Vitamin D 13.5 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 13.5 ng/ml means, what are its causes and how to calculate your Vitamin D deficiency risk score, and how to improve your Vitamin D as well as a treatment plan and possible risks.

What does a Vitamin D level of 13.5 mean?

A vitamin d level of 13.5 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 13.5 in standard units?

In order to convert the value of Vitamin D from ng/ml into the SI Units, we must use a formula of conversion : Vitamin D in SI units (nmol/L) = Vitamin D in ng/ml*2.496¹ Based on the given formula, the value of Vitamin D in SI units for a value in ng/ml of 13.5 is 33.7 nmol/L

Is a Vitamin D value of 13.5 considered low or high?

Based on your Vitamin D value of 13.5. you are classified as having a moderate Vitamin D deficiency.

Vitamin D Levels

Category	Level (ng/mL)	Description
Severe Deficiency	< 10	Severely low vitamin D levels
Moderate Deficiency	10 - 20	Moderate Vitamin D Deficiency **You are here**
Insufficiency	20 - 30	Mild to Insufficient
Healthy	30 - 80	Normal Vitamin D Levels
Toxicity	> 80	Potentially harmful vitamin D levels

What are the sources of Vitamin D?

Food	How it helps with Vitamin D
Canned mackerel	Canned mackerel, like fresh mackerel, is a good source of Vitamin D.
Goat cheese	Goat cheese provides Vitamin D and is a dairy alternative for those who are lactose intolerant.
Canned salmon	Canned salmon, especially with bones, provides a convenient source of Vitamin D.
Egg yolks	Egg yolks contain small amounts of Vitamin D, especially if the hens are raised on Vitamin D-enriched feed.
Pork chops	Pork chops contain Vitamin D, particularly if they include the bone.
Canned tuna	Canned tuna, especially if it's canned with bones, can be a source of Vitamin D.
Almond milk	Some almond milk products are fortified with Vitamin D.
Bluefin tuna	Bluefin tuna is a fatty fish that contains high levels of Vitamin D.
Fortified dairy products	Milk, yogurt, and cheese are often fortified with Vitamin D to increase intake.
Trout	Trout can provide Vitamin D, particularly when caught in the wild.

What are the causes of Vitamin D deficiency?

Cause	Description
Dark skin	Higher melanin levels in dark skin reduce the skin's ability to produce Vitamin D from sunlight.
Certain autoimmune diseases	Autoimmune disorders may interfere with Vitamin D metabolism and utilization.
Older age	As people age, their skin becomes less efficient at converting sunlight into Vitamin D.
Living in high latitudes	At higher latitudes, the angle of sunlight is lower, leading to reduced Vitamin D synthesis in the skin.
Certain medications (e.g., anticonvulsants)	Some medications interfere with Vitamin D metabolism and absorption.
Osteoporosis	Vitamin D is essential for bone health, and deficiency can contribute to conditions like osteoporosis.
Malabsorption disorders	Conditions like celiac disease can affect the body's ability to absorb Vitamin D from the digestive tract.
Chronic obstructive pulmonary disease (COPD)	People with COPD may have limited outdoor activities and altered Vitamin D metabolism.
Kidney disorders	Kidney diseases can reduce the activation of Vitamin D in the body, affecting its functions.
Celiac disease	An autoimmune disorder that damages the small intestine and impairs nutrient absorption.

What symptoms will I experience with a Vitamin D of 13.5 ng/ml?

The symptoms of Vitamin D deficiency in children and adults are manifested by rickets and osteomalacia respectively. These conditions may show a variety of symptoms ranging from mild muscle pain, and bone pain to developmental abnormalities and fractures. For a Vitamin D level of 13.5 the symptoms are enlisted in the table below:

Vitamin D level 13.5 Symptoms in Children

Symptom	Description
Enlarged Joints	Swelling and tenderness in the joints can occur as a result of rickets.
Muscle Weakness	Muscle weakness can result from compromised bone health and nutritional deficiencies associated with rickets.
Irritability	Children with rickets might exhibit increased irritability and discomfort due to the physical pain they experience.
Curvature of the Spine	Rickets can contribute to spinal deformities, such as scoliosis or kyphosis (excessive forward curvature of the upper spine).
Dental Problems	Rickets can affect the development of teeth, leading to dental issues such as delayed eruption and enamel defects.
Bone Deformities	Rickets can lead to bone deformities, such as bowed legs or knock-knees, due to weakened bones unable to support the body's weight properly.
Wide Fontanelles	The soft spots on a baby's skull, known as fontanelles, might take longer to close in cases of rickets.
Delayed Teething	Children with rickets might experience delays in the eruption of their teeth.
Bone Pain	Children with rickets often complain of bone pain, which can be especially pronounced in the legs, pelvis, and spine.
Fractures	Due to weakened bones, children with rickets are more prone to fractures even with minor injuries.

Vitamin D level 13.5 Symptoms in Adults

Symptom	Description
Easy Bruising	Weakened bones and blood vessels can lead to easy bruising in individuals with osteomalacia.
Bone Tenderness	Bones affected by osteomalacia can become tender to the touch.
Weight Loss	Some individuals with osteomalacia may experience weight loss due to the overall impact on health.
Joint Pain	Osteomalacia-related muscle and bone weakness can result in joint pain and discomfort.
Difficulty Climbing Stairs	Muscle weakness and bone pain can make climbing stairs difficult for those with osteomalacia.
Bone Pain	Osteomalacia often leads to bone pain, particularly in the hips, lower back, and legs.
Depression	Chronic pain and physical limitations in osteomalacia can contribute to feelings of depression.
Difficulty Standing	Weak bones and muscles can make it challenging to stand for prolonged periods.
Muscle Cramps	Deficiencies in bone mineralization and electrolytes can lead to muscle cramps and spasms.
Frequent Infections	Impaired bone health can weaken the immune system, leading to an increased susceptibility to infections.

What additional risks do I face with a Vitamin D level of 13.5?

Level	Risk
Your value is Less Than 25	Increased risk of fallsBischoff-Ferrari
Your value is Less Than 15	Two fold higher risk of having high blood pressure as those with Vitamin D above 26Reis JP
Your value is Less Than 21	Increased risk of diabetes, hypertension, obesity and high triglyceride levelsMartins D

What is my Vitamin D deficiency score and how to calculate it?

Since your value of Vitamin D 13.5 is below the normal limit of 30, you must evaluate the following 4 factors that may be contributing to your deficiency. Based on a study done by Garg et al the following Vitamin D Insufficiency and Deficiency Score can predict and determine your causes of deficiency.

As per the study 4 major factors are invovled in Vitamin D deficiency.

Factors and Descriptions

Factor	Description
Physical Activity	Engaging in regular physical activity can contribute to improved metabolism and Vitamin D levels.
Obesity	Obesity, indicated by a body mass index (BMI) of 25 kg/m² or higher, can lead to Vitamin D deficiencies
Diet	Dietary intake of at least 100 Grams (gms) of milk/dairy products OR at least 100 gms fish or 1 egg with yolk for four or more days in the last seven days was considered Adequate
Daily Sun Exposure	Daily exposure to sunlight is important for the body's synthesis of Vitamin D. Spending at least 1.75 hours in the sun each day can help maintain Vitamin D levels, which is essential for bone health and immune function.

• Insufficiency Score for Vitamin D : 13.5

• You get less than 1.75 hours of sunlight per day
• AND
• Insufficient Dietary Intake + Obesity
• AND
• Obesity OR Insufficient Exercise
• Score : Your Vitamin D Insufficiency Score ranges between 14 - 18.

What is the treatment plan for a Vitamin D level of 13.5?

Vitamin D supplmentation is the only way to correct for deficiencies. The tables below list the dosages of Vitamin D supplements recommeded for different age groups, depending on the level of the Vitamin D. Since your value of Vitamin D is 13.5 the relevant supplement dosages are indicated below.^{Pawel Pludowski}

Recommended Daily Dosing for Vitamin D in cases where the Vitamin D Level is between 10 ng/dl and upto 30 ng/dl

A first line of treatment involves increasing the dosage to 1.5-2 x the current level of supplements if the patient is taking any supplements.

If you are not taking any supplements, the values in the table below are to be followed.

Age Group	Vitamin D Intake Per Day	Duration
Infants < 1 month	1000 IU/d	2 months
Infants 1–12 months	1000 IU/d	2 months
Children 1–11 yrs.	1241 IU/d **(Represents a value in the range of 1000 - 2000, must be adjusted as per patient.)	2 months
Children 11–18 yrs.	2144 IU/d **(Represents a value in the range of 2000 - 4000, must be adjusted as per patient.)	2 months
Adults	4000 IU/d	2 months

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