Dr Chinnadorai Rajeswaran, consultant endocrinologist explains about vitamin D deficiency.

Vitamin D deficiency is quite common in the general population. Most people do not realise they have vitamin D deficiency, as they gradually get used to the usual symptoms of vitamin D deficiency. Some may have vague symptoms like tiredness or body ache. Usual symptoms in adults with vitamin D deficiency include: Generalised tiredness, aches and pains and feeling generally unwell.

In severe and long-standing vitamin D deficiency, there may be

• Severe tiredness
• Muscle weakness
• Difficulty in climbing stairs
• Difficulty getting up from the floor
• Bone pain and tenderness
• Backache
• Fractures
• Osteoporosis

Who can get vitamin D deficiency?

People who can get vitamin d deficiency, may either have one or more of the following conditions:

• Reduced vitamin D intake in their diet
• Their body may need more vitamin D
• Their body does not make adequate vitamin D
• Their body loses vitamin D
• Medications
• Medical conditions

Reduced vitamin intake in their diet: Vitamin D deficiency is more likely to occur in people who do not consume adequate dairy products like milk, cheese, yoghurt etc. This is more commonly seen in people who are strict vegetarians or on a vegan diet and do not take vitamin D replacement in other forms.

Body may need more vitamin D: During growth, that is growing children, vitamin D deficiency is noticed especially in those who do not have a balanced meal. It is also seen in pregnant and breast-feeding women where the need for vitamin D is increased.

Body does not make adequate vitamin D: People who remain indoors most of the time and are not exposed to sun, predominantly elderly do not synthesise adequate vitamin D. Vitamin D deficiency is also seen in people who live in countries where sun light is scarce, like in the UK.

Medical conditions: Certain medical conditions like coeliac disease, malabsorption due to Crohn’s disease, kidney failure, liver failure, weight loss surgery like gastric bypass and hyperparathyroidism also cause vitamin D deficiency.

Medications:  Certain drugs like carbamazepine, phenytoin and medications for HIV can lower vitamin D levels in the body. It is therefore important to regularly check for vitamin D levels and also get vitamin D level checked if there are any symptoms.

Investigations and management
 

Usually a blood test helps to determine if you are vitamin D deficient, insufficient or have adequate levels. Treatment will depend on the levels of vitamin D. In addition to replacing the correct dose of vitamin D, it is important to ensure people have investigations to find out why they are vitamin D deficient.

Those who cannot take oral vitamin D or if their body cannot absorb vitamin D due to problems with their bowels or bowel surgery, they can have vitamin D replacement in the form of injections.

Dr Chinnadorai Rajeswaran is a consultant Physician specialising in Endocrinology, Diabetes and Obesity. As a private endocrinologist he  has private endocrine, diabetes and weight loss clinics in Harley Street, London, Chennai (India), Claremont Hospital, Sheffield, Nuffield Hospital, Leeds and Simplyweight, Bradford.

He has face to face consultations with people from Barnsley, Rotherham, Chesterfield, Doncaster, Wakefield, Huddersfield, Bradford, Harrogate, Leeds, Sheffield, London and Chennai (India). He also offers video consultations.