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Vitamin D deficiency: 5 lesser known patient types at risk1,2

Woman in kayakMany 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

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

Take action

Learn more about vitamin D deficiency and how to test all of your at-risk patients.

References

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.