Short answer
Get tested for 25(OH)D, if the level is below 30 ng/ml - adjust the dose of vitamin D3 with your doctor. Monitor the indicator every 3-6 months, especially during the low insolation season.
Lack of the “sunshine vitamin” is a hidden cause of fatigue, decreased immunity and calcium metabolism disorders.
The mechanism in three steps, and where you can intervene.
Trigger
Lack of UV radiation (living in northern latitudes, winter season, constant use of SPF creams)
Mechanism
Impaired conversion of 25(OH)D to the active form → reduction in calcium absorption in the intestine by 30-40%
Symptom
Muscle weakness, frequent acute respiratory infections, poor healing of fractures, depression
Answer 3 questions to see likely causes and a baseline lab list.
How long has this been going on?
Is there marked fatigue?
Is stress high?
Likely causes
What to check
We will show a preliminary result before registration
Create an action plan in one click with a checklist, reminders, and a timeline.
Get tested for 25(OH)D, if the level is below 30 ng/ml - adjust the dose of vitamin D3 with your doctor. Monitor the indicator every 3-6 months, especially during the low insolation season.
A baseline panel for the most common causes.
The main marker of vitamin D reserves in the body (reflects dietary intake and synthesis in the skin)
Assessment of calcium metabolism (in case of D deficiency, it is often reduced)
The second key mineral whose metabolism depends on vitamin D
Increases with prolonged D deficiency as a compensatory reaction
Bone turnover marker (may be elevated in osteomalacia)
How each marker relates to vitamin d deficiency.
The main source of vitamin D (80%) is synthesis in the skin under the influence of UVB rays. Deficiency occurs when living north of 35° latitude, using sunscreens with SPF>15, dark skin (melanin blocks UVB). At risk are the elderly (reduced skin synthesis ability), obese people (the vitamin is deposited in adipose tissue), patients with malabsorption (celiac disease, Crohn's disease).
The gold standard is 25(OH)D (not to be confused with 1.25(OH)2D). The optimal level is 30-50 ng/ml (75-125 nmol/l). At a level of <20 ng/ml - severe deficiency, 20-30 - insufficiency. Additionally, calcium, phosphorus, and PTH are checked. You can upload PDF analyzes to Axioris: the system will automatically highlight key indicators and build a dynamics graph.
Urgent consultation is needed if 25(OH)D level <10 ng/ml + symptoms of osteomalacia (bone pain, pathological fractures). Planned - if the level does not increase while taking prophylactic doses (2000 IU/day). Pregnant women, patients with hyperparathyroidism, and renal failure require special attention.
1) Taking vitamin D without monitoring tests (risk of hypercalcemia at doses >4000 IU/day). 2) Ignoring concomitant magnesium deficiency (necessary for vitamin activation). 3) A single dose of a “loading” dose (preferably daily). 4) Stop taking it in the summer (in 60% of people, even in the sunny season, the level does not reach the norm).
«ТТГ оказался на границе. Без системной диагностики я бы ещё год занималась косметикой вместо причины.»
«Витамин D был 12 — я даже не знала, что это влияет на усталость и иммунитет. После коррекции заметила разницу через 6 недель.»
«Сын занимается спортом профессионально. Наконец выстроили нормальный контроль базовых показателей, не гадаем.»
Основано на структурированном медицинском подходе, не на хаотичных советах из интернета.
Не заменяет очную консультацию и постановку диагноза врачом.
Срочные симптомы требуют немедленного обращения за медицинской помощью.
Only the 25(OH)D blood test has proven diagnostic value. Saliva tests are not standardized and produce false results.
SPF>15 blocks 95% of UVB rays, but in practice people apply the cream in a thin layer and do not reapply every 2 hours. The actual contribution of SPF to D deficiency is about 10-15% of cases.
No: even foods rich in vitamin D (fatty fish, egg yolks) cover only 10-20% of the daily requirement. To correct deficiency, D3 (cholecalciferol) supplements are needed.
The first 3 months - every 8-12 weeks to select the dose. At a stable level of 30-50 ng/ml - 1-2 times a year (better at the end of winter). In Axioris, you can set reminders for repeat tests.
Possible causes: magnesium/vitamin K2 deficiency, inflammatory bowel disease, VDR gene mutations. If at a dose of 4000 IU/day the 25(OH)D level does not increase, in-depth diagnostics are needed.
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