Vitamin D deficiency

Question 1

what causes it?

Answer 1

dietary deficiency 
malabsorption 
- gastric surgery 
- coeliac disease 
- liver disease 
- pancreatic failure 
chronic renal failure causes 
- vitamin D deficiency 
- secondary hyperparathyroidism 
- can have a high 25-OH vitD level 
lack of sunlight 
drugs e.g. anticonvulsants

Question 2

what are the consequences?

Answer 2

rickets 
osteomalacia 
- low calcium 
- muscle wasting - proximal myopathy 
- dental defects (caries, enamel) 
- bone - tenderness, fractures, rib deformity, limb deformity

Question 3

how is it managed?

Answer 3

Vitmain D3 tablets (400-800 IU per day after loading with 3200IU per day for 12 weeks)
calcitriol (1-25 dihydroxycholecaliferol)
Alfacalcidol (1 alpha-hydroxycholecalciferol)
combined calcium + vitamin D e.g. adcal D3