Vitamin D deficiency is one of the most common health concerns worldwide, which affects over a billion people. Saudi Arabia also experiences high rates, particularly among women. (1)

Studies show that around 60% of people in the country have low vitamin D levels, (2) with 78% of women aged 20-50 affected. This percentage climbs to 85% after menopause. (3)

Vitamin D deficiency leads to numerous health problems, especially since it is one of the essential vitamins for health, as it plays an important role in: (4)

• Regulating calcium and phosphorus levels in the blood.
• Strengthening bones, teeth, and muscles.
• Promoting the health of the nervous system.
• Strengthening the immune system.

Possible Symptoms of Vitamin D Deficiency

Vitamin D deficiency weakens your bones and muscles, and the problem is that in many cases, no clear symptoms of deficiency appear, and it can only be accurately detected by a blood test.

However, with the continuation of the deficiency and its increasing severity, symptoms can be observed, including: (5)

• Feeling tired and exhausted noticeably and without justification.
• Weak immunity and frequent infections, such as influenza, colds, and other respiratory infections.
• Pain in the bones and muscles, especially in the lower back and joints.
• Feeling tingling or numbness in the hands or feet.
• Hair loss.
• Easy bone fractures.
• Difficulty walking and bowing of the legs in very severe cases.

On the other hand, vitamin D deficiency may be associated with an increased likelihood of developing some health problems such as anxiety and depression. (6) 

Causes of Vitamin D Deficiency

People who have low levels of vitamin D may be experiencing this deficiency due to one of the following reasons: (5)(7)

• Not getting the body's need for vitamin D through nutrition.
• Lack of exposure to sunlight.
• Taking certain medications, such as laxatives, cortisone, and some cholesterol-lowering drugs.
• The body's inability to absorb or use vitamin D properly.
• Dark skin (reduces the skin's ability to make vitamin D when exposed to the sun).
• Having rickets in childhood, or a family history of vitamin D deficiency.

Health conditions that may make it more difficult to absorb vitamin D

In addition to the above, there are some health conditions that make vitamin D absorption more difficult, especially for people with any of the following conditions:

• Obesity.
• Kidney disease and liver disease.
• People who have undergone obesity surgery such as sleeve gastrectomy and gastric bypass.
• Celiac disease.
• Cystic fibrosis.
• Chronic bowel diseases such as Crohn's disease or ulcerative colitis.

Diagnosing Vitamin D Deficiency

Vitamin D deficiency is diagnosed through a simple blood test that measures its levels in the blood, which are classified as follows: (7)

• Normal: Between 30-100 nanograms/ml, representing the ideal levels of vitamin D in the blood.
• Insufficient: Between 20-29 nanograms/ml.
• Deficient: If the level is less than 20 nanograms/ml, the person is considered to have a vitamin D deficiency.

Treatment of Vitamin D Deficiency

In most cases, consuming foods rich in vitamin D alone is not enough to compensate for the deficiency, so doctors usually recommend using vitamin D supplements to raise its levels in the body.

You should consult a doctor to determine the appropriate dose, which is determined based on the level of deficiency, age, and health condition. (5)(7)

• Supplements are available in the form of tablets or injections for adults, or syrup and liquid drops for children and infants.
• Doctors usually recommend a high dose of 50,000 international units once a week for 8 weeks for adults, then a maintenance dose (1500-2000 international units daily) to maintain normal levels.
• Some cases may require higher doses: those who are obese or have absorption problems may need higher doses, which are determined by the doctor depending on each case.

Nutritional sources rich in vitamin D

In addition to supplements, vitamin D levels can be supported by eating:

• Fatty fish such as tuna, salmon, and sardines.
• Egg yolk.
• Milk and its derivatives fortified with vitamin D.

Prevention and follow-up

It is preferable to have a blood vitamin D level test regularly to make sure that its levels are normal, especially for the groups most at risk of deficiency, such as women, the elderly, and those with obesity and chronic diseases. You can get accurate and fast results in our laboratories at Dr. Sulaiman Faqih Hospital.

References

1. PMC - The Association Between Knowledge, Perception, and Attitudes Towards Vitamin D and Hypovitaminosis D: A Cross-Sectional Study Conducted Among Saudi Women
2. Pmc - Vitamin D deficiency in Saudi Arabians: A reality or simply hype: A meta-analysis (2008–2015).
3. Researchgate - Bokhari FF, Albaik M. Vitamin D and Its Deficiency in Saudi Arabia
4. NIH - Vitamin D - Health Professional Fact Sheet
5. Yalemedicine - Vitamin D Deficiency
6. PMC - Is Vitamin D Important in Anxiety or Depression? What Is the Truth? -‍
7. Medscape - Vitamin D Deficiency and Related Disorders: Practice Essentials, Background, Pathophysiology