Vitamin D deficiency history and symptoms: Difference between revisions
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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> | 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> | 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> | ||
| Line 10: | Line 10: | ||
* Associated symptoms (muscle and bone pain) | * Associated symptoms (muscle and bone pain) | ||
* History of fall | * History of fall | ||
* Malabsorption symptoms (diarrhea, weight loss, growth retardation) | * [[Malabsorption]] symptoms ([[diarrhea]], [[weight loss]], [[growth retardation]]) | ||
* Medications | * Medications | ||
* Diet | * Diet | ||
| Line 16: | Line 16: | ||
* History of sun exposure | * History of sun exposure | ||
* Geographic area | * 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> | * [[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 | * Exclusive breast-feeding | ||
==Symptoms== | ==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> | * [[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> | * [[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 | * [[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> | * [[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> | ||
==Associated 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> | * 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> | ||
* 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> | * [[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> | * 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 | * 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> | * 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> | * [[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 | * Difficulty walking | ||
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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
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
- ↑ 1.0 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.
- ↑ 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.
- ↑ 3.0 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.
- ↑ 4.0 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.