Vitamin D Insufficiency/Deficiency

Vitamin D insufficiency / deficiency is a global public health problem in developed and developing countries. Vitamin D promotes and maintains healthy bones and teeth, but chronic insufficiency has gone largely unrecognized with the near eradication of rickets in the early 20th century through food fortification. However, with the current resurgence of nutritional rickets among infants, recent evidence that low circulating vitamin D levels are associated with increased risk of cancer and mortality, and evidence of vitamin D's potential beneficial effects on multiple sclerosis, rheumatoid arthritis, diabetes, cardiovascular disease, aging and microbial infections, interest in this vitamin has been renewed

Vitamin D is important for the correct development of the brain and the lack of this vitamin can be a factor that contributes to cause schizophrenia, Parkinson's disease and depression ...

Insufficiency

However, the clinical utility of the term "insufficiency" is not entirely clear. Since the functional effect of a given value of 25 (OH) D is highly variable, the interval defined as insufficiency is likely to represent an adequate state of vitamin D for some and a deficiency for others. The need for vitamin D appears to be lower when calcium intake is adequate. The definitions of insufficiency were based on the analysis of parathyroid suppression and / or calcium absorption. Some have argued that parathyroid suppression reaches a plateau at average concentrations of 25 (OH) D of 28-40 ng / ml

Inadequate levels of vitamin D, compared to little or no vitamin D (insufficiency rather than deficiency), increase the risk of a wide range of problems in adults, from osteoporosis to many other problems. Many groups of people are at risk of insufficient vitamin D

Deficiency

There is a spectrum of vitamin D deficiency, from infantile rickets, from adult osteomalacia to adult osteoporosis, as well as an increased risk of many diseases and problems throughout life

Severe vitamin D deficiency in children causes rickets. The main defect of rickets is soft bones. This leads to characteristic deformities of the skeleton. In adults, the lack of vitamin D also causes soft bones, a condition called osteomalacia. Weak muscles often accompany weak bones. Adults often have bone pain

Today, the definition of vitamin D deficiency has extended from the clinical diagnosis of rickets to a definition based on serum 25 (OH) D concentration. However, this is an imperfect marker, because it represents the intake of vitamin D instead of function of vitamin D. The metabolite 25 (OH) D has no physiological function and its conversion into active 1,25 (OH) 2D is strictly regulated. Rickets or osteomalacia generally occur with serum values ​​of 25 (OH) D <10 ng / ml (1.0 ng / ml = 2.5 nmol / l). Optimal bone health and other non-skeletal benefits can be achieved by higher concentrations of 25 (OH) D than necessary to prevent rickets and osteomalacia

There is currently no universal standard definition of vitamin D deficiency. The most common definitions include: deficiency <20 ng / ml (<50 nmol / l), insufficiency 20-30 ng / ml (50-75 nmol / l) and sufficiency > 30 ng / ml (> 75 nmol / l) or deficiency <12 ng / ml (<30 nmol / l), insufficiency 12-20 ng / ml (30-50 nmol / l) and sufficiency> 20 ng / ml ( > 50 nmol / l)