Vitamin D acts throughout the body; it is very active in the development and calcification of bones. It is synthesized in the skin by sunlight. Deficiency of vitamin D can occur in adult and in children. The liver is integral to the metabolism of vitamin D and therefore diseases affecting the liver also affect the metabolism of vitamin D.
Causes
Many reported cases of Hepatitis C and liver cirrhosis have been associated with a deficiency in vitamin D. Lack of sunlight exposure can cause vitamin D deficiency, especially in combination with poor dietary intake. Disease that affect the intestines, such as Irritable Bowel Syndrome and Crohn's disease, also lead to vitamin D deficiency.
Complications
Low vitamin D in the blood causes hypocalcemia, which is low calcium in the blood. Vitamin D is required for the absorption of calcium. The heart depends on a normal concentration of calcium in the blood to work properly; when calcium is low in the blood the heat beats irregularly. Low blood calcium is a stimulus for the parathyroid glands to release parathyroid hormone which causes hypophosphatemia, or low blood phosphate. Bone softening can also occur; its called osteomalacia in adults, and rickets in children.
Observed Symptoms
Muscle aches and weakness are often observed in vitamin D deficiency. Tetany is a symptom that occurs in relation to hypocalcemia associated with vitamin D deficiency. Tetany results in abnormal sensations in the lips, tongue and fingers. Facial spasms, or uncontrollable twitching of the facial muscles, may be seen. Neonates may have tetany if mother was deficient in vitamin D during pregnancy. Hypocalcemia also affects the brain by causing seizures.
Diagnosis
Investigating vitamin D deficiency involved drawing a blood sample from a person's arm. The blood is tested for 25OHD, which is the active form of vitamin D in body. Concentrations of 25OHD greater than 30 ng/mL is regarded as normal and below 20 ng/mL it is deficient.
Treatment
Supplemental vitamin D is used in the treatment of vitamin D deficiency. Vitamin D2 and D3 are different forms of vitamin D that can be supplemented. The naturally occurring Vitamin D3 is more effective in increasing 25OHD in the blood. Vitamin D3 is more efficient when supplemented together with calcium. The U.S. Department of Health & Human Services advises taking 700 to 800 IU of vitamin D3 per day with 500 to 1,200 mg per day of calcium.
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