How to Treat a Vitamin D Deficiency

Although summer may have you headed to the beach, winter is a time when more people, especially those living in northern climates, spend more time indoors. Lack of sunlight exposure is one of the most common causes of vitamin D deficiency. This article helps you identify the symptoms of vitamin D deficiency and how to treat it.

What is vitamin D?

Vitamin D does many things. It helps calcium absorption in the body, supports the immune functions, reduces inflammation, and supports cardiovascular health by regulating blood pressure. It also comes in two forms: vitamin D₂ and vitamin D₃. Both are metabolized primarily in the liver and then the kidneys to calcitriol, which interacts with vitamin D receptors throughout the body.

Your body obtains this vitamin in one of three ways. It obtains it from exposure of the skin to ultraviolet B radiation in sunlight (vitamin D₃), from food sources such as fortified foods (vitamin D₃) and plant sources (vitamin D₂), and supplements (vitamin D₂ and D₃)

Health care providers often order a yearly test to measure your vitamin levels. A range of 10-24 ng/mL for the serum 25-hydroxyvitamin D level is considered a mild to moderate deficiency. Optimal levels of this test should be in the range of 25-80 ng/mL.

Who is at risk?

Most of your vitamin D comes from exposure to the sun. People who spend lots of time indoors or live in northern climates have a much higher risk of being deficient due to decreased sun exposure.

Some other risk factors include limited intake of fortified food or oily fish, history of bariatric surgery or obesity, gastrointestinal diseases such as inflammatory bowel disease, celiac disease or pancreatitis, liver or kidney disease, being elderly, pregnant or breastfeeding women, and breastfed infants.

Symptoms

You might not even notice your deficiency if you have one. It is common to discover it on accident when your healthcare provider orders lab work to check your levels.

Those deficient in vitamin D may exhibit many symptoms. These include problems with bone health including osteoporosis, osteopenia or frequent fractures, difficulty getting pregnant, depression, anxiety, high blood pressure, and feelings of exhaustion or not being able to do as much as usual.

Since these symptoms often appear in other disease states as well, testing for a vitamin deficiency should be part of any workup that is done when experience vague symptoms.

Treatments

The treatment following your diagnosis involves oral supplements you can find at your local pharmacy. Supplements are available in tablet, capsule, and even liquid form for children. Although there are foods fortified with vitamin D, increasing the intake of these foods will not be enough to correct the deficiency.

As mentioned above, vitamin supplements are available as vitamin D₂ and vitamin D₃. Both forms metabolize into calcitriol, which vitamin D receptors use throughout the body. Vitamin D₃ is the most common form recommended by health care providers to correct a deficiency.

There are a variety of dosing regimens used to treat this deficiency. If you consider taking supplements, then you should take them with meals that contain fat to help it be absorbed. Your health care provider will individualize your treatment plan to meet your particular needs.  

Lastly, some medications can also affect vitamin levels. Prednisone and other corticosteroids, can interfere with your metabolism. Orlistat, a weight loss drug, can reduce the absorption of vitamin D. Phenobarbital and phenytoin, anti-seizure medications, can increase the liver metabolism of vitamin D and lead to lower levels and less calcium absorption. If you take any of these medications, then make sure your healthcare provider monitors your vitamin levels.

Maintenance treatment

Once you test your vitamin levels, you most likely will be put on a maintenance dose of vitamin D to prevent a deficiency from occurring again. In general, between 800 IU to 2000 IU of a vitamin D supplement will be needed to prevent a recurrence of a deficiency. Again, this is something that will be individualized by your healthcare provider.

In addition to supplements, you should eat a well-balanced diet that includes both foods with natural, high vitamin D levels. Some foods include cod liver oil (1360 IU), swordfish (266 IU), salmon (447 IU), fortified orange juice (137 IU), and fortified milk (115 IU). The United States Department of Agriculture (USDA) Food Composition Database allows consumers to search for foods and to determine nutritional content of common food items.

It is also recommended to get 15-20 minutes of natural sunlight daily to maintain the body’s vitamin production. Should you have a history of skin cancer or burn easily, make sure you discuss any increased time in the sun with your healthcare provider.

For more information

Maintaining adequate vitamin D levels is important for your health. If your healthcare provider has recommended that you take supplements, then contact Smith-Caldwell Drug Store at (501) 392-5470 for help in choosing the right vitamin supplement and all your pharmacy compounding questions.