Yesterday Sasa Jovenic gave an overview of vitamin D. Read today’s instalment of our weekly feature to explore the signs of deficiency.

Signs of deficiency

Vitamin D is implicated in lots of different body systems, “but is crucial in bone development, repair and remodeling,” explains Dr Tom Margham, a GP at Jubilee Street Practice in Tower Hamlets and also primary care lead at charity Arthritis Research UK.

“Because of this, vitamin D deficiency is understood to have a role in many conditions affecting a wide range of people including children and babies, pregnant women and the elderly, people with kidney disease, people taking anticonvulsant medications, and those with darker skins or who cover their skin and don’t get enough sun exposure. At the extreme end of the scale this includes rickets and (in adults) osteomalacia – painful conditions where bones become soft and deformed – which were largely thought to have disappeared after Victorian times but are having a resurgence lately.”

Rickets is unique to growing children and adolescents and occurs when growing bones do not develop adequately. As a result the bones soften, which can lead to distressing short-term (for example, pain, delayed walking) and sometimes long-term consequences such as deformed limbs needing surgical correction, and difficulty with child-bearing. In 2012, the Royal College of Paediatrics and Child Health reported that rates of rickets have risen fourfold in the past 15 years.

Osteomalacia, like rickets, develops because of softening of the bones. The main symptom of osteomalacia is a dull, throbbing and often severe bone pain that usually affects the lower section of the body. Osteomalacia can also result in muscle weakness.

A 2010, a BMJ clinical review on vitamin D deficiency also presented evidence that vitamin D deficiency may increase the risk of developing a number of chronic conditions such as heart disease, bowel cancer, breast cancer, multiple sclerosis and diabetes, although it stated at the time that the results were inconclusive.

Who is typically at risk from vitamin D deficiency? Join us tomorrow to find out.