our body. Too little sun exposure, sometimes due to the use of sunscreens, can create a vitamin D deficiency in our body.

Other causes of Vitamin D deficiency include intestinal surgeries leading to poor vitamin D absorption and certain prescription medications (phenytoin, phenobarbital and rifampin are examples).

TREATING VITAMIN D DEFICIENCY

The easiest approach to treating Vitamin D deficiency is to use a vitamin D supplement. Such supplements are available OTC (over the counter) and by prescription. Questions arise when asked about the optimal "dose" of vitamin D though. There is a broad range of "safe" doses. Overdose and toxicity are rare.

50,000IU once a week for 8-12 weeks is a fairly standard approach refilling our Vitamin D supply.

After 3 months it is recommended that Vitamin D level be checked again (this can only be done by a blood test at your physician's office). The goal is generally to reach 30-50ng/ml of active Vitamin D.

Choosing a Vitamin D Supplement:

When purchasing a vitamin D supplement from the vitamin section of the pharmacy, you will be confronted with the choice of Vitamin D2 or Vitamin D3 (or a blend of both). Which Vitamin D supplement is best? I recommend choosing Vitamin D3 (also called "cholecalciferol). Here are my reasons:

  • Vitamin D3 is identical to the Vitamin D that our bodies produce through exposure to the sun.
  • Vitamin D3 is more stable and will enjoy a longer shelf-life.
  • Vitamin D3 is more potent, due to the unique way it binds to circulating proteins.


Important Note: Treating Vitamin D deficiency is a little different than treating other conditions. Vitamin D deficiency is sort of like having an empty (or nearly empty) Vitamin D bucket in your body. Therefore, the only difference between taking 50,000IU once a week, or 10,000IU once a day, or 5000IU daily or 2000IU daily is simply (in most cases) how "fast" you will fill up that empty bucket. There are limits. Toxicity may be a concern with doses of 50,000IU daily for extended lengths of time for some patients. Also, OTC supplements that contain much smaller doses (like 400IU or 800IU) may take far too long to "fill up" your Vitamin D bucket, or would require taking too many tablets for convenience.

Vitamin D Units: You may notice that Vitamin D products typically express their "strength" in terms of IU (International Units). In order to convert mg to IU you need to know that 1mg of Vitamin D is equal to 40,000IU.

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      Joidevivre 6 years ago

      I am a pharmacist too very interested in Vitamin D deficiency, therapy and benefits. Please note the appropriate lab to order for Vitamin D deficiency. One is more accurate than the other. The other may show levels that *look* normal, but you may still be deficient. (From Mercola.com) There are two vitamin D tests -- 1,25(OH)D and 25(OH)D.

      25(OH)D is the better marker of overall D status. It is this marker that is most strongly associated with overall health.

    • pharmacist profile image
      Author

      Jason Poquette 6 years ago from Whitinsville, MA

      Hi Deanna,

      The sun plays a crucial role in converting cholesterol into Vitamin D. To say we "get it" from the sun is a convenient way of expressing the role the sun plays in its production.

    • profile image

      Deanna 6 years ago

      I thought that vitamin D was only activated by the sun, that you have to ingest it first (from food). and that it was a common misconception that you get it from the sun - the sun only activates it.

    • maxravi profile image

      Ravi Singh 6 years ago from India

      Such a good source of info.thats why I love hubpages as I get info on almost all the topics.good article keep it up!

    • profile image

      Harold Katz 6 years ago

      The article reads very well and is well organized in my opinion. Yes, you can hurt yourself with a vitamin misused. Isn't that why otc strengths were limited for so long??

    • profile image

      Eileen Petrain 6 years ago

      I am a tech and also a VitD defficient person and yes I believe that living in the north east low D is a culprit of the cold weather I did find the Article very informing and also how to convert IU to mg

    • profile image

      Tony Malafronte R.Ph 6 years ago

      Excellent patient information piece. This is a major problem today and most fear the toxicity issue. This was handeled in a meaningful way

    • profile image

      Francis R jones 6 years ago

      I recently submitted an FDA Medwatch Report on an over the counter VitD 50,000iu OTC from biotech Labs In Arkansas....My concern is that it plainly states "take one capsule weekly"...we have a mindset in the USA that if one capsule is good...then two is twice as good....comes in bottles of 100...(100 weeks)of cholecalciferol (12500 % of the MDR for Vit D) or if mistakenly daily...as are most nutritionals for the elderly...my fear is that the 30% of the general population that has less that 85% kidney function...could very well be harming themselves without realizing it...I agree that we are all generally deficient in Vit D3...but my concern that toxicity that could develop if used to excess...FRJ..(ps it was a well researched and well written article...Thanks)

    • profile image

      Annamaria Poldrugo 6 years ago

      I love it and I will pass it along to many more. I enjoyed it because it is simple to read and I'm sure it will be clear to the vast majority of people bringing it's benefits.

    • pharmacist profile image
      Author

      Jason Poquette 6 years ago from Whitinsville, MA

      vocalcoach,

      Thank you so much for sharing your experience with Vitamin D deficiency. I truly believe that stories like yours go much further in prompting people to be aware of Vitamin D deficiency than the articles themselves. Blessings!

    • vocalcoach profile image

      Audrey Hunt 6 years ago from Idyllwild Ca.

      An excellent and very informative hub on vitamin D deficiency and treatment. I have been deficient in Vit. D for quite a while now which my Doctor is treating me for. I have blood tests regularly. I was surprised to learn about my deficiency as I eat a very healthy diet and walk my dog every single day. I have suffered 2 spinal compression fractures. I just can't imagine how I became deficient. I also had a bonse density done and I have a problem in my right hip. My Doctor is sending me to a rhumetologist (sp). You have been so helpful and I am very grateful to you. Sharing this with friends. Voted UP!

      vocalcoach~

    • profile image

      Chanel 6 years ago

      thank you!

    • health-resource profile image

      health-resource 6 years ago from West Coast

      Vitamin D3 is so beneficial. 1000IU per day is fine, Chanel, but it's actually a bit on the low end. You can double or triple that dosage no problem and receive even more benefit.

      Anyway, some good information in this article!

    • profile image

      Chanel 6 years ago

      me liking your article a lot! was told to look for golden sealed bottle b/c it passes manufacturing and yadi yada. I did get a blood test done and it was around 34; not an alarming number but my dr said she wants it to be higher; she prescribed me one and said once it's done to keep on taking vit D3.

    • pharmacist profile image
      Author

      Jason Poquette 6 years ago from Whitinsville, MA

      Chanel,

      Splitting them up is fine, though taking them together is fine too. Time of day is not essential.

      1000IU is a good dose. However, the only way to really tell is to have a Vitamin D blood test done. Really it is impossible to tell if that dose is helping without such a blood test. There is a lot of variability between patients with respect to Vitamin D absorption, etc. But 1000IU daily is probably fine.

      By the way...if you see any article of mine that you deem helpful and wouldn't mind "liking" it for facebook, or posting in your social network even for a day...these things help me get the word out and allow me to help others. Thanks!

    • profile image

      Chanel 6 years ago

      good stuff; well writen article. Now that leads me to ask you this, I am currently taking 1000IU and Vit B12; I took B12 in the morning after breakfast and D3 1000 at night....does it matter when i take it; i just don't have the stomach to take two pills at once. And is VitD3 1000IU good enough or should go for a strong dosage?

    • pharmacist profile image
      Author

      Jason Poquette 6 years ago from Whitinsville, MA

      tarajeyaram,

      Yes, winter months seem to be the worst. Thanks for the comment!

    • tarajeyaram profile image

      tarajeyaram 6 years ago from Wonderland

      Thanks for the information. Vitamin D may be linked to winter months and staying indoors. Yes, this is a concern and most of us don't know. Your hub will make people be aware of such problem.

    • writer20 profile image

      Joyce Haragsim 6 years ago from Southern Nevada

      Living in Las Vegas NV. I think we do get enough Vitamin D by being outside for 10 minutes when it's not too hot.

    • pharmacist profile image
      Author

      Jason Poquette 6 years ago from Whitinsville, MA

      @RTalloni - Thanks for the link. Yes, it is an area of concern that physcians are just beginning to look at more closely. Still more research needed, but something to be aware of for sure.

      @annie - Bev may just be on to something! We all tend to get a bit Vitamin D deficient, especially in New England winters...

    • RTalloni profile image

      RTalloni 6 years ago from the short journey

      Also linking this hub to mine on adverse interactions between drugs and supplements if you have no objection. Thanks!

    • profile image

      annie 6 years ago

      Bev A. has had me on vitamin D gummies all this school year! She assures me they help keep flus and sniffles away!

    • RTalloni profile image

      RTalloni 6 years ago from the short journey

      So glad to see more info on this topic, especially in a well-done hub. Important because it is so needful, I'm hoping dermatologists will pick up the issue of vitamin D deficiency for their patients sake!

      Voted up, book marking this, and going to check out your other work.

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