vitamin%20d%20deficiency
VITAMIN D DEFICIENCY

Vitamin D deficiency is a condition wherein there is low circulating levels of vitamin D. Vitamin D is an essential steroid hormone found in the body.

It results from inadequate sunlight exposure, malabsorptions &/or inadequate nutrition.

Vitamin D insufficiency is a less severe state of calcidiol deficiency and associated w/ parathyroid hormones and osteoporosis.

 

Vitamin%20d%20deficiency Management

Prevention

  • Adequate sun exposure between 10:00 AM and 3:00 PM but should be done with caution in children ≤6 months
  • Fortification of food with vitamin D2 or D3
  • Vitamin D supplementation would help to prevent osteomalacia/rickets due to vitamin D deficiency
    • 1-12 months and exclusively breastfed infants - at least 400 IU/day
    • 1 -70 years old - 600 IU/day
    • ≥70 years old - 800 IU/day
    • In pregnant or lactating women, obese person, and on patients on anticonvulsants, steroid, antifungals and antiretroviral medication, should receive 2-3 times higher dose
  • Children with increased risk of vitamin D deficiency (eg chronic fat malabsorption, chronic intake of anticonvulsants) may be given higher doses of vitamin D supplementation wtih 25-OH-D level monitoring every 3 months and PTH and bone-mineral status monitoring every 6 months until normal levels have been achieved
  • Idiopathic infantile hypercalcemia may be triggered in infants receiving 600 IU bolus every 3 months
    • Attributed to mutation in CYP24A1
    • Manifests as dehydration, failure to thrive, hypercalcemia, nephrocalcinosis and vomiting
  • Most bone and mineral problems are prevented by 50,000 units of ergocalciferol given once monthly
  • Larger doses should be given in patients who underwent bypass surgery for obesity, celiac disease, gastric surgery
  • If osteomalacia is due to hypophosphatemia, lifelong phosphorus supplementation is needed
  • Increase in calcium-rich diet has been shown to increase serum 25(OH)D and decrease serum 1,25 (OH)2D concentration
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
02 Apr 2019
Using preventive zinc and micronutrient powder supplementation does not appear to improve growth in children, a recent study has found.
Roshini Claire Anthony, 28 Sep 2020

A 4-week course of amoxicillin-clavulanate in children with protracted bacterial bronchitis (PBB) does not improve cough resolution rates compared with a 2-week course, according to a study from Australia. However, the longer course may significantly extend time to first cough exacerbation.