Vitamin D-Few Practice points

What are Normal Vitamin D levels

Normal ranges of Vitamin D(25 Hydroxy Vitamin D) levels in blood as per IAP Classification are classified as –

Sufficient: >20ng/ml (50 nmol/L)
Insufficient: 12-20ng/ml (30-50 nmol/L)
Deficient: <12ng/ml (<30 nmol/L)
Toxicity: >100ng/ml (250 nmol/L)

Some labs would give reports in nmol/L and others as ng/ml.

Multiply ng/ml value by 2.5 to get approximate value in nmol/L.

Why Vitamin D Deficiency is on the rise ?

Pollution filters the UVB spectrum, which is needed for Vitamin D formation, so practically most of the people(studies show as high as 93%) in metropolis eventually get deficient if not supplemented

Certain scenarios are more at-risk for Vitamin D deficiency

Pre-Maturity
Exclusively breastfed infants when most mothers themselves are Vitamin D deficient
Dark skinned individuals
Limited sun exposure due to altered life-styles
Sunscreen usage

Should Vitamin D be measured routinely ?

One does not have to measure Vitamin D levels as a routine. Measure the level only in situations like-

Suspecting rickets/ osteomalacia
Symptoms and signs of muscle weakness
Evaluating Symptomatic cases of Hypocalcemia
Abnormal bone profile etc.

It should be noted that the other isomeric form of Vitamin D i.e. 1, 25 Di-Hydroxy Vitamin D, should not be requested for while ordering screening tests for routine evaluation of Vitamin D sufficiency.

Specifically mention as “25-Hydroxy Vitamin D” while ordering a blood test

READ IAP 2017 GUIDELINES ON VITAMIN D

Next POST: Vitamin D – Food Facts