Deficiency of nutrients is not uncommon in unhealthy and stressful lifestyles. Widespread vitamin D deficiency is also common in countries with a rich food supply.
What is vitamin D deficiency?
Vitamin D deficiency occurs when the body’s need for this vitamin is not adequately met. A deficiency can be detected by blood levels. Normal is a concentration of the precursor of the D vitamin (vitamin D3) in the blood of an adult person of 20 to 60 ng/ml (at least in summer, these values should be reached without supplementation). If levels are below 10 ng/ml, this indicates that the individual is vitamin D deficient.
Causes
In most people, the concentration of vitamin D in the blood is lower than the recommended level of 20 ng/ml or 50 nmol/l. The winter months are particularly risky, as vitamin D is produced in the body through exposure to sunlight. Especially during the dark season, vitamin D deficiency can easily occur.
Symptoms, complaints and signs
The cause of a deficiency of vitamin D lies in an insufficient supply or formation of the vitamin. This, in turn, can be caused by various factors. First, a lack of daylight should be mentioned as a cause. This is because the formation of vitamin D in the body is stimulated when the skin is exposed to sunlight. Those who use a sunblock in the summer and do not allow UV radiation to reach their skin, those who have dark skin and those who cover their body heavily have a higher risk of suffering from a vitamin D deficiency. Also in winter, when naturally less sunlight is available, many people suffer from vitamin D deficiency. Furthermore, a deficiency occurs when too little vitamin D is ingested with food or when the body cannot utilize the ingested vitamin D, such as in celiac disease, also known as sprue.
Diagnosis and course of the disease
The typical symptoms and complaints of a deficiency of the so-called “sun vitamin” D include fatigue, dejection and muscle twitching. So-called winter depression may be due to a vitamin D deficiency. Sleep disturbances can also occur, as well as pain in the bones and feet. Bones can become brittle, and back pain and damage to intervertebral discs can occur. This is because when there is a vitamin D deficiency, the calcium from food can no longer be sufficiently incorporated into the bones. The poorer storage of calcium in the bones leads to softening of the bones, a condition known as osteomalacia. In children, this leads to rickets, a deformation of the head, spine and legs. The susceptibility to infections will also increase due to a vitamin deficiency. Likewise, there may be an increased occurrence of allergic reactions. Susceptibility to hay fever, asthma and hives (urticaria), for example, can be increased by a vitamin D deficiency, and cardiovascular diseases, especially cardiac insufficiency, can also occur. The risk of suffering from autoimmune diseases such as ulcerative colitis and thyroiditis as well as cancer (breast cancer in particular) increases. Pregnant women may suffer massive damage to their unborn child, because the bones and also the brain of the fetus cannot develop optimally due to the deficiency. Gum disease (periodontitis) and diabetes are also promoted by a vitamin D deficiency. If a vitamin D deficiency is suspected on the basis of certain signs, a blood test can confirm the diagnosis. Further progression of a deficiency can lead to permanent damage (for example, tumor diseases, schizophrenia, depression).
Complications
A vitamin D deficiency puts a strain on the body after only a short time. The affected person then suffers, among other things, from concentration disorders, complaints of the cardiovascular system and/or muscle pain. In the further course it comes to hair loss, sleep disturbances and nervousness. Serious complications occur if the vitamin D deficiency is not corrected. Then permanent damage occurs and the risk of mental illnesses such as mood swings and depression increases. In severe cases, epileptic seizures occur as a result of vitamin D deficiency, which are also associated with an acute risk of injury and possible shock reactions for the affected person. Possible secondary diseases of the deficiency symptoms include asthma, multiple sclerosis and cancer.Vitamin D deficiency also seems to promote the development of forgetfulness, memory disorders and Alzheimer’s disease. In children, it can lead to growth disorders. In young children, deficiency leads to changes in the skeletal system (rickets), accompanied by deformities and other complications. If vitamin supplements are overdosed, poisoning may occur as part of the treatment. Some supplements also contain additives that can cause allergies and symptoms of intolerance. Intravenous vitamin D administration carries the risk of injury, infection, and bleeding.
When should you see a doctor?
People suffering from vitamin deficiency can often relieve the symptoms themselves by changing their lifestyle. Particularly in the early stages of deficiency, self-help measures can provide the necessary compensation to correct the imbalance. Food intake, sufficient outdoor exercise, and a healthy lifestyle can contribute to recovery. In case of vitamin D deficiency, sufficient intake of daylight is especially important. For this reason, stays in fresh air should be daily. At the first signs of insomnia, back problems, low spirits or a general feeling of malaise, it is necessary to check whether the daily routine is optimized for the needs of the organism. The intake of food should be checked for its ingredients and the way it is prepared. The intake of fresh food is important. If the complaints persist for a longer period of time or if there is an increasing character of health irregularities, a control visit to a doctor should be initiated. In case of pain, emotional problems or repeated muscle twitching, an examination is advisable. Mood swings, an increased number of illnesses, disturbances of the heart rhythm as well as a feeling of illness indicate a health disorder. A visit to the doctor is advisable to clarify the symptoms. Via a blood test, the extent of the vitamin deficiency can be detected.
Treatment and therapy
The treatment of vitamin D deficiency is quite simple. First, an attempt can be made to expose the body to more intense sunlight. For this purpose, it may be possible to resort to artificial UV light (in a solarium). If this is not possible (e.g. due to a sunlight allergy or particular sensitivity to light), foods with a particularly high vitamin D content can be used. These include foods such as eggs, offal (especially beef liver and poultry), avocado, oily fish, mushrooms (especially mushrooms), nuts of all kinds and cheese. Alternatively, the deficiency of the D vitamin can also be compensated by suitable preparations from the drugstore or pharmacy, for example in the form of a multivitamin preparation or a monopreparation with vitamin D. In the case of an already existing deficiency, recourse should be made to a higher-dose preparation, possibly in consultation with the doctor.
Prevention
To prevent vitamin D deficiency, attention should be paid to regular exposure to fresh air in daylight. In summer, a half-hour sunbath with only a weak light protection filter can be helpful to support the formation of vitamin D through the skin. In winter, foods with a particularly high vitamin D content should be eaten. Especially in old age and during pregnancy, attention should be paid to an adequate supply of vitamin D. Menopausal women can also particularly benefit from an adequate supply. The recommended daily intake for an adult is about 15 micrograms of vitamin D per day, which is equivalent to 600 i.U..
Follow-up
Vitamin D deficiency is very common in our relatively sunless latitudes, but in many cases can already be compensated for by spending enough time outdoors. Affected individuals should spend time in the fresh air several times a week so that the body can form sufficient vitamin D with the help of sunlight. At least 20 percent of the body surface should be exposed to the sun. Sunscreens hinder the absorption of the UV light that triggers vitamin D production. However, one should not expose oneself to the sun for too long without protection, 15 to 20 minutes are usually sufficient.Daylight lamps can also be used to boost the body’s vitamin D production. Particularly in the months with little sunshine, an appropriate diet is recommended in order to provide the body with sufficient vitamin D. Up to 20 percent of the daily requirement can be covered through food. Fatty foods such as herring, mackerel, salmon, tuna, redfish, liver, egg yolk, butter, cream, as well as mushrooms, porcini mushrooms and chanterelles contribute to the vitamin D supply. If, despite all efforts, the vitamin D deficiency persists, the stores must be replenished in the long term in consultation with a physician. Over-the-counter dietary supplements or medically prescribed and particularly high-dose products from the pharmacy can help.
What you can do yourself
A vitamin D deficiency can often already be compensated by sufficient exercise in the fresh air. Affected individuals should spend time in the sun three to five times a week, so that the body can absorb sufficient vitamin D. At least 15 to 20 percent of the body surface should be exposed to the sun. Alternatively, a daylight lamp can be used to provide sufficient vitamin D to the body. In the summer months, exercise in the sun should be limited to 15 to 20 minutes to avoid sunburn. Suntan oil and sunscreen inhibit the absorption of vitamin D. During months when the sun is low, a change in diet is recommended. The diet should be rich in eggs, fish oil and cod liver oil. Emmental cheese, cottage cheese, goat’s milk and other dairy products, as well as various fish and seafood such as oysters, herring or salmon are also recommended. If the signs of vitamin D deficiency persist, the general practitioner or an internist must be consulted in any case. The individual symptoms such as dizziness or fatigue can be alleviated in the short term by sleep and rest. In the long term, vitamin D deficiency requires replenishment of the body’s own vitamin D stores.
