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Vitamin D Deficiency

Frank J. Domino, MD and Samir Malkani, MD, MRCP—UK Reviewed 06/2018
 


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

1
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 ...

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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