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 2-3 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 and 1,25-dihydroxyvitamin 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 children with rickets and adults with osteomalacia improves bone mineral density as a result of stimulating mineralisation of the collagen matrix, resulting in resolution of bone pain. Improvement in bone mineral density can be observed after 1-2 years of vitamin D therapy. Improvement in secondary hyperparathyroidism, muscle strength, and osteomalacic bone pain is usually observed within 3-6 months after correction of vitamin D deficiency.