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Vitamin D Deficiency

Frank J. Domino, MD Reviewed 06/2022
 


BASICS

This topic covers the commonly acquired vitamin D deficiency and not type II vitamin D–resistant rickets/type I pseudovitamin D–resistant rickets (both rare autosomal recessive disorders). 

DESCRIPTION

DIAGNOSIS

  • Nonspecific musculoskeletal complaints

  • Weak antigravity muscles

  • Fracture with minimal trauma

HISTORY

  • Senior citizens at risk of falling

  • Renal disease

  • GI (malabsorption) disorders; liver dysfunctio...

TREATMENT

  • Treatment goals remain unclear, but current “normal” 25-OH vitamin D levels are based on suppression of PTH.

  • Obesity: Treatment of VDD in obesity, especially those who are obese and depressed...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Follow-up of abnormal 25-OH vitamin D not required 

DIET

  • Cod liver oil is most potent source of vitamin D and has ~1,300 IU vitamin D/tablet/tablespoon.

  • Fatty fish (...

REFERENCES

1
Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011 Jan;31(1):48-54.
2
Vinkhuyzen AAE, Eyles DW, Burne THJ, et al. Gestational vitamin ...

CODES

ICD10

  • E55 Vitamin D deficiency

  • E55.0 Rickets, active

  • E55.9 Vitamin D deficiency, unspecified

  • E64.3 Sequelae of rickets

SNOMED

  • 190646000 Adult osteomalacia due to malnutrition

  • 386072000 Deficiency of vi...

CLINICAL PEARLS

  • Common risk factors for vitamin D deficiency include inadequate sun exposure or dietary intake; obesity; Black or Hispanic ethnicity; and obesity.

  • 25-OH vitamin D (most sensitive measur...

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