Vitamin D Deficiency

Frank J. Domino, MD and Samir Malkani, MD, MRCP–UK Reviewed 06/2019

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 dysfunction
I...

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

Munns CF, Shaw N, Kiely M, et al. Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab. 2016;101(2):394–415. [View Abstract o...

CODES

ICD10

E55.9 Vitamin D deficiency, unspecified
M83.8 Other adult osteomalacia

ICD9

268.9 Unspecified vitamin D deficiency
268.2 Osteomalacia, unspecified

SNOMED

34713006 Vitamin D deficiency (disorder)
3...

CLINICAL PEARLS

Risk factors for vitamin D deficiency include age >65 years, renal disease, GI (malabsorption) disorders, liver dysfunction, immigration from tropical to colder climates, dark-skinn...

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