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==Overview==
==Overview==
 
Mild to moderate vitamin D deficiency could be asymptomatic in children and adults. However, severe vitamin D deficiency may be presented as rickets in children and osteomalacia in adults. Some nonspecific associated symptoms including muscle weakness or bone pain may be seen. <ref name="pmid19835345">{{cite journal |vauthors=Bordelon P, Ghetu MV, Langan RC |title=Recognition and management of vitamin D deficiency |journal=Am Fam Physician |volume=80 |issue=8 |pages=841–6 |year=2009 |pmid=19835345 |doi= |url=http://www.aafp.org/link_out?pmid=19835345}}</ref> <ref name="LeFevre2015">{{cite journal|last1=LeFevre|first1=Michael L.|title=Screening for Vitamin D Deficiency in Adults: U.S. Preventive Services Task Force Recommendation Statement|journal=Annals of Internal Medicine|volume=162|issue=2|year=2015|pages=133|issn=0003-4819|doi=10.7326/M14-2450}}</ref>
==History==
==History==
Obtaining the history from a patient with vitamin D deficiency is helpful in determining the cause, treatment and prevention strategy. It is essential to question about risk factors that predispose individuals to this condition. Main focuses on taking history are outlined below: <ref name="pmid18400738">{{cite journal |vauthors=Holick MF, Chen TC |title=Vitamin D deficiency: a worldwide problem with health consequences |journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=1080S–6S |year=2008 |pmid=18400738 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400738}}</ref> <ref name="Holick2006">{{cite journal|last1=Holick|first1=M. F.|title=Resurrection of vitamin D deficiency and rickets|journal=Journal of Clinical Investigation|volume=116|issue=8|year=2006|pages=2062–2072|issn=0021-9738|doi=10.1172/JCI29449}}</ref>
* Onset, duration, and progression of symptoms
* Associated symptoms (muscle and bone pain)
* History of fall
* Malabsorption symptoms (diarrhea, weight loss, growth retardation)
* Medications
* Diet
* Lifestyle
* History of sun exposure
* Geographic area
* Maternal history <ref name="LeeSmith2016">{{cite journal|last1=Lee|first1=Joyce M.|last2=Smith|first2=Jessica R.|last3=Philipp|first3=Barbara L.|last4=Chen|first4=Tai C.|last5=Mathieu|first5=Jeffrey|last6=Holick|first6=Michael F.|title=Vitamin D Deficiency in a Healthy Group of Mothers and Newborn Infants|journal=Clinical Pediatrics|volume=46|issue=1|year=2016|pages=42–44|issn=0009-9228|doi=10.1177/0009922806289311}}</ref>
* Exclusive breast-feeding
==Symptoms==
* Growth retardation <ref name="pmid18400738">{{cite journal |vauthors=Holick MF, Chen TC |title=Vitamin D deficiency: a worldwide problem with health consequences |journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=1080S–6S |year=2008 |pmid=18400738 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400738}}</ref>
* Osteopenia <ref name="pmid18400738">{{cite journal |vauthors=Holick MF, Chen TC |title=Vitamin D deficiency: a worldwide problem with health consequences |journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=1080S–6S |year=2008 |pmid=18400738 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400738}}</ref>
* Osteomalacia
* Rickets <ref name="Holick2006">{{cite journal|last1=Holick|first1=M. F.|title=Resurrection of vitamin D deficiency and rickets|journal=Journal of Clinical Investigation|volume=116|issue=8|year=2006|pages=2062–2072|issn=0021-9738|doi=10.1172/JCI29449}}</ref>


==Common Symptoms==
==Associated symptoms==
 
* Nonspecific musculoskeletal pain <ref name="pmid14661675">{{cite journal |vauthors=Plotnikoff GA, Quigley JM |title=Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain |journal=Mayo Clin. Proc. |volume=78 |issue=12 |pages=1463–70 |year=2003 |pmid=14661675 |doi=10.4065/78.12.1463 |url=https://linkinghub.elsevier.com/retrieve/pii/S0025-6196(11)62742-0}}</ref>
==Less Common Symptoms==
* Muscle weakness <ref name="pmid14661673">{{cite journal |vauthors=Holick MF |title=Vitamin D deficiency: what a pain it is |journal=Mayo Clin. Proc. |volume=78 |issue=12 |pages=1457–9 |year=2003 |pmid=14661673 |doi=10.4065/78.12.1457 |url=https://linkinghub.elsevier.com/retrieve/pii/S0025-6196(11)62740-7}}</ref>
* Symmetric low back pain <ref name="pmid19835345">{{cite journal |vauthors=Bordelon P, Ghetu MV, Langan RC |title=Recognition and management of vitamin D deficiency |journal=Am Fam Physician |volume=80 |issue=8 |pages=841–6 |year=2009 |pmid=19835345 |doi= |url=http://www.aafp.org/link_out?pmid=19835345}}</ref> <ref name="HicksShardell2008">{{cite journal|last1=Hicks|first1=Gregory E.|last2=Shardell|first2=Michelle|last3=Miller|first3=Ram R.|last4=Bandinelli|first4=Stefania|last5=Guralnik|first5=Jack|last6=Cherubini|first6=Antonio|last7=Lauretani|first7=Fulvio|last8=Ferrucci|first8=Luigi|title=Associations Between Vitamin D Status and Pain in Older Adults: The Invecchiare in Chianti Study|journal=Journal of the American Geriatrics Society|volume=56|issue=5|year=2008|pages=785–791|issn=00028614|doi=10.1111/j.1532-5415.2008.01644.x}}</ref>
* Throbbing bone pain
* Fall <ref name="HolickBinkley2011">{{cite journal|last1=Holick|first1=Michael F.|last2=Binkley|first2=Neil C.|last3=Bischoff-Ferrari|first3=Heike A.|last4=Gordon|first4=Catherine M.|last5=Hanley|first5=David A.|last6=Heaney|first6=Robert P.|last7=Murad|first7=M. Hassan|last8=Weaver|first8=Connie M.|title=Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline|journal=The Journal of Clinical Endocrinology & Metabolism|volume=96|issue=7|year=2011|pages=1911–1930|issn=0021-972X|doi=10.1210/jc.2011-0385}}</ref>
* Fracture <ref name="pmid18400738">{{cite journal |vauthors=Holick MF, Chen TC |title=Vitamin D deficiency: a worldwide problem with health consequences |journal=Am. J. Clin. Nutr. |volume=87 |issue=4 |pages=1080S–6S |year=2008 |pmid=18400738 |doi= |url=http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400738}}</ref>
* Difficulty walking


==References==
==References==

Revision as of 00:53, 2 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Mild to moderate vitamin D deficiency could be asymptomatic in children and adults. However, severe vitamin D deficiency may be presented as rickets in children and osteomalacia in adults. Some nonspecific associated symptoms including muscle weakness or bone pain may be seen. [1] [2]

History

Obtaining the history from a patient with vitamin D deficiency is helpful in determining the cause, treatment and prevention strategy. It is essential to question about risk factors that predispose individuals to this condition. Main focuses on taking history are outlined below: [3] [4]

  • Onset, duration, and progression of symptoms
  • Associated symptoms (muscle and bone pain)
  • History of fall
  • Malabsorption symptoms (diarrhea, weight loss, growth retardation)
  • Medications
  • Diet
  • Lifestyle
  • History of sun exposure
  • Geographic area
  • Maternal history [5]
  • Exclusive breast-feeding

Symptoms

  • Growth retardation [3]
  • Osteopenia [3]
  • Osteomalacia
  • Rickets [4]

Associated symptoms

  • Nonspecific musculoskeletal pain [6]
  • Muscle weakness [7]
  • Symmetric low back pain [1] [8]
  • Throbbing bone pain
  • Fall [9]
  • Fracture [3]
  • Difficulty walking

References

  1. ↑ 1.0 1.1 Bordelon P, Ghetu MV, Langan RC (2009). "Recognition and management of vitamin D deficiency". Am Fam Physician. 80 (8): 841–6. PMID 19835345.
  2. ↑ LeFevre, Michael L. (2015). "Screening for Vitamin D Deficiency in Adults: U.S. Preventive Services Task Force Recommendation Statement". Annals of Internal Medicine. 162 (2): 133. doi:10.7326/M14-2450. ISSN 0003-4819.
  3. ↑ 3.0 3.1 3.2 3.3 Holick MF, Chen TC (2008). "Vitamin D deficiency: a worldwide problem with health consequences". Am. J. Clin. Nutr. 87 (4): 1080S–6S. PMID 18400738.
  4. ↑ 4.0 4.1 Holick, M. F. (2006). "Resurrection of vitamin D deficiency and rickets". Journal of Clinical Investigation. 116 (8): 2062–2072. doi:10.1172/JCI29449. ISSN 0021-9738.
  5. ↑ Lee, Joyce M.; Smith, Jessica R.; Philipp, Barbara L.; Chen, Tai C.; Mathieu, Jeffrey; Holick, Michael F. (2016). "Vitamin D Deficiency in a Healthy Group of Mothers and Newborn Infants". Clinical Pediatrics. 46 (1): 42–44. doi:10.1177/0009922806289311. ISSN 0009-9228.
  6. ↑ Plotnikoff GA, Quigley JM (2003). "Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain". Mayo Clin. Proc. 78 (12): 1463–70. doi:10.4065/78.12.1463. PMID 14661675.
  7. ↑ Holick MF (2003). "Vitamin D deficiency: what a pain it is". Mayo Clin. Proc. 78 (12): 1457–9. doi:10.4065/78.12.1457. PMID 14661673.
  8. ↑ Hicks, Gregory E.; Shardell, Michelle; Miller, Ram R.; Bandinelli, Stefania; Guralnik, Jack; Cherubini, Antonio; Lauretani, Fulvio; Ferrucci, Luigi (2008). "Associations Between Vitamin D Status and Pain in Older Adults: The Invecchiare in Chianti Study". Journal of the American Geriatrics Society. 56 (5): 785–791. doi:10.1111/j.1532-5415.2008.01644.x. ISSN 0002-8614.
  9. ↑ Holick, Michael F.; Binkley, Neil C.; Bischoff-Ferrari, Heike A.; Gordon, Catherine M.; Hanley, David A.; Heaney, Robert P.; Murad, M. Hassan; Weaver, Connie M. (2011). "Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline". The Journal of Clinical Endocrinology & Metabolism. 96 (7): 1911–1930. doi:10.1210/jc.2011-0385. ISSN 0021-972X.


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