Vitamin D deficiency causes
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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
Common causes of vitamin D deficiency are inadequate vitamin D skin production, less dietary vitamin D intake and impaired absorption. Other causes of vitamin D deficiency include vitamin D loss, abnormal metabolism, resistance to vitamin D and medication.[1]
Causes
Vitamin D deficiency may be caused by:[1][2][3][4][5][6][7][8]
- Inadequate vitamin D skin production
- Inadequate vitamin D dietary intake
- Vitamin D loss
- Malabsorption
- Impaired metabolism
- Resistance to Vitamin D
- Medication
Common causes
- Antiepileptic medication
- Glucocorticoid
- Inadequate sun exposure including dark skin and clothing
- Inadequate vitamin D dietary intake
- Malabsorption
Less common cause
- Autosomal dominant hypophosphatemic rickets
- Celiac disease
- Chronic kidney disease: impaired renal 1α-hydroxylation
- Crohn disease
- Cystic fibrosis
- Highly active antiretroviral therapy (HAART)
- Hyperthyroidism
- Impaired enterohepatic circulation
- Nephrotic syndrome
- Post gastric bypass surgery
- Primary hyperparathyroidism
- Rifampin
- Sarcoidosis
- Severe liver failure: impaired hepatic 25-hydroxylation
- Short bowel syndrome
- St John's wort
- Tuberculosis
- Type I hereditary vitamin D–dependent rickets
- Type II hereditary vitamin D–dependent rickets
- Vitamin D-resistant rickets
- Whipple disease
- X-linked familial hypophosphatemia
Causes by organ system
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | St John's wort |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Glucocorticoid, Highly Active Antiretroviral Therapy (HAART), Phenobarbital, Phenytoin, Primidone, Rifampin, Valproate |
| Ear Nose Throat | No underlying causes |
| Endocrine | Autosomal-dominant hypophosphatemic rickets, Hyperthyroidism, Primary hyperparathyroidism, Type I hereditary vitamin D–dependent rickets, Type II hereditary vitamin D–dependent rickets, Vitamin D-resistant rickets, X-linked familial hypophosphatemia |
| Environmental | No underlying causes |
| Gastroenterologic | Celiac disease, Crohn disease, Cystic fibrosis, Liver failure, Post gastric bypass surgery, Short bowel syndrome, Whipple disease |
| Genetic | Autosomal-dominant hypophosphatemic rickets, Type I hereditary vitamin D–dependent rickets, Type II hereditary vitamin D–dependent rickets, Vitamin D-resistant rickets, X-linked familial hypophosphatemia |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | Tuberculosis |
| Musculoskeletal/Orthopedic | Autosomal-dominant hypophosphatemic rickets, Type I hereditary vitamin D–dependent rickets, Type II hereditary vitamin D–dependent rickets, Vitamin D-resistant rickets, X-linked familial hypophosphatemia |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | Inadequate vitamin D dietary intake |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | Chronic kidney disease, Nephrotic syndrome |
| Rheumatology/Immunology/Allergy | Sarcoidosis |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in alphabetical order
- Autosomal dominant hypophosphatemic rickets
- Carbamazepine
- Celiac disease
- Chronic kidney disease
- Crohn's disease
- Cystic fibrosis
- Glucocorticoid
- Highly active antiretroviral therapy (HAART)
- Hyperthyroidism
- Impaired enterohepatic circulation
- Inadequate sun exposure
- Inadequate vitamin D dietary intake
- Nephrotic syndrome
- Phenobarbital
- Phenytoin
- Post gastric bypass surgery
- Primary hyperparathyroidism
- Primidone
- Rifampin
- Sarcoidosis
- Severe liver failure
- Short bowel syndrome
- St John's wort
- Tuberculosis
- Type I hereditary vitamin D–dependent rickets
- Type II hereditary vitamin D–dependent rickets
- Valproate
- Vitamin D-resistant rickets
- Whipple's disease
- X-linked familial hypophosphatemia
References
- ↑ 1.0 1.1 Hossein-nezhad A, Holick MF (2013). "Vitamin D for health: a global perspective". Mayo Clin Proc. 88 (7): 720–55. doi:10.1016/j.mayocp.2013.05.011. PMC 3761874. PMID 23790560.
- ↑ Pack AM, Morrell MJ (2004). "Epilepsy and bone health in adults". Epilepsy Behav. 5 Suppl 2: S24–9. doi:10.1016/j.yebeh.2003.11.029. PMID 15123008.
- ↑ Zhou C, Assem M, Tay JC, Watkins PB, Blumberg B, Schuetz EG; et al. (2006). "Steroid and xenobiotic receptor and vitamin D receptor crosstalk mediates CYP24 expression and drug-induced osteomalacia". J Clin Invest. 116 (6): 1703–12. doi:10.1172/JCI27793. PMC 1459072. PMID 16691293.
- ↑ Kyriakidou-Himonas M, Aloia JF, Yeh JK (1999). "Vitamin D supplementation in postmenopausal black women". J Clin Endocrinol Metab. 84 (11): 3988–90. doi:10.1210/jcem.84.11.6132. PMID 10566638.
- ↑ Holick MF (2012). "Vitamin D: extraskeletal health". Rheum Dis Clin North Am. 38 (1): 141–60. doi:10.1016/j.rdc.2012.03.013. PMID 22525849.
- ↑ Lo CW, Paris PW, Clemens TL, Nolan J, Holick MF (1985). "Vitamin D absorption in healthy subjects and in patients with intestinal malabsorption syndromes". Am J Clin Nutr. 42 (4): 644–9. PMID 4050723.
- ↑ Ali FN, Arguelles LM, Langman CB, Price HE (2009). "Vitamin D deficiency in children with chronic kidney disease: uncovering an epidemic". Pediatrics. 123 (3): 791–6. doi:10.1542/peds.2008-0634. PMID 19255004.
- ↑ Pappa HM, Gordon CM, Saslowsky TM, Zholudev A, Horr B, Shih MC; et al. (2006). "Vitamin D status in children and young adults with inflammatory bowel disease". Pediatrics. 118 (5): 1950–61. doi:10.1542/peds.2006-0841. PMC 3205440. PMID 17079566.