Vitamin D deficiency

Asymptomatic vitamin D deficiency

Most children and adults have no overt clinical signs or symptoms of vitamin D deficiency. Treatment with pharmacological doses of vitamin D can correct vitamin D deficiency within 2 to 3 months, as long as there are no additional risk factors or disease states that prevent the absorption of vitamin D or metabolism of vitamin D to 25-hydroxyvitamin D.

Symptomatic vitamin D deficiency

For children with skeletal manifestations of rickets, the earlier the intervention, the more likely a favourable prognosis, with resolution of many of the associated skeletal deformities. This is especially true for deformities in the legs. Within 1 week after initiation of treatment, biochemical changes (a rise in the levels of phosphorus and calcium) and radiographic changes may be evident, and physical examination findings revert to normal within 6 months.

Correction of vitamin D deficiency in adults improves bone mineral density as well as stimulating mineralisation of the collagen matrix, resulting in resolution of bone pain associated with osteomalacia. Improvement in bone mineral density can be observed after 1 to 2 years of vitamin D therapy. Improvement in secondary hyperparathyroidism, muscle strength, and osteomalacic bone pain is usually observed within 3 to 6 months after correction of vitamin D deficiency.