Vitamin D is fat-soluble, and it naturally exists as vitamin D3. Vitamin D3 is synthesized beneath the skin under direct sunlight. Vitamin D is active in the development and calcification of bone. Its absorption is mainly from diets high in vitamin D, such as fish, eggs and vitamin D fortified milk. The heart is one organ that requires a normal and stable concentration of calcium to function properly. Abnormally low calcium leads to palpitations, or an irregularity in heartbeat.
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Healthy intestines and adequate dietary intake of vitamin D are important for maintaining normal levels of calcium in the blood. Diseases such as ulcerative colitis and Crohn's disease that affect the intestine also affect the absorption of calcium by inhibiting the action of vitamin D.
Liver diseases such as cirrhosis and hepatitis, which impair the organ's function, also affect the use of vitamin D.
Anti-seizure medications and steroids increase the breakdown of vitamin D in the body, causing a need for vitamin D supplementation.
Lack of direct sunlight exposure may also contribute to deficiency in vitamin D.
Vitamin D-associated hypocalcemia elicits serious complications such as palpitations and seizures. Palpitations increase an individual's risk for enlargement of the heart and heart failure. Hypocalcemia leads to secondary hyperparathryoidism, a condition in which the parathyroid gland actively secretes parathyroid hormone because of a stimulus, in this case a lack of calcium in the blood due to low vitamin D. Osteomalacia in adults and rickets in children are associated with softening of bones due to a problem with vitamin D.
Heart palpitations are associated with shortness of breath, which can make an individual tired and less active. In vitamin D-associated secondary hyperparathyroid, the bones become fragile and are prone to fracture. Bone and joint pain are chief complaints. Nausea, weakness and depression are other symptoms that can occur. Tetany, or involuntary contractions of muscles, can also occur in hypocalcemia. Tetany results in peculiar sensations over the lips, tongue and fingers. Facial spasms also occur.
A physician has to order an evaluation for vitamin D deficiency. A blood sample is sent to a lab for analysis. The lab tests the blood sample for the concentration of active vitamin D, or 25OHD. A 25OHD concentration greater than 30 ng/mL is normal. When 25OHD concentration is less than 20 ng/mL, it is defined as vitamin D deficient. Borderline concentrations, which may need to be monitored, are between 30 to 20 ng/mL.
To avoid complications like heart palpitations, an individual with low 25OHD should make changes to his diet and, if necessary, supplement vitamin D. The US Department of Health & Human Services has recommended the supplementation of 700 to 800 IU of vitamin D3 per day with 500 to 1,200 mg of calcium; this combination has led to decreased incidence of fracture in vitamin D deficient individuals.
Maintaining adequate sunlight exposure is recommended as well. Consider adding foods such as eggs, fish and vitamin D fortified milk to your diet; these foods are high in vitamin D.
- The Merck Manuals Online Medical Library: Vitamin D
- Science Daily: Vitamin D Deficiency Common In Patients With IBD, Chronic Liver Disease
- U.S. Department of Health &amp; Human Services: Effectiveness and Safety of Vitamin D in Relation to Bone Health
- Mayo Clinic.com: Symptoms of Hyperparathyroidisim
- University of Iowa Health Care: Heart Palpitations: Frequently Asked Questions