Deficiency of vitamin D can result from a number of factors: inadequate intake coupled with inadequate sunlight (UVB) exposure, disorders that limit its absorption from the gastrointestinal tract, conditions that impair conversion of vitamin D into active metabolites, such as liver or kidney disorders and body characteristics such as skin color and body fat. Rarely, deficiency can result from a number of hereditary disorders. including:
- Rickets, a childhood disease characterized by impeded growth, and deformity, of the long bones. Rickets was first described in the 17th century, by Daniel Whistler and Francis Glisson. The role of diet in the development of rickets was determined by Edward Mellanby between 1918–1920. By altering the diets of dogs raised in the absence of sunlight, he was able to establish unequivocally that rickets was linked with a deficiency of diet, and identified cod liver oil as an excellent anti-rachitic agent. In 1921 Elmer McCollum identified a substance found in certain fats that could prevent rickets. Prior to the fortification of milk products with vitamin D, rickets was a major public health problem. In the United States, the fortification of milk with 10 micrograms (400 IU) of vitamin D per quart in the 1930s led to a dramatic decline in the number of rickets cases. A number of reports thus indicate that vitamin D deficiency may be related to various types of pain, but of the five small double-blind randomized controlled trials, only one found a reduction in pain after supplementation, and there is no persuasive evidence of lower vitamin D status in chronic pain sufferers compared to controls.
- Osteoporosis, a condition characterized by reduced bone mineral density and increased bone fragility.
Vitamin D malnutrition may also be linked to an increased susceptibility to several chronic diseases, such as high blood pressure, tuberculosis, cancer, periodontal disease, multiple sclerosis, chronic pain, seasonal affective disorder, peripheral artery disease, cognitive impairment which includes memory loss and foggy brain, and several autoimmune diseases including type 1 diabetes. A resurgence of interest in vitamin D deficiency has led to continued studies on the topic and a focus on educating the consumer on the prevalence and degree of deficiency among the general public.
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