Pearce SH, Cheetham TD. (2010) BMJ. 340 Jan 11, b5664. doi: 10.1136/bmj.b5664.
Vitamin D insufficiency is common in the UK population
Vitamin D deficiency typically presents with bony deformity (rickets) or hypocalcaemia in infancy and childhood, and with musculoskeletal pain and weakness in adults
Many other health problems—including cardiovascular disease, type 2 diabetes, several cancers, and autoimmune conditions—have recently been associated with vitamin D insufficiency
Risk factors include skin pigmentation, use of sunscreen or concealing clothing, being elderly or institutionalised, obesity, malabsorption, renal and liver disease, and anticonvulsant use
Vitamin D status is most reliably determined by assay of serum 25-hydroxyvitamin D (25-OHD)
Rickets and osteomalacia should be treated with high strength calciferol (ergocalciferol or colecalciferol) for 8-12 weeks, followed by regular vitamin D supplements