Vitamin D Deficiency: Symptoms, Treatments, Causes and More
Vitamin D is an extremely important vitamin that has many important functions throughout your body (1).
Unlike other vitamins, vitamin D functions like a hormone. Many cells in your body have a receptor for it.
Your body makes it from cholesterol when your skin is exposed to sunlight.
Itâ€™s also found in certain foods such as fatty fish and fortified dairy products, though itâ€™s very difficult to get enough from your diet alone.
The Endocrine Society recommends that most adults get 1,500â€“2,000 IUs of vitamin D daily (2).
Why is vitamin D so important?
There are seven key benefits of vitamin D, with this nutrient potentially helping with (3):
- bone loss
- cancer prevention
- type 2 diabetes
- cardiovascular disease
- weight loss
- multiple sclerosis (MS)
Vitamin D deficiency is very common. Itâ€™s estimated that about 1 billion people worldwide have low blood levels of the vitamin (4).
According to one review, 41.6% of adults in the United States are deficient. This number goes up to 69.2% in Hispanic adults and 82.1% in African American adults (5).
Here are some signs and symptoms of vitamin D deficiency.
Being sick or getting infections often
One of vitamin Dâ€™s most important roles is keeping your immune system strong so youâ€™re able to fight viruses and bacteria that cause illness.
It directly interacts with the cells that are responsible for fighting infection (6).
If you often become sick, especially with colds or the flu, low levels of vitamin D may be a contributing factor.
Several large observational studies have shown a link between a deficiency and respiratory tract infections such as colds, bronchitis, and pneumonia (7, 8).
A number of studies have found that taking vitamin D supplements at a dosage of up to 4,000 IU daily may reduce your risk of developing a respiratory tract infection (9, 10, 11).
Vitamin D plays important roles in immune function. One of the most common symptoms of a deficiency is an increased risk of illness or infections.
Fatigue and tiredness
Excessive fatigue and tiredness may be a sign of vitamin D deficiency. Taking supplements may help improve energy levels.
Bone and back pain
Vitamin D helps maintain bone health in a number of ways.
For one, it improves your bodyâ€™s absorption of calcium.
Bone pain and lower back pain may be signs of inadequate vitamin D levels in the blood.
Large observational studies have found a relationship between a deficiency and chronic lower back pain (17, 18).
One study including 98 people with lower back pain found that increased pain severity was associated with lower levels of vitamin D (19).
Another review of 81 studies also found that people with arthritis, muscle pain, and chronic widespread pain tended to have lower levels of vitamin D than people without these conditions (20).
Low blood levels of vitamin D may be a cause or contributing factor to bone pain and lower back pain.
A depressed mood may also be a sign of vitamin D deficiency.
In review studies, researchers have linked vitamin D deficiency to depression, particularly in older adults (21, 22).
In one analysis, 65% of the observational studies found a relationship between low blood levels of vitamin D and depression.
On the other hand, most of the controlled trials, which carry more scientific weight than observational studies, did not show a link between the two (23).
However, the researchers who analyzed the studies noted that the dosages of vitamin D in controlled studies were often very low.
In addition, they observed that some of the studies may not have lasted long enough to see vitamin D supplementationâ€™s effects on mood.
Some studies have shown that giving vitamin D to people who are deficient helps improve depression, including seasonal depression, which typically occurs during the colder months (24, 25).
Depression is associated with low vitamin D levels, and some studies have found that supplementing improves mood.
Impaired wound healing
Slow wound healing after surgery or injury may be a sign that your vitamin D levels are too low.
In fact, results from a test-tube study suggest that the vitamin increases the production of compounds that are crucial for forming new skin as part of the wound-healing process (26).
One review of four studies found that vitamin D deficiency compromised certain aspects of healing in people who had dental surgery (27).
It has also been suggested that vitamin Dâ€™s role in controlling inflammation and fighting infection is important for proper healing.
One analysis looked at patients with diabetes-related foot infections.
It found that those with severe vitamin D deficiency were more likely to have higher levels of inflammatory markers that can jeopardize healing (28).
Unfortunately, thereâ€™s very little research on the effects of vitamin D supplements on wound healing in people with a deficiency.
However, one study involving 60 people with diabetes-related foot ulcers found that taking a vitamin D supplement for 12 weeks significantly improved wound healing compared with a control group (29).
Inadequate vitamin D levels may lead to poor wound healing following surgery, injury, or infection.
Vitamin D plays a crucial role in calcium absorption and bone metabolism.
Many older people who are diagnosed with bone loss believe they need to take more calcium. However, they may be deficient in vitamin D as well.
Low bone mineral density is an indication that your bones have lost calcium and other minerals. This places older adults, especially women, at an increased risk of fractures.
In a large observational study in more than 1,100 middle-age menopausal or postmenopausal women, researchers found a strong link between low vitamin D levels and low bone mineral density (30).
However, a controlled study found that women who were deficient in vitamin D experienced no improvement in bone mineral density when they took high-dose supplements, even if their blood levels improved (31).
Regardless of these findings, getting adequate vitamin D intake and maintaining blood levels within the optimal range may be a good strategy for protecting your bone mass and reducing your fracture risk.
A diagnosis of low bone mineral density may be a sign of vitamin D deficiency. Getting enough of this vitamin is important for preserving bone mass as you get older.
Hair loss is often attributed to stress, which is certainly a common cause.
However, when hair loss is severe, it may be the result of a disease or nutrient deficiency.
Hair loss in women has been linked to low vitamin D levels, though there is very little research on this to date (32).
In particular, research suggests that low vitamin D levels are linked to alopecia areata and may be a risk factor for developing the disease (33, 34).
Alopecia areata is an autoimmune disease characterized by severe hair loss from the head and other parts of the body. Itâ€™s associated with rickets, which is a disease that causes soft bones in children due to vitamin D deficiency (35).
One study among people with alopecia areata showed that lower vitamin D blood levels tended to be associated with more severe hair loss (36).
In another study, applying a synthetic form of the vitamin topically for 12 weeks was found to significantly increase hair regrowth in 48 people with alopecia areata (37).
Many other foods and nutrients may affect the health of your hair. If you experience hair loss, you may be interested in the 14 best foods for hair growth.
Hair loss may be a sign of vitamin D deficiency in female pattern hair loss or the autoimmune condition alopecia areata.
The causes of muscle pain are often difficult to pinpoint.
Thereâ€™s some evidence that vitamin D deficiency may be a potential cause of muscle pain in children and adults (38, 39).
In one study, 71% of people with chronic pain were found to be deficient in the vitamin (40).
The vitamin D receptor is present in nerve cells called nociceptors, which sense pain.
According to one review, vitamin D may be involved in the bodyâ€™s pain signaling pathways, which could play a role in chronic pain (41).
A few studies have found that taking high-dose vitamin D supplements may reduce various types of pain in people who are deficient (42, 43).
One study including 120 children with vitamin D deficiency who had growing pains found that a single dose of the vitamin reduced pain scores by an average of 57% (44).
Thereâ€™s a link between chronic pain and low blood levels of vitamin D. It may have to do with the interaction between the vitamin and pain-sensing nerve cells.
Obesity is one risk factor for vitamin D deficiency (45).
Thereâ€™s also research that indicates that vitamin D deficiency may increase the risk of weight gain, too.
One longitudinal study including men and women found a possible link between low vitamin D status and both abdominal fat and increased weight. However, this study found that such effects were more prominent in men (46).
Another review confirms that while vitamin D deficiency may be seen in cases of obesity, further studies are needed to determine whether vitamin D could help prevent weight gain (47).
As with depression, there may be links between vitamin D deficiency and anxiety disorders.
According to one review, levels of calcidiol, a form of vitamin D, was found to be lower in people with anxiety, as well as those with depression (48).
A separate study in pregnant women found that vitamin D levels could help reduce anxiety, improve sleep quality, and possibly help prevent postpartum depression (49).
Treatment for vitamin D deficiency primarily consists of supplementation. If your doctor determines that you are indeed lacking this nutrient, they may recommend the following options.
A vitamin D deficiency may be treated with vitamin D supplementation. You may find these easily over the counter, but you should ask your doctor for specific recommendations to ensure the right dosage.
For severe deficiency, or if your levels donâ€™t improve with over-the-counter supplements, your doctor may recommend prescription vitamin D. These come in much stronger doses of up to 50,000 IU (50).
Another potential option your doctor may consider is vitamin D injections (51).
Aside from vitamin D supplementation, your doctor may recommend adding more vitamin-D-rich foods to your daily diet. Options may include (52):
- fatty fish
- egg yolks
- fortified cereals
- milk and juices with added vitamin D
- beef liver
Since sunlight is also a natural source of vitamin D, your doctor may recommend going outside more often. However, given the negative effects of too much ultraviolet (UV) exposure, you must follow your doctorâ€™s instructions carefully.
Having vitamin D deficiency is defined as having blood levels below 20 ng/mL (53).
Thereâ€™s no single cause of having this type of nutritional deficiency, but your overall risk may be linked to certain underlying conditions, as well as lifestyle factors.
Here are some of the most common risk factors for vitamin D deficiency:
- having dark skin
- being an older adult
- having overweight or obesity
- not eating much fish or dairy
- living far from the equator in areas where there is little sun year-round
- always using sunscreen when going out; however, using sunscreen is important in helping prevent the sunâ€™s damaging effects to the skin, including skin cancer
- staying indoors
- having chronic kidney disease, liver disease, or hyperparathyroidism
- having a health condition that affects nutrient absorption, such as Crohnâ€™s disease or celiac disease
- having gastric bypass surgery
- using certain medications that impact vitamin D metabolism, such as statins and steroids
People who live near the equator and get frequent sun exposure are less likely to be deficient, as their skin produces enough vitamin D.
When to see a doctor
Most people do not realize that theyâ€™re vitamin D deficient, as symptoms are generally subtle. You may not recognize them easily, even if theyâ€™re significantly affecting your quality of life.
As a rule of thumb, you may consider asking your doctor to check for vitamin D deficiency if you notice any possible symptoms and have any risk factors. They can check your vitamin D levels with a blood test.
Your doctor may also help rule out other causes behind some of the symptoms youâ€™re experiencing.
The bottom line
Vitamin D deficiency is incredibly common, and most people are unaware of it.
Thatâ€™s because the symptoms are often subtle and nonspecific, meaning that itâ€™s hard to know whether theyâ€™re caused by low vitamin D levels or other factors.
If you think you may have a deficiency, itâ€™s important that you speak with your doctor and get your blood levels measured.
Fortunately, a vitamin D deficiency is usually easy to fix.
You can either increase your sun exposure or add more vitamin-D-rich foods to your diet, such as fatty fish or fortified dairy products.
In some cases, your doctor may also recommend taking a vitamin D supplement. You can find a variety of vitamin D supplements on Amazon. Always talk with your doctor first if youâ€™re considering adding supplements to your treatment regimen.
Fixing your deficiency is simple, easy, and can have big benefits for your health.