Besides the skin, the digestive system is a major avenue for maintaining vitamin D levels in the blood. In the gut, vitamin D is mainly absorbed from fish, eggs, cod liver oil and vitamin D-fortified milk; these foods are rich in vitamin D. Vitamin D occurs naturally as vitamin D3, which is the form synthesized in the skin under direct sunlight. Vitamin D is needed for the absorption of calcium in the gut. The heart depends on calcium to work properly; low blood calcium causes an irregular pulse.
Heart Disease
The heart receives oxygen-rich blood from the lungs and pumps it to the body. It also receives oxygen-poor blood from the body and pumps it to the lungs. The heart muscle needs calcium to work efficiently. Very low blood calcium weakens the heart and has been linked with congestive heart failure. When the heart's contraction are not effective in pumping blood, blood flow is affected, and oxygen-rich blood backs up to the lungs. Heart disease is very discomforting and has to be addressed right away.
Several Complications
Any disease or process that decrease active vitamin D in the blood will also lower calcium in the blood. Low dietary intake of vitamin D and poor absorption in the gut are major causes of low vitamin D. Inadequate sunlight exposure is also a cause of low vitamin D. Low blood calcium affects the function of the heart by causing an irregular pulse. Very low blood calcium is a potential cause of irreversible heart failure. Low blood calcium also causes excessive release of parathyroid hormone, which leads to the breakdown and weakening of the bone.
Associated Symptoms
Shortness of breath while lying down occurs when calcium is very low in the blood. Leg and abdominal swelling can also occur with very low blood calcium. Tetany is also caused by low blood calcium; it's a condition of uncontrollable muscle contractions. It causes unusual sensations over the lips and tongue; it may also cause abnormal twitching of the facial muscles. Low blood calcium also leads to excess parathyroid hormone release, which causes the breakdown of bone to release calcium to the blood. The action of parathyroid hormone weakens bones. Individuals with excess parathyroid hormone often complain of bone and joint pain. Generalized weakness, abdominal pain, nausea and depression are also seen with excess parathyroid hormone.
Diagnosis
A simple blood test ordered by the physician is needed to diagnose vitamin D deficiency. The blood sample is taken to a lab and is tested for the concentration of active vitamin D. A normal concentration of active vitamin D should be greater than 30 nanograms per milliliter, or ng/mL; if less than 30 ng/mL it is abnormal. An active vitamin D concentration less than 20 ng/mL is defined as vitamin D deficiency.
Treatment
When the cause of low vitamin D is disease, then it should be treated in conjunction with supplementation of vitamin D and calcium. The U.S. Department of Health and Human Services suggests the use of vitamin D at doses of 700 to 800 international units, or IUs, with 500 to 1,200 mg of calcium; this has proven effective in strengthening bone. Any dietary modifications should include intake of fish, eggs, vitamin D-fortified milk and cod liver oil; these are abundant sources of vitamin D.
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