Vitamin D Deficiency - Who is at Risk?
The Elderly
Amounts of the vitamin D precursor in the skin decrease with age, therefore elderly people are particularly prone to deficiency, and living in rest home or becoming homebound can limit exposure to sunshine. Muscle weakness and osteoporosis associated with vitamin D deficiency make the elderly more susceptible to falling and fracture risk. Trails indicate that vitamin D supplementation may decrease the risk of fractures.
Dark Skinned People
Higher melanin levels in dark skinned people block the action of sunlight on vitamin D precursors in the skin, requiring much longer sunlight exposure to generate adequate circulating vitamin D compared to fair-skinned people.
People with Limited Sunlight Exposure
People living at northern latitudes or who have limited sunlight exposure because of their working environment or cultural dress rules may have low vitamin D levels.
Musculoskeletal Pain Sufferers
Patients with symptoms of hypothyroidism, non-specific musculoskeletal pain, chronic low back pain, or fibromyalgia are frequently found to have low vitamin D levels and show clinical improvement after supplementation. Vitamin D screening is strongly recommended in patients presenting with musculoskeletal pain.
Overweight or Obese People
Vitamin D can be locked up in fat stores in obese patients, who have been found to have lower levels of circulating vitamin D and are at risk of deficiency.
Breast-Fed Infants, and Children with Limited Sunlight Exposure
All children require adequate circulating vitamin D to prevent rickets. Dark-skinned children and those who spend much of the day in indoor daycare centers are at risk of deficiency, and breast-fed children often receive inadequate amounts of vitamin D, particularly when their mothers are deficient. Maternal supplementation or the use of cod liver oil or other vitamin D supplements in infants and children can avoid the risk of developing type 1 diabetes in childhood.
Routine vitamin D screening has been recommended as a routine part of the annual physical examination. Deficiency may be present, even when there are no symptoms, yet it is simple to treat and may solve a number of subclinical health problems and reduce risk for more serious diseases.
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