Vitamin D Testing

Vitamin D Deficiency

January 2009

Recently vitamin D deficiency has been reported in adults, especially in the aging population and the population living in nursing homes. Sunlight is the best source for vitamin D production. UVB from sunlight helps in synthesizing vitamin D in the skin from its precursor. Vitamin D is then converted to 25-hydroxy vitamin D by the liver. 25-hydroxy vitamin D is converted to 1,25-dihydroxy vitamin D by the kidney, which helps in resorbing the bone from intestine and thus maintaining calcium in circulation and preserving calcium in bones.

Our aging population cannot get the benefit of UVB from the sun if they apply too much sunscreen, if they have high melanin in their skin, and they live in high latitude and of course, the UVB penetration in winter is also very low.

The aging population can be affected with various conditions like malabsorption. A few examples like Crohn’s, Whipple, cystic fibrosis, celiac. Population affective to the organ failure can also absorb calcium or absorb vitamin D if they have liver disease, renal failure, nephrotic syndrome.

Certain drug also seems to inhibit vitamin D synthesis and vitamin D metabolites are unable to absorb calcium. As a result of vitamin D deficiencies, various diseases have been associated, in addition to bone and muscles: osteoporosis, osteomalacia, osteoarthritis, rickets, muscle aches and weakness.

Coronary heart disease and cardiovascular disease and cancers have also been added to the list, which have been added as a vitamin D deficiency.

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Jump to section:

• Introduction
• Objectives
• Rickets
• UVB Light
• Vitamin D Deficiency
• Interaction Between Vitamin D and Calcium
• Vitamin D3
• Vitamin D2
• Various Vitamin D Tests
• History of 25-OH Vitamin D Testing
• Accreditation Agencies for Precision Among Peers
• Quality of the 25-OH Vitamin D Testing
• 25-OH Vitamin D Volume
• Reference Ranges for 25-OH Vitamin D
• Various Vitamin D Tests
• Case Study - Rickets in a Premature Infant
• Birth History
• Ionized Calcium
• Fractures Identified on Routine Radiographic Surveillance for Line Placement
• Vitamin D Supplementation
• Lab Values After Vit-D Supplementation
• Mother's History
• Infant's X-ray
• Mother's Creatinine
• The Connection Between the Mother and the Infant
• Summary
• Questions?