VITAMIN D DEFICIENCY

What is it?

Vitamin D deficiency is a shortage of vitamin D, which is needed for healthy bones.

What causes it?

There are four main reasons for you to be short of vitamin D.

First, you may not be taking in enough of the vitamin, which is found in oily fish such as sardines and salmon, eggs, and vitamin D- fortified foods like margarine, bread and breakfast cereals.

Second, since most vitamin D is changed into a usable form in your body by sunlight on your skin, you can lack vitamin D if your skin is dark or you do not get out in the sun much.

Third, you can become short of vitamin D when your body is using it up very fast to grow bone, such as during young childhood, puberty, pregnancy or breastfeeding.

Finally, you may not be absorbing vitamin D properly if you have problems with your liver, kidney or bowels.

Who gets it?

Your child is at high risk of vitamin D deficiency if he or she is Asian, especially if he or she was breastfed for a long time. You are more at risk of the condition if you are Asian (especially if religion requires you to keep yourself covered up outside), if you are pregnant or breastfeeding, if your diet is low in the foods mentioned above, or if you have medical problems like liver or kidney disease. As you get older, your risks also go up, especially if you are confined to home.

What are the symptoms?

In childhood, shortage of vitamin D causes rickets. If your child has rickets, he or she may be short and light for his or her age, with bow legs, swelling at the ends of some bones and a pot belly. The child may be slow to walk and get its milk teeth, and he or she may seem floppy and miserable.

if your child develops rickets in puberty, he or she may well get knock knees rather than bow legs. If you get vitamin D deficiency as an adult, you often have rather vague symptoms such as bone and muscle pain and tenderness or muscle weakness in your thighs. You may not realise you have the problem until after you break a bone, often following a relatively minor fall, and your X-rays show thinning of your bones.

When should I go to my doctor?

If you think your child has bow legs or is slow to walk or crawl, especially if you are Asian and he or she is purely breastfed, you may want to make a routine appointment to discuss it with your GP. If you are worried for yourself because you have some of the risk factors above, you should make an appointment with your GP to discuss it.

What tests will my Doctor want to do?

Your GP will ask you some questions, examine you, and may send you for a blood test or X-rays.

What is the short-term treatment?

If you are short of vitamin D, you can get your levels up to normal by taking tablets or drops. You may need blood tests to monitor your levels of the vitamin to begin with, because too much vitamin D can be bad for you.

How can I prevent it?

If you are in a high-risk group - an Asian child, a pregnant or breastfeeding Asian woman, an Asian teenager, or if you are elderly, housebound, or have chronic kidney or liver disease or problems with your absorption - you may want to consider taking vitamin D supplements.

You should make sure you get decent amounts of vitamin D-rich foods in your diet. You can also make sure you take in plenty of calcium (also important for healthy bones) and get out in the sunshine.

Weight-bearing exercise such as brisk walking can also help protect your bones.