Vitamin D 18.4 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 18.4 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 18.4 mean?

A vitamin d level of 18.4 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 18.4 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 18.4 is 45.9 nmol/L

Is a Vitamin D value of 18.4 considered low or high?

Based on your Vitamin D value of 18.4. 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
Shrimp	Shrimp contain some Vitamin D, especially when consumed in larger quantities.
Bluefin tuna	Bluefin tuna is a fatty fish that contains high levels of Vitamin D.
Canned tuna	Canned tuna, especially if it's canned with bones, can be a source of Vitamin D.
Fatty fish (salmon, mackerel, tuna)	Fatty fish are excellent sources of Vitamin D, particularly wild-caught species.
Sardines	Sardines are a good source of Vitamin D, especially when consumed with the bones.
Trout	Trout can provide Vitamin D, particularly when caught in the wild.
Beef liver	Organ meats like beef liver contain Vitamin D, though levels can vary.
Oysters	Oysters provide Vitamin D and other nutrients, though levels can vary.
Mushrooms	Some mushrooms exposed to UV light can produce Vitamin D2.
Salmon skin	Salmon skin contains some Vitamin D, but it's recommended to consume the flesh for better nutrient balance.

What are the causes of Vitamin D deficiency?

Cause	Description
Inflammatory bowel disease	Conditions like Crohn's disease can impair nutrient absorption, including Vitamin D.
Limited sunlight exposure	Insufficient exposure to sunlight, which is necessary for the skin to produce Vitamin D.
HIV/AIDS	The virus and certain treatments can affect nutrient absorption and utilization, leading to deficiency.
Use of sunscreen	Sunscreen blocks UV rays that are needed for Vitamin D production when exposed to sunlight.
Cystic fibrosis	Individuals with cystic fibrosis are at a higher risk of Vitamin D deficiency due to malabsorption.
Certain genetic factors	Certain genetic variations can impact how the body processes and uses Vitamin D.
Crohn's disease	An inflammatory bowel disease that can lead to malabsorption and nutrient deficiencies.
Multiple sclerosis	People with multiple sclerosis often have lower Vitamin D levels, although the relationship is complex.
Certain types of cancer	Some cancers and their treatments can impact Vitamin D levels and metabolism.
Chronic kidney disease	Kidney dysfunction can disrupt the activation of Vitamin D, leading to deficiency.

What symptoms will I experience with a Vitamin D of 18.4 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 18.4 the symptoms are enlisted in the table below:

Vitamin D level 18.4 Symptoms in Children

Symptom	Description
Irritability	Children with rickets might exhibit increased irritability and discomfort due to the physical pain they experience.
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.
Fractures	Due to weakened bones, children with rickets are more prone to fractures even with minor injuries.
Delayed Teething	Children with rickets might experience delays in the eruption of their teeth.
Dental Problems	Rickets can affect the development of teeth, leading to dental issues such as delayed eruption and enamel defects.
Curvature of the Spine	Rickets can contribute to spinal deformities, such as scoliosis or kyphosis (excessive forward curvature of the upper spine).
Muscle Cramps	Vitamin D deficiency associated with rickets can lead to muscle cramps and spasms.
Enlarged Joints	Swelling and tenderness in the joints can occur as a result of rickets.
Wide Fontanelles	The soft spots on a baby's skull, known as fontanelles, might take longer to close in cases of rickets.
Brittle Nails	Rickets can cause nails to become brittle and prone to breaking.

Vitamin D level 18.4 Symptoms in Adults

Symptom	Description
Difficulty Climbing Stairs	Muscle weakness and bone pain can make climbing stairs difficult for those with osteomalacia.
Muscle Cramps	Deficiencies in bone mineralization and electrolytes can lead to muscle cramps and spasms.
Waddling Gait	A waddling gait may develop due to weakened hip and leg muscles associated with osteomalacia.
Bone Tenderness	Bones affected by osteomalacia can become tender to the touch.
Muscle Weakness	Muscle weakness can result from the lack of proper mineralization in the bones caused by osteomalacia.
Bone Deformities	Osteomalacia can lead to bone deformities, such as bowed legs or a curvature of the spine.
Dental Problems	Osteomalacia can affect the teeth, leading to enamel defects and other dental issues.
Delayed Healing	Fractures and injuries may take longer to heal due to impaired bone mineralization in osteomalacia.
Depression	Chronic pain and physical limitations in osteomalacia can contribute to feelings of depression.
Fatigue	Generalized fatigue and weakness are common symptoms of osteomalacia.

What additional risks do I face with a Vitamin D level of 18.4?

Level	Risk
Your value is Less Than 25	Increased risk of fallsBischoff-Ferrari
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 18.4 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 : 18.4

• 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 18.4?

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 18.4 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.	1173 IU/d **(Represents a value in the range of 1000 - 2000, must be adjusted as per patient.)	2 months
Children 11–18 yrs.	3952 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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