Protean Manifestations of Vitamin D Deficiency, Part 1

The Epidemic of Deficiency

David S.H. Bell, MB


South Med J. 2011;104(5):331-334. 

In This Article

Abstract and Introduction


Just when vitamin deficiencies were thought to be a "thing of the past" a new vitamin deficiency-that of vitamin D has developed over the past 20 years. Vitamin D works like a hormone being produced primarily in one organ (the kidney) before circulating through the bloodstream to multiple organs where it has multiple effects. The increased prevalence of vitamin D deficiency is due to changes in modern lifestyle-mainly lack of exposure to sunlight and the increased prevalence of obesity that, results in sequestration of this fat-soluble vitamin in adipose tissue. Distance from the Equator and increasing age and skin pigmentation are additional risk factors. In pregnancy vitamin D deficiency can result in low birth weight, pre-term labor, pre-term birth, infections, and pre-eclamptic toxemia. While vitamin D deficiency is classically associated with rickets and osteomalacia, its effects are much more protean.


In recent years it has become obvious that the addition of a vitamin supplement, when the vitamin is not deficient, is not advantageous and may even be harmful. Until recently in modern Western society it was believed that vitamin deficiencies were a "thing of the past," but in the past 20 years, changes in lifestyle have led to a new vitamin deficiency-that of vitamin D. In addition, evidence that the effects of vitamin D deficiency are not confined to bone but are protean, affecting multiple organs and systems, has been accumulating. In contrast, evidence that correction of vitamin D levels into the normal range will prevent, ameliorate, or cure the diseases associated with vitamin D deficiency is sparse but is slowly but surely accumulating.


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