Vitamin D deficiency: 5 lesser known patient types at risk1,2
Many of your patients may not be getting their recommended daily intake of vitamin D, which could lead to vitamin D insufficiency or deficiency. Vitamin D insufficiency is defined as 25-hydroxyvitamin D (25(OH)D) of 20-29 ng/mL, while vitamin D deficiency is defined as less than 20 ng/mL.1
Physicians typically test for vitamin D in patients who are dark-skinned, have osteoporosis, receive little or no sun exposure, or are advanced in age. But other at-risk patient types may benefit from routine testing, too.1,2
Do you know which lesser-known patient types are at risk of vitamin D deficiency? Take a look at this list and learn how you can help your patients by testing for vitamin D.
Patients at high risk of vitamin D deficiency1-3
- Obese patients (defined as BMI>30 kg/m2). Since vitamins are stored in body fat, patients with a higher density of body fat are less able to absorb vitamin D. There is an inverse relationship between BMI and 25-hydroxyvitamin D levels.
- Patients taking certain medications. Some drugs increase the catabolism of 25(OH)D, thereby reducing levels of vitamin D. These include anticonvulsants or AIDS medications, glucocorticoids, antifungals (such as ketoconazole), and cholestyramine.
- Patients with malabsorption disorders (such as cystic fibrosis, Crohn's disease, or celiac disease). These patients are unable to absorb adequate levels of Vitamin D.
- Patients with chronic kidney disease or liver failure. Both disorders lead to decreased synthesis of 25(OH)D, which results in lower Vitamin D levels.
- Patients who are pregnant or lactating. The skeleton of the fetus begins to calcify during the last trimester, which demands higher circulating levels of Vitamin D. Prenatal Vitamin D deficiency can increase the risk of preeclampsia and gestational diabetes. Lactating women require adequate Vitamin D levels in order to prevent vitamin D deficiency in infants, which can cause rickets.
Make sure all of your patients are getting the right daily dose of vitamin D.
1. Kulie T V, Groff A, Redmer J, Hounshell J, Schrager S. Vitamin D: an evidence-based review. J Am Board Fam Med. 2009;22(6):698-706.
2. Holick M, Binkley N, Bischoff-Ferrari H, et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930.
3. Holick M. Vitamin D deficiency. N Engl J Med. 2007;357:266-281.
4. De-Regil L, Palacios C, Ansary A, et al. Vitamin D supplementation for women during pregnancy. The Cochrane database of systematic reviews. 2012.