Signs of Vitamin D Deficiency

You’ll often hear people talking about vitamin D deficiency. 

You may have questions such as “am I at risk for low vitamin D levels?” and “what do I do about it if I am?”. 

As with most deficiencies and health conditions, prevention is the best way to go about it. 

It’s much easier to prevent health problems than it is to fix them once they occur.

Keep reading to learn how to prevent vitamin D deficiency and the signs and symptoms that you’re deficient in this vitamin.

What is a Vitamin D Deficiency?

Simply put, a vitamin D deficiency is when you do not have enough vitamin D in your body. What makes vitamin D special is that your skin produces it using light from the sun. This is why we often refer to it as the sunshine vitamin. 

Younger populations with fair complexions convert sunshine into vitamin D much more effectively than people over 50 with dark complexions.

The optimum serum level of vitamin D has not been fully established. Experts believe it falls somewhere between 30 and 50 nanograms per milliliter. Most authors agree from observational studies that a serum or plasma level of 25 (OH) vitamin D concentration under 30 nanograms per milliliter is a deficiency.

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Symptoms of Vitamin D Deficiency

In children, a severe vitamin D deficiency causes a condition called rickets. Rickets is very rare. Symptoms of rickets include the following:

  • Incorrect growth patterns

  • Muscle weakness

  • Joint deformities

  • Muscle pain

Vitamin D deficiency symptoms in adults can include the following:

  • Fatigue

  • Bone pain (vitamin D is important for healthy bones)

  • Muscle weakness

  • Muscle cramps

  • Mood changes (such as depression)

  • Muscle aches

Having enough vitamin D can help maintain your health. If you do not have enough vitamin D, you could have increased risk factors for developing the following conditions:

  • Cardiovascular disease (heart disease)

  • Infections

  • Immune system disorders

  • Falls in the elderly

  • Multiple sclerosis

  • Low calcium absorption

  • Low bone mineral density (osteomalacia)

What causes a vitamin D deficiency?

Health conditions

Health conditions such as cystic fibrosis, celiac disease, and Crohn’s disease affect absorption. These conditions do not allow enough absorption of vitamin D from supplements.

Obesity can increase your risk of vitamin D insufficiency and deficiency. This is true of people with a body mass index over 30 and slow vitamin D metabolism. 

This happens because fat cells keep vitamin D isolated. Vitamin D is a fat-soluble vitamin. They don’t allow for the release of vitamin D. This is why people who are overweight often need larger doses of vitamin D supplementation to achieve and maintain healthy vitamin D levels.

Kidney and liver diseases reduce the amount of an enzyme that we need to change vitamin D into its active form. Deficiency of this enzyme then leads to vitamin D deficiency.

Medications and medical procedures

Weight loss surgery can increase your risk of vitamin D deficiency. This is because they shrink the stomach. 

Sometimes they also cause food to bypass part of the small intestine. Since the small intestine absorbs nutrients, you may not be able to absorb as much vitamin D from your food and supplements. 

If you have had weight loss surgery, it is important that your health care provider monitors your nutrient levels, particularly vitamin D.

The following medications can also increase your risk of developing a deficiency of vitamin D:

  • Laxatives

  • Steroids (prednisone)

  • Seizure control drugs (phenobarbital and phenytoin)

  • Tuberculosis drug (rifampin)

  • Weight loss drug (orlistat)

Certain demographics

Certain demographics are at higher risk of vitamin D deficiency. One example of this is the elderly population. This is because the skin’s ability to produce vitamin D decreases as we age.

People who cannot leave their homes are also at higher risk of vitamin D deficiency. This includes people living in institutions or nursing homes. This is because they are not able to get as much sunlight exposure.

Patients with a darker complexion are also at higher risk of vitamin D deficiency. This happens because darker skin is not as efficient at vitamin D production compared to fair-colored skin.

Infants are another age group at higher risk of vitamin D deficiency. Breast milk only has a small amount of vitamin D content. Infant formulas often don’t contain excess vitamin D, either. 

Diagnosing Vitamin D Deficiency

A healthcare provider can test levels of vitamin D in your blood. There are two different types of tests that they can order. The most common one is the 25-hydroxyvitamin D (called 25 OH D for short).

A technician will use a needle to remove blood from your vein and test it. You don’t need to fast or do any other kind of preparation for a vitamin D test.


The goal of treatment is to achieve and maintain adequate vitamin D levels. You can get vitamin D in a few different ways. One method is to get sun exposure 15 to 20 minutes, three days a week.

You can also consume foods that are high in vitamin D, such as the following:

  • Fatty fish: 1 tablespoon of cod liver oil has 1360 International Units of vitamin D.

  • Swordfish: Three ounces of cooked swordfish has 447 International Units of vitamin D.

  • Salmon: Three ounces of cooked sockeye salmon has 447 International Units of vitamin D.

  • Tuna: Three ounces of tuna canned in water, drained has 154 International Units of vitamin D.

  • Orange juice: One cup of orange juice fortified with vitamin D has 137 International Units of vitamin D.

  • Milk: One cup of milk fortified with vitamin D has between 115 and 124 International Units of vitamin D.

  • Yogurt: Six ounces of yogurt fortified with 20% of the daily value of vitamin D has 80 International Units of vitamin D.

  • Oily fish: two sardines canned in oil has 46 International Units of vitamin D.

  • Liver beef: Three ounces of cooked liver beef has 42 International Units of vitamin D.

  • Egg yolk: One large egg yolk has 41 International Units of vitamin D.

  • Cereal: One cup of cereal fortified with ten percent of the daily value of vitamin D has 40 International Units of vitamin D.

  • Swiss cheese: One ounce of Swiss cheese has 6 International Units of vitamin D.


Another way to treat vitamin D deficiency is through supplementation. There are two forms of vitamin D. Vitamin D2 (dihydroxy vitamin D) is called ergocalciferol. This comes from plants. Vitamin D3 is also called cholecalciferol. It comes from animals. You need a prescription to get D2, whereas D3 is available over the counter. The body better absorbs D3. It also lasts in the body longer per dose.


Your healthcare provider can let you know if you should take a vitamin D supplement to prevent a deficiency. They will also let you know which dose is most appropriate for you.

In order to prevent vitamin D deficiency, ensure that you eat more foods that contain vitamin D (such as those listed above). However, remember that getting your vitamin D intake through food may not be enough to meet your daily recommendations.

You can also get vitamin D from the sun! It’s unclear how much sun exposure is necessary. The common recommendation is 10 to 15 minutes two to three times per week. Make sure you get some on your face, arms, legs, and back.

You might need more exposure to the sun if you are older, have a darker complexion, or live in a northern climate. This is especially true of winter, early spring, and late fall.

Do keep in mind that using sunscreen and standing behind a window prevents vitamin D from being produced in the skin. On the other hand, if you get too much exposure to the sun, this can age the skin and increase the risk of skin cancer. 


Keep an eye out for the symptoms of vitamin D deficiency discussed in this article.

It’s always important to address the root cause of any health issue. For example, if you have Crohn’s disease causing vitamin deficiencies, seek a health care provider for treatment of your Crohn’s disease.

A healthcare provider will be able to test and diagnose you for vitamin D deficiency. They can then guide you through treatment. But as we mentioned before, prevention is always your best bet!

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  1. Amrein, K; Scherkl, M; Hoffmann, M; Neuwersch-Sommeregger; Kostenberger, M; Berisha, AT; Martucci, G; Pilz, S & Malle, O. (2020). Vitamin D deficiency 2.0: an update on the current status worldwide. European Journal of Clinical Nutrition. 1 (74), 1498-1513. 
  2. LeFevre, M & Lefevre, NM. (2018). Vitamin D screening and supplementation in community-dwelling adults: Common questions and answers. American Family Physician. 15 (1), 1. 
  3. Podd, D. (2015). Hypovitaminosis D: A common deficiency with pervasive consequences. Journal of the American Academy of Physician Assistants. 28 (2), 20-26. 
  4. Ross, AC; Manson, JE; Abrams, SA; Aloia, JF; Brannon, PM; Clinton, SK; Durazo-Arvizu, RA; Gallagher, JC; Gallo, RL; Jones, G; Kovacs, CS; Mayne, ST; Rosen, CJ & Shapses, SA. (2011). The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 96 (1), 53-8. 
  5. Sadat-Ali, M; Essa, ON; Alani, FM; Omar, HK & Ebrahim, WY. (2018). Correlation of symptoms to serum vitamin D levels?. Clinical Nutrition ESPEN. 24 (1), 31-34. 

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