Do you have enough vitamin D level?

Vitamin D insufficiency or deficiency is common, and is defined as a lower than normal vitamin D level. This a problem, because the body needs vitamin D to absorb calcium and for other important jobs. People who do not have enough vitamin D can have weak or soft bones, which can break easily or change in shape and weak muscles, which makes them more likely to fall.

A low vitamin D level can be diagnosed with a blood test called 25-hydroxy-vitamin D (25OH-D). Although there is no formal definition of vitamin D deficiency, some groups use the following values in adults as the table below

 

Type	Vitamin D concentration (ng/mL)
Normal	More than 30
Vitamin D insufficiency	20 - 30
Vitamin D deficiency	Lower than 20

You can check your vitamin D level from annual check up.
 

Causes of vitamin D deficiency?

• Insufficiency intake of vitamin D from food especially vegetarian and non-fish-eating are intent to have daily insufficiency vitamin D intake
• Limited effective sun exposure due to protective clothing or consistent use of sun screens
• Malabsorption, including inflammatory bowel disease and celiac disease
• Taking medications that accelerate the metabolism of vitamin D, such as bronchodilator, anticonvulsant, anti-tuberculosis

 

What is the role of vitamin D?

            Vitamin D is an oil-soluble vitamin that has several important functions in the body:

• It helps to absorb dietary calcium and phosphorus from the intestines and keeps the calcium and phosphate levels in the blood normal.
• It suppresses the release of parathyroid hormone, a hormone that causes bone resorption.

The most serious complications of vitamin D deficiency are low blood calcium, low blood phosphate, rickets disease (softening of the bones during childhood), and osteomalacia (softening of the bones in adults).
 

How to prevent vitamin D insufficiency or deficiency?

             Vitamin D is made in the skin under the influence of sunlight. The amount of sunlight needed to synthesize adequate amounts of vitamin D varies, depending upon the person’s age, skin color, sun exposure, and any underlying medical problems.

There are many ways to prevent vitamin D insufficiency or deficiency in persons, for example

• Having outdoor activities at least 15 minutes for 2-4 times/weeks, sunlight will change cholesterol in the body to vitamin D
• Taking highly vitamin D containing food, such as
  • Oily fish (such as sardines, trout, tuna, salmon, and mackerel)
  • Cod-liver oil
  • Egg yolk
  • Milk
  • Fortified foods that have vitamin D added to them (such as margarine, some cereals, and infant formula milk).

 

Treatment of vitamin D deficiency?

            There are many types of vitamin D preparations available for the treatment of vitamin D deficiency or insufficiency. The two commonly available forms of vitamin D supplements are

1. Ergocalciferol (vitamin D2) and
2. Cholecalciferol (vitamin D3), the naturally occurring from of the vitamin

The recommended dose of vitamin D depends upon the nature and severity of the vitamin D deficiency.
 
If you have any other questions or concerns, please do not hesitate to contact Drug Information Service, Bumrungrad International hospital (available 24 hours).
 

Reference:

• La-or C, Wichai A, Boonsong O. Regional variation and determinants of vitamin D status in sunshine-abundant Thailand. BMC Public Health 2011; 11:853
• UpToDate. Patient Education: Vitamin D Deficiency (Beyond and Basics). Available from: https://www.uptodate.com/contents/vitamin-d-deficiency-beyond-the-basics [Accessed 26 February 2019]
• Uwe G, Klaus K. Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinology 2012; 4(2): 158-166.

 Contact information: Drug Information Service. Bumrungrad international hospital.
Tel: +66(0) 2 011 3399 Email: [email protected]