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What does vitamin D deficiency look like? In its most extreme form, prolonged and severe vitamin D deficiency during childhood, known as rickets, can delay growth and lead to visible skeletal deformities.
Today, rickets is relatively rare, but that doesn’t mean that vitamin D deficiency is—more than 40 percent of Americans are deficient. The potential health consequences of this epidemic are serious, as vitamin D deficiency is linked to osteoporosis, heart disease, diabetes, autoimmune diseases, high blood pressure, and poor pregnancy outcomes.
D-ficient? Odds are you don't know.
According to the Vitamin D Council, symptoms of vitamin D deficiency can be subtle—or even nonexistent—in the early stages. You might experience some tiredness and general aches and pains, but these symptoms are easy to dismiss because there are many things that cause them.
Aches and pains? You can easily chalk them up to the aftereffects of your last workout—or simply not being 20 anymore. Tiredness? That could be because you aren’t getting enough quality sleep.
Lindsay Obermeyer, MS, RDN, CLT, a Portland, Oregon–based registered dietitian nutritionist and owner of Your Time Nutrition, said she personally experienced chronic joint pain, had labs done, and discovered that her vitamin D was 29 ng/dL (nanograms per deciliter), which is considered deficient by some standards. She started taking a daily dose of vitamin D3, and her joint pain was gone within a week.
I had two different clients with the same symptoms, had them tested for vitamin D, both were less than 30, both had relief from joint pain after supplementing. It's a very common problem up here in the Northwest.
It can sometimes be hard to tell when you're in need of more vitamin D. Here are 15 signs that will help you know if you're vitamin D deficient.
1. Muscle Weakness
You should be aware that muscle weakness can present as generalized body fatigue. If you’re experiencing a more general fatigue around your body, muscle weakness issues in specific areas may stay hidden and go unnoticed for months.
As vitamin D deficiency worsens, symptoms become stronger and harder to ignore. General aches and pains may become muscle and bone (musculoskeletal) pain, and tiredness may progress to muscle weakness. Still, it’s easy to search for answers in the wrong direction.
2. Bone Pain
In a study of 150 patients referred to a clinic in Minnesota for persistent, general musculoskeletal pain, 93 percent had vitamin D levels equal to or below 20 ng/mL, a level considered deficient by most experts.
As an adult, your bones are no longer growing, but new bone tissue constantly replaces the old. Severe vitamin D deficiency interferes with that replacement, leading to the softening of bones known as osteomalacia (or “adult rickets”), which causes pain and increases of osteoporosis.
Shunning the sun and avoiding dairy can leave you with a vitamin D deficiency that might lead to bone pain. This can be difficult to distinguish from muscle or joint pain, but it generally manifests itself as a deep, aching pain that isn't isolated in an exact area.
There are some indicators that can help differentiate bone pain from muscle pain. Muscle pain is usually centralized to one point and is exaggerated by movement or physical activity. Bone pain, on the other hand, is broader and deeper.
3. Constant Respiratory Problems
Studies show that vitamin D may help defend against respiratory illness, and this is especially true in children. If your child has severe asthma, you may want to increase their vitamin D intake.
Constant respiratory problems may present in different ways. Someone suffering from these issues may feel easily winded after a task they'd normally be fine handling. Or it may be as seemingly obvious as struggling to catch a breath for an extended period.
Breathing issues need to be addressed by a medical professional quickly because they can lead to other issues. Often, a person suffering constant respiratory problems will also suffer from an anxiety disorder, like panic attacks. The inability to take a full breath may quickly spiral into a panic that your life is in immediate danger.
4. Sweaty Head
Years ago, doctors used to ask new mothers if their newborns' heads were sweating more than normal. This can be a very early sign that a baby is vitamin D deficient. If you're breastfeeding, it may be helpful to consume more foods that are rich in vitamin D or include some vitamin D drops in your regimen to make sure your baby is getting a sufficient amount.
Foods that contain higher concentrations of vitamin D include fatty fish (such as tuna), orange juice, soy milk, and some cereals. You'll also want to stock up on dairy products, such as cheese, that are enriched with vitamin D.
Don’t be fooled into thinking that head sweating from a lack of vitamin D only affects infants. If you find sweat pouring from your forehead in situations that wouldn’t normally cause you to perspire, then you may want to talk to a healthcare professional.
As it turns out, the sun is vital to keeping a smile on your face. Vitamin D is often referred to as the sunshine vitamin because it is activated in your skin by sunlight. If you live in a place that sees less sunlight than global averages, the lack of light could literally kill your mood.
According to the Vitamin D Council, this essential nutrient helps your brain's neurotransmitters produce serotonin, which affects our feelings of happiness. Studies have linked low levels of vitamin D with episodes of depression.
In Alaska and other locales with significantly less sunlight for months out of the year, depression due to lack of sun exposure is treated as a very serious medical issue. Residents are encouraged to purchase light boxes—devices that emit therapeutic light that will help them maintain vitamin D levels during dark winter months.
It's important that light therapy be used to deal with depression caused by vitamin D deficiencies because the two can become seriously intertwined.
There are many different types of light boxes that can improve your health. The Sperti Vitamin D Light Box is “the only recognized ultraviolet light box for vitamin D production,” and the NatureBright SunTouch Plus Light and Ion Therapy Lamp, a bestseller on Amazon, “balances your body clock, leaving you feeling rested, refreshed, and nourished all over.” Each type has the potential to improve your health, but if you're in need of light therapy, choose one based on what you hope to get out of it.
Research suggests that vitamin D deficiency may play a role in the development of polycystic ovary syndrome (PCOS), a leading cause of female infertility. One common symptom of PCOS is acanthosis nigricans, which results in dark, velvety skin patches.
“In the fertility world in the Northwest we like to get a baseline on all of our patients and we see many who are deficient,” said Seattle-area registered dietitian nutritionist Judy Simon MS, RDN, CD, CHES, of Mind Body Nutrition.
“One young woman in her early twenties had visible acanthosis nigricans around her neck and on her chest. She had PCOS and pre-diabetes. After six weeks of Vitamin D supplementation the acanthosis was practically gone and she was feeling much less fatigued.”
7. Chronic Infections
Vitamin D is known to have an effect on over 2,000 genes in the human body, so it’s no surprise that the strength of your body’s immune system is also tied to how much vitamin D you are taking in.
When there’s a healthy amount of vitamin D being processed by your body, your immune system is resilient and able to fight off infections and disease. However, a lack of vitamin D can be devastating to your overall health and leave you vulnerable to constant attacks and health problems or scares.
Vitamin D supplements are sold everywhere, but make sure your doctor helps you select the best option for you based on your health needs.
8. Cardiovascular Disease
Cardiovascular diseases are heart conditions that may include damaged blood vessels or frequent blood clotting, among other issues. Articles published by the National Institutes of Health have shown that deficiencies in vitamin D can lead to congestive heart failure.
Some cardiovascular disease-related symptoms that are easier to spot are dizziness, heavy bloating (particularly in the legs), respiratory issues, and chest pain. If you’re experiencing any of these symptoms, you should contact your doctor immediately.
If you want to make sure you’re on the right path, home tests are available to check for a lack of vitamin D. These tests will screen your blood and possibly show you if you need to make some changes in your supplementation routine.
Psoriasis may present itself as a scaly rash on your scalp or other parts of your body. Often it can be agitated by stress (unfortunately, finding out you have psoriasis tends to cause stress too). Although psoriasis is not always connected to a lack of vitamin D, the vitamin is sometimes used during treatment. The Mayo Clinic claims that if you have a lack of vitamin D, it will be harder for your body to defend itself against psoriasis.
There is no cure for psoriasis, but it is controllable with treatment. Besides reducing stress and getting your vitamin D, there are other methods for dealing with troubles caused by psoriasis.
For example, specially medicated shampoos can be prescribed to keep your scaly rashes at bay. Depending on the severity of your condition, there are also ointments, oils, and other treatments that could help reduce your psoriasis-related discomfort.
10. Chronic Pain
If you experience chronic, widespread pain throughout your body, it could be due in part to a lack of vitamin D. This connection was only recently discovered. In 2010, researchers began looking into the link between chronic pain and a lack of vitamin D.
Studies have now shown that low vitamin D levels increase a person's chances of having chronic pain; supplements can sometimes help relieve it. So, if you're in pain, talk to your physician about the best way to boost your vitamin D intake.
If you want to try a preliminary test for determining if what you’re experiencing is the same thing as chronic pain, doctors have a recommendation: Press against the area of your chest known as your breastbone (also called your sternum). If you feel a sharp pain when you press down on that area, it’s likely that you’re experiencing chronic pain related to vitamin D deficiency.
Vitamin D is one of the vitamins your body needs to create energy, and without it, you can end up feeling tired most of the day. This will make it hard for you to get around or even get to work. Without much energy, you may start changing your daily behavior in negative ways, which in turn may impair your overall health.
Continued tiredness can contribute to other symptoms caused by low amounts of vitamin D in the body. If you’re tired, you’re less likely to exercise or go outside. Avoiding activity or sunshine can amplify the effects of a vitamin D deficiency. If you fall into a routine that involves avoiding strenuous activity or sunlight, you’re much more susceptible to issues like depression or mood swings.
Listen to what your body is telling you. Something might be seriously off if you notice that you just don’t have the drive to stay active anymore. You should consult your doctor if you have constant feelings of tiredness that last longer than a few days.
Harvard University conducted review of health studies across numerous cohorts that associated increased risk of multiple health outcomes including cardiovascular disease and hypertension (abnormally high blood pressure) with vitamin D deficiency.
Another study, published in Circulation in 2015, considered the viability of vitamin D supplementation as a treatment for patients with hypertension and prehypertension.
It's important to note that high blood pressure can significantly increase your risks for serious health issues such as heart attacks and strokes.
But don't panic if you think or know you’re suffering from hypertension. It’s a common health issue that affects more than 3 million people in the U.S. every year. It can be identified without any blood or medical tests but will require an official diagnosis from your doctor, at which point appropriate treatment can be prescribed.
If you do suffer from anxiety, you may want to consider purchasing vitamin D supplements and adding them to your daily routine for that reason. Vitamin D has been proven to have positive effects similar to antidepressants and may reduce your overall blood pressure.
As we mentioned in relation to depression, vitamin D affects the levels of serotonin in your brain, which is what affects your mood. If you're feeling cranky, it might be because you're not producing enough serotonin. Vitamin D will help your moods stay balanced by ensuring your brain is working with the materials it needs to stay energized and focused.
If you notice mood swings that seem out of the ordinary, visit your doctor for a simple blood test. They will be able to identify what’s going on, and if a lack of vitamin D is the issue, they’ll help you make a plan to get better.
The solution may be as simple as getting out in sunlight more often or eating foods that are rich in vitamin D. For people who can’t handle too much direct exposure to the sun, supplements are readily available, so consider reaching for some before going off on anyone or getting too frustrated with yourself!
14. Chronic Kidney Disease
Kidneys help remove waste from your blood. When they’re not functioning correctly, your bloodstream can fill up with waste, seriously damaging your health. Doctors have recently connected kidney health to cardiovascular disease. They’ve also discovered how important vitamin D can be to your kidneys’ health.
As you get older your kidneys are not as efficient at processing vitamin D. Be sure to eat some vitamin D–rich foods or take a supplement. If you do take a supplement, also consider taking vitamin K2 to activate the right proteins in the digestion process. Ensuring that your kidneys are working properly to process vitamin D is just as important as getting your proper nutrients.
15. Reduced Endurance
If you're an athlete and you're seeing your endurance decrease for no apparent reason, it might be because you have low vitamin D levels. Experts in athletic circles now realize that vitamin D is crucial to energy levels, especially when it comes to endurance. Even active people who get outside every day can experience these issues, despite getting more than the recommended amount of sunlight per day (20 to 30 minutes).
Fortunately, if vitamin D deficiency is causing your issues, your endurance should return to normal when you get your vitamin D levels back to normal. Remember: You don’t always need to opt for pills to get your proper dose of vitamin D. Try a supplement in powder or liquid form to mix with your smoothies or protein shakes.
A Side Effect of Modern Life?
For many of us, work means days spent at a desk and leisure means binge-watching the latest Netflix series or catching up on social media. That’s a lot of indoor time, but even when we are outdoors we’re likely to double down on sun protection to prevent premature aging and skin cancer.
Dairy products are fortified with vitamin D, but milk sales are in decline, as more people avoid dairy due to restrictive diets, milk allergies, or lactose intolerance.
What’s your risk?
Although 4 in 10 Americans may be deficient in vitamin D, some people have a higher risk. As mentioned, if you spend a lot of time indoors and protect your skin with clothing or sunscreen when you are outdoors (as you should), your risk increases. Living in northern climates—where winters are longer, colder and darker—amplifies this risk. But a few other risk factors might surprise you:
1. Dark skin. The darker your skin, the more sun it takes to make vitamin D.
2. Body mass index (BMI) over 30. Vitamin D can become "sequestered" in excess body fat instead of making its way to the bloodstream.
3. Past gastric bypass surgery.
Why It Matters
Linke says that bringing vitamin D levels back to the normal range has been a “game changer” for many of her clients who have autoimmune conditions. She cites another client—a woman in her late twenties—whose vitamin D was a 4.
Her rheumatoid arthritis was very bad, she couldn’t walk down stairs unassisted, couldn’t walk without holding on to walls, couldn’t fit into her shoes so she wore flip flops.
Within 10 days of starting vitamin D, along with magnesium (magnesium deficiency can interfere with vitamin D metabolism) and dietary changes, she was able to wear regular shoes and walk without assistance.
As with all health-related issues, talk with your doctor or another medical professional if you are seeing any signs or symptoms that concern you. Deficiency is simple to test for and simple to treat. If in doubt, talk to your healthcare provider.