Vitamin D Deficiency

What it is

Vitamin D is a hormone produced in the skin through sun exposure, and it is essential for calcium absorption, bone health and muscle function. Deficiency is common in people who spend little time outdoors, use sunscreen daily, have darker skin, carry excess weight, or have conditions that impair intestinal absorption. In women, it becomes especially important after menopause, when bone loss accelerates. Replacement, when indicated, should be done with a dose and duration set by the endocrinologist, since both deficiency and excess carry risks. Follow-up ensures that testing and supplementation are done only when there is a real benefit.

Most common symptoms

• Often no specific symptoms
• Muscle pain and weakness in the legs
• Diffuse bone pain, especially in the spine
• Persistent fatigue and low mood
• Frequent cramps and tingling
• Fractures from minor falls

Causes and risk factors

• Little sun exposure and constant sunscreen use
• Excess weight, which traps the vitamin in fat tissue
• Conditions that reduce intestinal absorption, such as celiac disease and bariatric surgery
• Older age and darker skin
• Kidney or liver disease and use of anticonvulsant medications

How it is diagnosed

Measuring 25-hydroxyvitamin D in the blood is the test that defines levels, but it is not recommended as screening for everyone: the endocrinologist orders it in risk groups, such as postmenopausal women, patients with osteoporosis, absorption disorders, obesity, kidney disease, or use of medications that interfere with vitamin metabolism. Along with it, calcium, phosphorus, parathyroid hormone and kidney function are assessed, to interpret the result in the context of bone metabolism. When bone loss is suspected, a bone density scan rounds out the investigation. The visit also includes a review of diet, sun exposure and supplement use.

How we treat it at Femi Saúde

Replacement is done with vitamin D in capsules or drops, at doses that vary according to the degree of deficiency, weight and cause, with an initial loading regimen followed by maintenance. After about three months, the test is repeated to confirm the target has been reached and to adjust the dose, avoiding excess, which can raise calcium levels and cause kidney damage. At the same time, patients are guided on safe sun exposure, adequate calcium intake and weight-bearing physical activity. In cases of osteopenia or osteoporosis, the endocrinology team at Femi Saúde adds specific treatment for the bones.

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