Vitamin D 18.9 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 18.9 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 18.9 mean?

A vitamin d level of 18.9 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 18.9 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 18.9 is 47.2 nmol/L

Is a Vitamin D value of 18.9 considered low or high?

Based on your Vitamin D value of 18.9. 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
Beef liver	Organ meats like beef liver contain Vitamin D, though levels can vary.
Halibut	Halibut is a fish that contains moderate levels of Vitamin D.
Mushrooms	Some mushrooms exposed to UV light can produce Vitamin D2.
Caviar	Fish roe, or caviar, can provide small amounts of Vitamin D.
Cod liver oil	A rich source of Vitamin D, often available as a dietary supplement.
Egg yolks	Egg yolks contain small amounts of Vitamin D, especially if the hens are raised on Vitamin D-enriched feed.
Herring	Herring is a fatty fish that can contribute to Vitamin D intake.
Pork	Pork contains Vitamin D, particularly when sourced from pasture-raised animals.
Oysters	Oysters provide Vitamin D and other nutrients, though levels can vary.
Mackerel	Mackerel is a fatty fish with high Vitamin D content.

What are the causes of Vitamin D deficiency?

Cause	Description
Certain hormonal disorders	Hormonal imbalances can influence Vitamin D metabolism and its effects on the body.
HIV/AIDS	The virus and certain treatments can affect nutrient absorption and utilization, leading to deficiency.
Multiple sclerosis	People with multiple sclerosis often have lower Vitamin D levels, although the relationship is complex.
Gastric bypass surgery	Surgical procedures that alter the digestive system can limit the absorption of nutrients, including Vitamin D.
Living in high latitudes	At higher latitudes, the angle of sunlight is lower, leading to reduced Vitamin D synthesis in the skin.
Chronic kidney disease	Kidney dysfunction can disrupt the activation of Vitamin D, leading to deficiency.
Liver diseases	Liver disorders can affect the conversion of Vitamin D into its active form.
Older age	As people age, their skin becomes less efficient at converting sunlight into Vitamin D.
Limited outdoor activities	A sedentary lifestyle with minimal outdoor time can result in reduced sunlight exposure.
Being homebound or institutionalized	Limited exposure to sunlight due to confinement indoors can lead to deficiency.

What symptoms will I experience with a Vitamin D of 18.9 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 18.9 the symptoms are enlisted in the table below:

Vitamin D level 18.9 Symptoms in Children

Symptom	Description
Dental Problems	Rickets can affect the development of teeth, leading to dental issues such as delayed eruption and enamel defects.
Wide Fontanelles	The soft spots on a baby's skull, known as fontanelles, might take longer to close in cases 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.
Delayed Growth	Children with rickets may experience slowed growth and development compared to their peers.
Weak or Soft Bones	Rickets can cause bones to become weak and soft, leading to an increased risk of fractures.
Curvature of the Spine	Rickets can contribute to spinal deformities, such as scoliosis or kyphosis (excessive forward curvature of the upper spine).
Delayed Healing	Fractures and other injuries may take longer to heal in children with rickets.
Difficulty Breathing	In severe cases, rickets can cause deformities of the ribcage, leading to difficulty in breathing and increased susceptibility to respiratory infections.
Delayed Walking	Some children with rickets may experience delays in achieving developmental milestones, like walking.

Vitamin D level 18.9 Symptoms in Adults

Symptom	Description
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.
Difficulty Climbing Stairs	Muscle weakness and bone pain can make climbing stairs difficult for those with 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.
Chest Deformities	In severe cases, osteomalacia can lead to deformities in the ribs and chest.
Difficulty Walking	Muscle and bone weakness can make walking and moving difficult for individuals with osteomalacia.
Fractures	Brittle and weak bones due to osteomalacia increase the risk of fractures even with minor injuries.
Bone Tenderness	Bones affected by osteomalacia can become tender to the touch.

What additional risks do I face with a Vitamin D level of 18.9?

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 18.9 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 : 18.9

• 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 18.9?

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 18.9 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.	1875 IU/d **(Represents a value in the range of 1000 - 2000, must be adjusted as per patient.)	2 months
Children 11–18 yrs.	2031 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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