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Vit stämpeldyna

However, subclinical vitamin D deficiency occurs even in developed countries and is associated with osteoporosis and possibly fractures.

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Vitamin D stores decline with age, especially in the winter [ ]. In temperate areas such as Boston and Edmonton, for example, cutaneous production of vitamin D virtually ceases in winter [ 2 ]. Thus, identification and treatment of vitamin D deficiency is important for musculoskeletal health and possibly even extraskeletal health, including the immune and cardiovascular systems.

See "Vitamin D and extraskeletal health". This topic will review the definition, clinical manifestations, and treatment of vitamin D deficiency in adults. The causes of vitamin D deficiency, vitamin D supplementation in osteoporosis, and the treatment of vitamin D deficiency in children are reviewed separately. See "Causes of vitamin D deficiency and resistance" and "Calcium and vitamin D supplementation in osteoporosis" and "Vitamin D insufficiency and deficiency in children and adolescents".

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The optimal serum 25 OH D concentration for skeletal health is controversial. The optimal serum 25 OH D concentrations for extraskeletal health have not been established. These recommendations are based upon evidence related to bone health. The systematic review by the NAM concluded there are insufficient data to determine the safe upper limit of serum 25 OH D [ 8 ].

See "Vitamin D and extraskeletal health", section on 'Cancer' and "Vitamin D and extraskeletal health", section on 'Mortality'. Given the controversy surrounding optimal serum 25 OH D concentrations, the definitions of vitamin D sufficiency, insufficiency, and deficiency are only approximate. The majority of groups currently use the following values to categorize the vitamin D status in adults [ 13 ].

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