Vitamin D 18.5 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 18.5 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 18.5 mean?

A vitamin d level of 18.5 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 18.5 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 18.5 is 46.2 nmol/L

Is a Vitamin D value of 18.5 considered low or high?

Based on your Vitamin D value of 18.5. 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
Sunlight exposure	The skin produces Vitamin D when exposed to sunlight, specifically UVB rays.
Egg yolks	Egg yolks contain small amounts of Vitamin D, especially if the hens are raised on Vitamin D-enriched feed.
Lamb	Lamb meat contains small amounts of Vitamin D.
Mackerel	Mackerel is a fatty fish with high Vitamin D content.
Goat cheese	Goat cheese provides Vitamin D and is a dairy alternative for those who are lactose intolerant.
Fortified orange juice	Certain brands of orange juice are fortified with Vitamin D to increase its nutritional value.
Halibut	Halibut is a fish that contains moderate levels of Vitamin D.
Cod liver oil	A rich source of Vitamin D, often available as a dietary supplement.
Fortified cereals	Many cereals are enriched with Vitamin D to improve nutritional content.
Bluefin tuna	Bluefin tuna is a fatty fish that contains high levels of Vitamin D.

What are the causes of Vitamin D deficiency?

Cause	Description
Use of sunscreen	Sunscreen blocks UV rays that are needed for Vitamin D production when exposed to sunlight.
Dark skin	Higher melanin levels in dark skin reduce the skin's ability to produce Vitamin D from sunlight.
Strict vegan or vegetarian diet	Limited intake of animal products, which are sources of Vitamin D, can contribute to deficiency.
Limited sunlight exposure	Insufficient exposure to sunlight, which is necessary for the skin to produce Vitamin D.
Lack of fortified foods	A diet lacking in fortified dairy products or cereals may lead to lower Vitamin D intake.
Osteoporosis	Vitamin D is essential for bone health, and deficiency can contribute to conditions like osteoporosis.
Certain hormonal disorders	Hormonal imbalances can influence Vitamin D metabolism and its effects on the body.
Alcoholism	Excessive alcohol consumption can affect nutrient absorption and metabolism, including Vitamin D.
Cystic fibrosis	Individuals with cystic fibrosis are at a higher risk of Vitamin D deficiency due to malabsorption.
Inflammatory bowel disease	Conditions like Crohn's disease can impair nutrient absorption, including Vitamin D.

What symptoms will I experience with a Vitamin D of 18.5 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 18.5 the symptoms are enlisted in the table below:

Vitamin D level 18.5 Symptoms in Children

Symptom	Description
Delayed Teething	Children with rickets might experience delays in the eruption of their teeth.
Fatigue	Chronic pain and muscle weakness can result in increased fatigue and reduced activity levels.
Muscle Weakness	Muscle weakness can result from compromised bone health and nutritional deficiencies associated with rickets.
Delayed Walking	Some children with rickets may experience delays in achieving developmental milestones, like walking.
Wide Fontanelles	The soft spots on a baby's skull, known as fontanelles, might take longer to close in cases of rickets.
Bone Pain	Children with rickets often complain of bone pain, which can be especially pronounced in the legs, pelvis, and spine.
Difficulty Breathing	In severe cases, rickets can cause deformities of the ribcage, leading to difficulty in breathing and increased susceptibility to respiratory infections.
Vision Problems	Rickets can affect the eyes, leading to problems such as night blindness and other visual disturbances.
Brittle Nails	Rickets can cause nails to become brittle and prone to breaking.
Fractures	Due to weakened bones, children with rickets are more prone to fractures even with minor injuries.

Vitamin D level 18.5 Symptoms in Adults

Symptom	Description
Delayed Healing	Fractures and injuries may take longer to heal due to impaired bone mineralization in osteomalacia.
Bone Pain	Osteomalacia often leads to bone pain, particularly in the hips, lower back, and legs.
Chest Deformities	In severe cases, osteomalacia can lead to deformities in the ribs and chest.
Weight Loss	Some individuals with osteomalacia may experience weight loss due to the overall impact on health.
Fatigue	Generalized fatigue and weakness are common symptoms of osteomalacia.
Short Stature	In childhood cases, untreated osteomalacia can result in short stature and growth delays.
Muscle Weakness	Muscle weakness can result from the lack of proper mineralization in the bones caused by osteomalacia.
Joint Pain	Osteomalacia-related muscle and bone weakness can result in joint pain and discomfort.
Easy Bruising	Weakened bones and blood vessels can lead to easy bruising in individuals with osteomalacia.
Muscle Cramps	Deficiencies in bone mineralization and electrolytes can lead to muscle cramps and spasms.

What additional risks do I face with a Vitamin D level of 18.5?

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 18.5 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 : 18.5

• 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 18.5?

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 18.5 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.	1481 IU/d **(Represents a value in the range of 1000 - 2000, must be adjusted as per patient.)	2 months
Children 11–18 yrs.	2868 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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