Vitamin D deficiency is a common vitamin deficiency that causes issues with your bones and muscles. It most commonly affects people over the age of 65 and people who have darker skin. It’s preventable and treatable.
Vitamin D deficiency means you don’t have enough vitamin D in your body. It primarily causes issues with your bones and muscles.
You can get vitamin D in a variety of ways, including:
Despite all these methods to get vitamin D, vitamin D deficiency is a common worldwide problem.
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Vitamin D is one of many vitamins your body needs to stay healthy. It plays a crucial role in maintaining the balance of calcium in your blood and bones and in building and maintaining bones.
More specifically, you need vitamin D so your body can use calcium and phosphorus to build bones and support healthy tissues.
With chronic and/or severe vitamin D deficiency, a decline in calcium and phosphorus absorption by your intestines leads to hypocalcemia (low calcium levels in your blood). This leads to secondary hyperparathyroidism (overactive parathyroid glands attempting to keep blood calcium levels normal).
Both hypocalcemia and hyperparathyroidism, if severe, can cause symptoms, including muscle weakness and cramps, fatigue and depression.
To try to balance calcium levels in your blood (via secondary hyperparathyroidism), your body takes calcium from your bones, which leads to accelerated bone demineralization (when a bone breaks down faster than it can reform).
Osteomalacia and osteoporosis put you at an increased risk for bone fractures. Rickets is the same as osteomalacia, but it only affects children. Since a child’s bones are still growing, demineralization causes bowed or bent bones.
Anyone can have vitamin D deficiency, including infants, children and adults.
Vitamin D deficiency may be more common in people with higher skin melanin content (darker skin) and who wear clothing with extensive skin coverage, particularly in Middle Eastern countries.
Vitamin D deficiency is a common global issue. About 1 billion people worldwide have vitamin D deficiency, while 50% of the population has vitamin D insufficiency.
Approximately 35% of adults in the United States have vitamin D deficiency.
Severe lack of vitamin D in children causes rickets. Symptoms of rickets include:
This is very rare. Children with a mild vitamin deficiency may just have weak, sore and/or painful muscles.
Lack of vitamin D isn’t quite as obvious in adults. Signs and symptoms might include:
However, you may have no signs or symptoms of vitamin D deficiency.
In general, the two main causes of vitamin D deficiency are:
There are several specific causes of vitamin D deficiency, including:
Several different biological and environmental factors can also put you at a greater risk of developing vitamin D deficiency, such as older age and the amount of melanin (pigment) in your skin.
Medical conditions that can cause vitamin D deficiency include:
Weight-loss surgeries that reduce the size of your stomach and/or bypass part of your small intestines, such as gastric bypass surgery, make it difficult for your body to absorb sufficient quantities of certain nutrients, vitamins and minerals.
If you’ve had weight-loss surgery, it’s important to see your healthcare provider regularly so they can monitor your vitamin D levels and other nutrient levels. You’ll likely need to take vitamin D supplements and other supplements throughout your life.
Certain medications can lower vitamin D levels, including:
Always tell your healthcare provider about your medications and any supplements and/or herbs you take.
Healthcare providers don’t usually order routine checks of vitamin D levels, but they might need to check your levels if you have certain medical conditions or risk factors for vitamin D deficiency and/or have symptoms of it.
Your provider can order a blood test to measure your levels of vitamin D. There are two types of tests that they might order, but the most common is the 25-hydroxyvitamin D, known as 25(OH)D for short.
The goals of treatment and prevention for vitamin D deficiency are the same: to reach and then maintain an adequate vitamin D level in your body.
While you might consider eating more foods containing vitamin D and getting more sunlight, your healthcare provider will likely recommend taking vitamin D supplements.
Vitamin D comes in two forms: D2 and D3. D2 (ergocalciferol) comes from plants. D3 (cholecalciferol) comes from animals. You need a prescription to get D2. D3, however, is available over the counter. Your body more easily absorbs D3 than D2.
Work with your healthcare provider to find out if you need a vitamin supplement and how much to take, if needed.
Aside from medical conditions that can lead to vitamin D deficiency, biological and environmental factors that put someone at an increased risk of vitamin D deficiency include:
The best way to prevent vitamin D deficiency is to ensure you’re getting enough vitamin D in your diet and/or through sun exposure. But be careful about being in the sun for too long without sunscreen. Excessive sun exposure puts you at an increased risk for skin cancer.
The amount of vitamin D you need each day depends on your age. The average daily recommended amounts are listed below in micrograms (mcg) and International Units (IU).
|Age / Life Stage||Recommended Amount|
|Infants up to 12 months old||10 mcg (400 IU)|
|People 1 to 70 years old||15 mcg (600 IU)|
|Adults 71 years and older||20 mcg (800 IU)|
|Pregnant and breastfeeding people||15 mcg (600 IU)|
|Age / Life Stage|
|Infants up to 12 months old|
|10 mcg (400 IU)|
|People 1 to 70 years old|
|15 mcg (600 IU)|
|Adults 71 years and older|
|20 mcg (800 IU)|
|Pregnant and breastfeeding people|
|15 mcg (600 IU)|
There are a few foods that naturally have some vitamin D, including:
You can also get vitamin D from fortified foods. Be sure to check the nutrition labels to find out if a food has vitamin D. Foods that often have added vitamin D include:
Vitamin D is in many multivitamins. There are also vitamin D supplements.
Talk to your healthcare provider if you’re concerned about getting enough vitamin D.
The most serious complications of vitamin D deficiency include:
All of these conditions are treatable. While rickets is a treatable and often curable disease, treating it as soon as possible is important. When not treated, milder cases of rickets can result in long-term bone damage that can keep bones from growing properly. Severe cases that aren’t treated can lead to seizures, heart damage and death.
The good news is that thanks to vitamin D-fortified infant formula and fortified cow’s milk, rickets is very uncommon in the United States.
If you’re concerned about whether you’re getting enough vitamin D or if your body is using it properly, talk to your provider.
If you have risk factors for vitamin D deficiency, your provider may recommend checking your vitamin D levels regularly to ensure they’re in a healthy range.
Yes. You can get too much vitamin D if you take too many supplements. Interestingly, you can’t get too much vitamin D from the sun. Vitamin D toxicity is rare, but it can lead to hypercalcemia. Symptoms can include:
Don’t take higher-than-recommended doses of vitamin D without first discussing it with your healthcare provider. Also, be cautious about getting large doses of vitamin A along with the D in some fish oils. Vitamin A can also reach toxic levels and can cause serious problems.
A note from Cleveland Clinic
Vitamin D is an important vitamin your body needs to be healthy. If you have risk factors for developing vitamin D deficiency or are experiencing symptoms, be sure to contact your healthcare provider to get a blood test to check your levels.
Last reviewed by a Cleveland Clinic medical professional on 08/02/2022.
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