![]() ![]() Vitamin D deficiency is defined as a 25(OH)D below 50nmol/l. Parathyroid hormone is only raised in a proportion of patients with vitamin D deficiency and cannot be used as a surrogate for 25(OH)D. Vitamin D status is most reliably determined by assay of serum 25(OH)D. 3 But a causal relationship hasn't been established and it is not known if vitamin D treatment alters the prognosis of these conditions.Ĥ. To assess vitamin D status, measure 25hydroxyvitamin D levels. In the absence of bone disease, low vitamin D levels have been associated with non-musculoskeletal conditions such as cardiovascular disease, diabetes, cancer and multiple sclerosis. These patients have a definite indication for treatment. Severe muscle weakness and hypotonia may be a prominent feature. Osteomalacia in adults usually presents with pain in the ribs, hips, pelvis, thighs and feet. Patients who have had bariatric surgery, and patients taking anticonvulsants and antiretrovirals.ģ. Look for the typical signs of vitamin D deficiency.Ĭhildren with profound vitamin D deficiency present with the classical skeletal deformities of rickets. Other at-risk groups include patients with fat malabsorption syndromes and nephrotic syndrome, People with pigmented skin are at high risk, as are the elderly, who spend more time indoors, and obese patients, who metabolise vitamin D differently. ![]() ![]() 1įrom October to April, 90% of the UK lies above the latitude that permits adequate exposure to sunlight necessary for vitamin D synthesis.Īnd a healthy diet is usually not enough to achieve vitamin D sufficiency, as few foods contain substantial amounts of vitamin D – the most significant dietary sources are oily fish and cod liver oil.Ģ. Be aware of which patients are at high risk of vitamin D deficiency. 1. A healthy diet is usually not enough to achieve vitamin D sufficiency.Ī recent survey found that 47% of the UK adult population have low vitamin D (less than 40nmol/l). ![]()
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