Vitamin D 18.6 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 18.6 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 18.6 mean?

A vitamin d level of 18.6 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 18.6 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 18.6 is 46.4 nmol/L

Is a Vitamin D value of 18.6 considered low or high?

Based on your Vitamin D value of 18.6. 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
Salmon skin	Salmon skin contains some Vitamin D, but it's recommended to consume the flesh for better nutrient balance.
Pork	Pork contains Vitamin D, particularly when sourced from pasture-raised animals.
Fortified dairy products	Milk, yogurt, and cheese are often fortified with Vitamin D to increase intake.
Canned mackerel	Canned mackerel, like fresh mackerel, is a good source of Vitamin D.
Fatty fish (salmon, mackerel, tuna)	Fatty fish are excellent sources of Vitamin D, particularly wild-caught species.
Cheese	Certain types of cheese, like Swiss and cheddar, contain small amounts of Vitamin D.
Herring	Herring is a fatty fish that can contribute to Vitamin D intake.
Canned salmon	Canned salmon, especially with bones, provides a convenient source of Vitamin D.
Caviar	Fish roe, or caviar, can provide small amounts of Vitamin D.
Sardines	Sardines are a good source of Vitamin D, especially when consumed with the bones.

What are the causes of Vitamin D deficiency?

Cause	Description
Lack of fortified foods	A diet lacking in fortified dairy products or cereals may lead to lower Vitamin D intake.
Malabsorption disorders	Conditions like celiac disease can affect the body's ability to absorb Vitamin D from the digestive tract.
Cystic fibrosis	Individuals with cystic fibrosis are at a higher risk of Vitamin D deficiency due to malabsorption.
Certain autoimmune diseases	Autoimmune disorders may interfere with Vitamin D metabolism and utilization.
Liver diseases	Liver disorders can affect the conversion of Vitamin D into its active form.
Multiple sclerosis	People with multiple sclerosis often have lower Vitamin D levels, although the relationship is complex.
Older age	As people age, their skin becomes less efficient at converting sunlight into Vitamin D.
Being homebound or institutionalized	Limited exposure to sunlight due to confinement indoors can lead to deficiency.
Certain genetic factors	Certain genetic variations can impact how the body processes and uses Vitamin D.
Certain hormonal disorders	Hormonal imbalances can influence Vitamin D metabolism and its effects on the body.

What symptoms will I experience with a Vitamin D of 18.6 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 18.6 the symptoms are enlisted in the table below:

Vitamin D level 18.6 Symptoms in Children

Symptom	Description
Difficulty Breathing	In severe cases, rickets can cause deformities of the ribcage, leading to difficulty in breathing and increased susceptibility to respiratory infections.
Bone Pain	Children with rickets often complain of bone pain, which can be especially pronounced in the legs, pelvis, and spine.
Weak or Soft Bones	Rickets can cause bones to become weak and soft, leading to an increased risk of fractures.
Brittle Nails	Rickets can cause nails to become brittle and prone to breaking.
Delayed Healing	Fractures and other injuries may take longer to heal in children with rickets.
Delayed Growth	Children with rickets may experience slowed growth and development compared to their peers.
Irritability	Children with rickets might exhibit increased irritability and discomfort due to the physical pain they experience.
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.
Dental Problems	Rickets can affect the development of teeth, leading to dental issues such as delayed eruption and enamel defects.

Vitamin D level 18.6 Symptoms in Adults

Symptom	Description
Difficulty Walking	Muscle and bone weakness can make walking and moving difficult for individuals with osteomalacia.
Delayed Healing	Fractures and injuries may take longer to heal due to impaired bone mineralization in osteomalacia.
Difficulty Standing	Weak bones and muscles can make it challenging to stand for prolonged periods.
Dental Problems	Osteomalacia can affect the teeth, leading to enamel defects and other dental issues.
Bone Tenderness	Bones affected by osteomalacia can become tender to the touch.
Frequent Infections	Impaired bone health can weaken the immune system, leading to an increased susceptibility to infections.
Muscle Cramps	Deficiencies in bone mineralization and electrolytes can lead to muscle cramps and spasms.
Short Stature	In childhood cases, untreated osteomalacia can result in short stature and growth delays.
Fractures	Brittle and weak bones due to osteomalacia increase the risk of fractures even with minor injuries.
Easy Bruising	Weakened bones and blood vessels can lead to easy bruising in individuals with osteomalacia.

What additional risks do I face with a Vitamin D level of 18.6?

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 18.6 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 : 18.6

• 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 18.6?

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 18.6 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.	1810 IU/d **(Represents a value in the range of 1000 - 2000, must be adjusted as per patient.)	2 months
Children 11–18 yrs.	3386 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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