Vitamin D is a fat-soluble vitamin necessary for health. Humans can get vitamin D from the sun or their food supply. Many Americans are deficient in vitamin D; this can lead to rickets in children or osteomalacia in adults, both disorders of the bone. Vitamin D works with calcium and phosphate for bone health, and elderly people who become deficient may develop osteoporosis. This vitamin is also necessary for certain nervous system, immune system and muscular functions. There are several causes for vitamin D deficiency; treatment decisions depend on the underlying cause.
Lack of Sunlight
Many people fail to get enough sunlight to keep a healthy level of Vitamin D in their bloodstream. People at risk include those who spend extended amounts of time in nursing homes, hospitals, prisons or other facilities that do not lend themselves to outdoor activities. People who wear heavy clothing are also at risk, such as Muslim women who only go outdoors with their face and full body covered. People who live in latitudes far from the equator may also suffer vitamin D deficiency, especially in the winter months. Exposure of multiple body parts for five to 30 minutes of sunshine on two or more days of the week is usually sufficient to maintain adequate levels. This exposure must occur without sunscreen.
Dietary Deficiency
Vitamin D is naturally obtained in small amounts from the typical American diet. People who do not eat either fish flesh from mackerel, salmon and tuna or fish liver oil--good dietary sources--may find themselves with a vitamin D deficit. The National Institute of Health's Office of Dietary Supplements lists egg yolks, beef liver, cheese and some mushrooms as having a small amount of natural vitamin D. Many foods are fortified with this vitamin. It is added to milk, for example, and by reading labels, you may find it in fortified orange juice, cereal, margarine and yogurt.
Drinking Only Breast Milk
Babies who drink breast milk and no formula or cow's milk may develop a deficiency of vitamin D. Concerns about this should be discussed with the baby's pediatrician.
Fat Malabsorption
Vitamin D must be absorbed in the intestine along with a small amount of fat. Some disorders, such as cystic fibrosis, interfere with this process. Inflammatory diseases of the intestine can also cause fat--and vitamin D--to not be absorbed at a healthy level.
Skin Absorption Difficulties
Some people have skin that does not properly utilize sunlight to trigger the production of vitamin D. People over 65 and those with dark skin colors are at risk of this problem.
Inability to Convert Vitamin D
According to Merck Online Manual, the body must be able to convert the initial form of vitamin D into a form it can use. People with certain inherited disorders, such as familial hypophospatemia, may become deficient for this reason. Those with certain liver or kidney disorders may also have this problem.
Drug Side Effects
Some drugs alter the body's absorption or use of vitamin D, potentially leading to deficiency. Some types of antibiotics, central nervous system drugs and weight-loss agents fall into this category.
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