Vitamin D Deficiency

General information about vitamin D

Vitamin D is a hormone produced in the skin by exposure to sunlight or other UVB rays. The body can also get vitamin D from foods or supplements that are absorbed from the gut.

Vitamin D is fat-soluble and is stored in the liver and adipose tissue. It exists in two forms. Vitamin D3 is formed by sunlight and is contained in fatty fish, meat and eggs, for example. Vitamin D2 is found in wild mushrooms and certain plants, among other things. Vitamin D2 and D3 can be obtained from foods fortified with vitamin D and from dietary supplements.

Vitamin D is necessary for the body to absorb calcium and phosphorus, which are important for the development of bones and teeth, among other things. A pronounced vitamin D deficiency leads to a lack of calcium and phosphorus. This can lead to deficiency symptoms such as muscle weakness, stiffness, fatigue and depression. In more severe cases, vitamin D deficiency can weaken bone structure in adults and children.

Research has not yet captured all of the functions of vitamin D. However, it is clear that vitamin D affects our physical and mental well-being in a variety of ways. The body has vitamin D receptors in cells including the skin, skeleton, brain, thyroid and kidneys. Vitamin D also influences cell division.

Studies show that vitamin D is linked to various disease states. It’s possible that vitamin D can reduce the risk of things like cancer, heart attack, stroke and depression , but there’s no definitive evidence of this.

Different forms of vitamin D supplementation

When you are in the sun, vitamin D is formed in the skin and then stored in the body. How much is stored and for how long varies from person to person. It depends, for example, on what time of year, for how many hours and where in the world you have been in the sun. The skin’s ability to convert sunlight into vitamin D is linked to latitude, time of year, sun exposure and skin type.

Darker skin needs more sun to form vitamin D – dark pigments, like clothing and a high sun protection factor, prevent the sun’s rays from penetrating the skin. This provides protection against sunburn , but also means it takes longer to increase vitamin D levels.

In Central Europe, UV radiation is strongest from May to September, especially in June and July. Then the body can absorb large amounts of vitamin D in a very short time – significantly more than via the intestine through nutrition and dietary supplements. Exposing the skin to the sun for 15 to 30 minutes a few days a week is enough.

From October to April, the amount of sunlight and the power of the sun is often too low for the body to absorb a sufficient amount of vitamin D. Then the vitamin D already stored in the body is used. The vitamin D level then gradually decreases. For the vast majority of people, supplies are lowest in January and February. Then it is particularly important to create a balance with a diet rich in vitamin D.

Sources of vitamin D:

• Sun – when skin is exposed to the sun’s UVB rays, the sun’s rays are converted into vitamin D, which is stored in the body
• Artificial UVB radiation – the radiation in certain solariums and the so-called narrow-wave UVB light, which is used to treat various skin diseases, can also be converted into vitamin D in the skin
• Animal foods – Vitamin D is found in many animal foods, especially oily fish such as salmon and herring, but also other types of fish, eggs, cheese, milk and various types of meat
• Plant foods – Vitamin D is found in mushrooms and avocados, among other things, but levels are often lower than animal vitamin D
• Vitamin D-fortified foods – Margarine is sometimes fortified with vitamin D
• Dietary Supplements – Vitamin D can also be obtained through dietary supplements, which come in various strengths and formulations.

Symptoms of vitamin D deficiency

Vitamin D deficiency in adults is a condition that builds up over a period of time. Symptoms are often diffuse and rarely directly related to vitamin D. They may include a general feeling of tiredness, depression, lack of energy, or muscle weakness. You may need to support yourself with your hands when getting up from a chair, or you may find it difficult to climb stairs.

Examples of different symptoms:

• fatigue
• dejection
• powerlessness
• muscle weakness
• diffuse pain
• cramps
• difficulty walking
• sometimes pain in the bones.

In more serious cases, prolonged and severe vitamin D deficiency can make bones weaker or more fragile. Bone softening is called osteomalacia in medical jargon and the reduction in bone density is called osteoporosis.

Vitamin D deficiency in children

Children are particularly susceptible to vitamin D deficiency. The bone structure needs vitamin D to develop properly. Otherwise the skeleton may soften and deform. For example, the child may become knock-kneed or bow-legged, develop a funnel chest or a deformed pelvis. The fontanel closes later and the head can grow larger. This is called rickets or “English disease”.

In order to prevent rickets, children in Germany are given vitamin D drops as a dietary supplement from birth until their second spring (age 1-1.5 years). Children with darker skin pigments need supplementation for an even longer period, usually until they are five years old.

Causes of vitamin D deficiency

Low vitamin D levels, or vitamin D deficiency, are often due to not getting enough sun exposure or not getting enough vitamin D in your diet. Certain medical conditions can also lead to vitamin D deficiency, such as when the gut has trouble absorbing calcium. The production of vitamin D in the skin also decreases with age.

Common causes:

• low vitamin D production in the skin – common explanations are, for example, old age, dark skin, sun protection, protective clothing, the season or geographical location
• low absorption of fat in the intestine – this can be due to celiac disease, gastrointestinal diseases, cystic fibrosis or gastric bypass surgery, for example
• Overweight and obesity – then vitamin D is stored in the fatty tissue and does not benefit the body
• Breastfeeding without a vitamin D supplement – the milk from the breast does not contain enough vitamin D
• Pregnancy – the body needs more vitamin D during pregnancy
• certain diseases – this applies, for example, to chronic kidney failure, severe liver disease and an overactive thyroid gland
• Medications – Certain medications can make it difficult to absorb vitamin D, for example, anti-epileptic drugs, antiviral drugs and St. John’s wort

The risk group

Studies show that approximately one billion people around the world are vitamin D deficient or have low vitamin D levels. Older people are more represented, but vitamin D deficiency occurs in all age groups.

Risk groups with increased susceptibility to vitamin D deficiency:

• older persons
• People who spend too little time in the sun, wear covering clothing or always use a high sun protection factor
• black people who live or stay in northern countries for a long time
• premature babies
• young children who are not taking vitamin D supplements
• Pregnant women who do not eat enough vitamin D-containing food
• People who do not eat fish or dairy products
• people who are overweight
• People who have problems absorbing food in their intestines.

what you can do yourself

To prevent low vitamin D levels, you should take preventive measures to choose foods rich in vitamin D and expose your skin to the sun for 15 to 30 minutes a few days a week during the warmer and lighter months of the year. If you’re going to be in the sun for more than 30 minutes, protect yourself with SPF or appropriate clothing.

If you belong to a risk group or have low levels in winter, you need vitamin D as a dietary supplement. Talk to your doctor about it.

Recommended daily dose of vitamin D:

• Children 0-2 years – 10 micrograms
• Children and adults under 75 years – 10 micrograms
• Adults over 75 years – 20 micrograms

The risk of consuming too much vitamin D, which can try negative side effects, is small. In exceptional cases, excessive amounts of vitamin D can lead to an overdose or vitamin D poisoning. Then you can get high blood calcium levels, calcium deposits in the kidneys, and kidney failure. You can’t get dangerous amounts through your diet or through your skin — you can only get too much vitamin D through supplements.

When to seek medical help

If you belong to a risk group, you should speak to a doctor.

See your doctor if you feel tired, limp, or weak in your muscles over a long period of time. This also applies if you feel mentally bad in the winter months and think that your well-being can be linked to the season.

Call 911 if you have severe pain in your body.

Here’s how Med-Healths can help you

If you suspect a vitamin D deficiency, you can contact us via video appointment. A doctor will make an individual assessment based on your symptoms. You can then be referred for further medical care.

Remember: If your child has any symptoms, they must be present at the doctor’s appointment.