Are there symptoms for vitamin D deficiency?
The last decade has seen a renaissance in our understanding of the many roles of Vitamin D in our well-being, with hundreds of studies defining ever more precisely its role in health and disease. Vitamin D could as accurately be called a hormone as much as a vitamin. It influences the calcium metabolism in most every cell of the body, not just in bone. It also affects the immune system; helping us to fight infections, to find and clear precancerous cells and to moder
ate inappropriate autoimmune processes. How can one nutrient have such an effect in so many areas? It turns out that Vitamin D plays an important role in genetic expression, and that hundreds if not thousands of our genes are modulated by Vitamin D. Stated simply, if your genes are bathed in the right amount of Vitamin D, they respond more efficiently. If not, their maladaptive expression can provoke or allow a wide range of chronic health problems.
So, as low Vitamin D levels can affect every organ system, wouldn’t it be useful for a person to know if their body is telling them about a low Vitamin D level? To interpret what your body may be saying, I’d like to review some of the symptoms and conditions that can be associated with Vitamin D deficiency. A symptom is a physical complaint that is a noticeable deviation from normal, such as fatigue, or muscle aches. A condition is more of a definable quality or diagnosis, such as depression, asthma, osteoporosis or a lab result such as an elevated parathyroid hormone level. We should keep in mind that while a low Vitamin D level may be a major contributing factor to a problem, many times it is only part of a larger picture. After reviewing the clues that may lead us to suspect a low level, we will discuss what it takes to measure Vitamin D, and then some basic advice about interpreting and treating low levels. We have included click through links to some of the basic research related to many of the conditions we discuss below.
Symptoms suggesting low Vitamin D levels include:
- muscle weakness, feeling too easily fatigued.
- excess daytime sleepiness
- general aches and pains, particularly bone ache. A simple test for test for periosteal bone pain is to see if you have discomfort from placing firm pressure on your breastbone or shin bone.
- a sweaty head. Strange as it may seem, excess sweating in the head vs. the rest of the body has been associated with low Vitamin D levels.
- keep in mind that now that we are screening for Vitamin D, many people with low levels have no recognizable symptoms at all at the time of diagnosis. The goal is to get ahead of the problems that can emerge over months or years of having deficient levels.
There are many common conditions associated with low Vitamin D, where its deficiency may be a causal factor, or a part of disease progression. If you have one or more of these conditions, you should have your Vitamin D level evaluated and discussed with your personal physician. These could include:
- a diagnosis of fibromyalgia or chronic fatigue syndrome. It is interesting how these disorders and Vitamin D deficiency share many symptoms. Given the debilitation of these disorders it would be a shame to ignore an easily remediable factor like Vitamin D deficiency.
- a series of infections, or seasonal or yearly recurrences of viral respiratory infections, sore throat, and influenza.
- being a woman using a statin drug for cholesterol, and having fatigue or muscle aches. Also keep in mind that lower levels of the nutrient CoQ10 have been implicated in these symptoms for both men and women.
- depression: individuals with the lowest levels of Vitamin D had 11 X risk for depression over those with healthy levels.
- those diagnosed with schizophrenia are more likely to have low Vitamin D levels. Therapeutic benefits are still a matter of ongoing research.
- a diagnosis of osteopenia or osteoporosis. These have a well-documented causal relationship with Vitamin D. Vitamin D deficiency has also been associated with reduced balance and stability, weaker quadriceps, slower reaction times and impaired postural stability. All of these conditions predispose to falls. Also, if you are over fifty and have a fracture, you should consider screening for both Vitamin D and bone density.
- the skin condition of psoriasis
- individuals who receive little or no direct sunlight, such as elderly shut-ins, people living in northern latitudes and those who seek solar protection by extensive use of sunscreen are often Vitamin D deficient. Also keep in mind that in aging we make less Vitamin D out of sunlight. It is estimated that anywhere from 50-90% of American seniors are low in Vitamin D.
- hair growth. The Vitamin D receptor and indirectly Vitamin D levels can play an important role in hair follicle development and the hair growth cycle, especially the anagen phase, where new hair growth is initiated. This may be a factor in patients with hereditary vitamin D receptor deficiency, and optimizing Vitamin D levels plays a role in maintaining hair follicles and hair thickness, especially in mid-life. Visit HairLossRevolution for more information on vitamin D deficiency and hair loss.
- those who have dark skin, where one may generate significantly less Vitamin D from sunlight.
- some autoimmune conditions, especially multiple sclerosis where Vitamin D has been shown to be a factor in preventing or moderating the disease.
- inflammatory bowel disease. The relationship between low D3 and Crohn’s disease or ulcerative colitis cuts both ways, as these individuals may not absorb Vitamin D as efficiently, and Vitamin D is known to reduce inflammation in these disorders.
- childhood asthma. Children with asthma are twice as likely to be Vitamin D deficient as compared to those without asthma. It’s not clear yet whether additional Vitamin D will improve their asthma, but it would be reasonable to check Vitamin D levels in these children.
- elevated blood pressure. While adults with hypertension tend to have lower Vitamin D levels, studies have not shown that supplementing Vitamin D is helpful in reducing blood pressure. This would be an example of how a condition might be useful as an indicator to test for Vitamin D, without implying that Vitamin D is a treatment for that particular problem.
- dental cavities in children. One study showed that in children under 13, proactive Vitamin D supplementation reduced dental caries by 47%.
- individuals taking drugs known to interfere with Vitamin D metabolism, including seizure drugs phenobarbital and phenytoin (Dilantin) or the antibiotic rifampin.
- a past or current diagnosis of cancer, or families wi
th a high prevalence of cancer diagnosis. This is particularly true of prostate cancer.
- cognitive impairment, starting with ‘senior moments’ on up to Alzheimer’s: Studies show that individuals with the lowest levels of Vitamin D had twice the incidence of dementia as those with healthy levels.
- Parkinson’s disease. Those with lower Vitamin D levels have a highe
r Parkinson’s risk. Although studies are ongoing about the long term benefits of Vitamin D in treating Parkinson’s, it is clear that augmenting Vitamin D can reduce cognitive decline and depression in these patients.
- obesity: if you carry large stores of body fat you are at greater risk of vitamin D deficiency. When vitamin D is synthesized or ingested it is stored in body fat stores. However, the larger your store of body fat, the less bio-available the Vitamin D.
- proper levels of calcium and phosphorus. A deficiency during pregnancy can cause growth retardation and skeletal deformities. It has also been linked to a greater risk of pregnancy complications, including preeclampsia (see below), and a higher likelihood of needing a cesarean section delivery, of having gestational diabetes, an increased risk of delivery related infections and for a low birth weight. If your baby is deficient in Vitamin D after birth, it can be at risk for rickets (which can lead to fractures and deformity) and abnormal or delayed bone growth and physical development. These Vitamin D deficiency effects can be long lasting. Research is showing that a Vitamin D deficit during pregnancy can affect bone development and immune function of the child onward into adulthood. A major study has shown that taking 4,000 IU of vitamin D daily had the greatest benefits in preventing preterm labor/births and infections. This study also confirmed that Vitamin D at this level is not only safe for you, but for the baby as well. The researchers from this study recommend this daily dosage of vitamin D for all pregnant women. Some practitioners advise as high as 6000 IU/day if you are significantly deficient at the onset of pregnancy.
The average prenatal vitamin only contains 400 IU of vitamin D, so a pregnant woman will most likely need additional supplementation.
- history of preeclampsia. Elevation of blood pressure late in pregnancy and into delivery can be a dangerous condition, and it occurs in 5-8% of pregnancies. Research has shown that women with low levels of vitamin D during the first 26 weeks of pregnancy were 40% more likely to develop severe preeclampsia, compared with those who had adequate levels.
- breastfeeding: infants who are exclusively breast fed infants are at risk for Vitamin D deficiency, because human milk generally provides 25 IU of vitamin D per liter, which is not enough for an infant if breast milk is the sole source of Vitamin D. It is advised that all infants who are not consuming at least 500 ml (16 ounces) of vitamin D fortified formula or milk should be given a vitamin D supplement of 400 IU/day
- HIV/AIDS: Vitamin D helps combat progression of AIDS by reducing bone and muscle loss, by improving immune system function and by reducing inflammation. A five year study in Tanzania showed that in women with HIV, higher vitamin D levels were associated with a slower progression of HIV to AIDS. Women with vitamin D levels above 32 had a 25% lower risk of disease progression. Those with the higher vitamin D levels also had a lower risk of dying from any cause during the study.
- overactive parathyroid activity, if due to Vitamin D deficiency (if not due to Vitamin D deficiency, your case may require surgery)
- elevated risk for coronary heart disease: studies show that low Vitamin D may increase one’s risk of having a heart attack, or of dying from a heart attack, should it occur.
- congestive heart failure patients have demonstrably lower Vitamin D levels.
- erectile dysfunction. Low Vitamin D levels have been associated with problems getting or maintaining an erection.
If you have any of these symptoms or conditions, you could be low on Vitamin D, and it would be advisable for you to have your level checked. The technical name for this test is 25-hydroxy vitamin D, or 25(OH) D. The ‘normal range’ for the result is a value between 30 and 100. An optimal level would be in the 50-70 range, and up to 80-90 is often advised for cancer patients or for certain autoimmune problems.
Getting your Vitamin D level checked
Most physicians can readily obtain this blood test through local labs and hospitals. A typical retail cost through a clinic is $45-50, and it may be covered by insurance if medically indicated. It would be advisable to review this result with your personal physician, and to correlate it with any concerning symptoms or conditions you may have.
If you want to get this done on your own, you will pay $50-75, and they usually have you send in a blot of blood obtained with a finger pinprick. Some options include:
- the Grassroots Health D*Action Study. This ongoing study is designed to both give you specific feedback on your Vitamin D levels and optimal dosing advice based on those results, for $70. They do ask you to fill out a questionnaire about your health to assist in determining the relationship of initial and treated Vitamin D levels on long term health. If you want to continue monitoring and participation, they recommend a recheck every 6 months. This is optional, but advisable, as you will need more than one data point to know you have achieved a new and optimal steady state level.
- Doctor’s Option $57 for a home test kit and a three day turnaround for results, but no specific advice based on the results.
However you choose to do it, find out your Vitamin D status. I believe it won’t be long before this will be considered as important a ‘vital sign’ as your blood pressure, blood sugar or cholesterol level is today.