Vitamin D 23.3 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 23.3 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 23.3 mean?

A vitamin d level of 23.3 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 23.3 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 23.3 is 58.2 nmol/L

Is a Vitamin D value of 23.3 considered low or high?

Based on your Vitamin D value of 23.3. you are classified as having a mild or insufficient 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
Insufficiency	20 - 30	Mild to Insufficient **You are here**
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
Fatty fish (salmon, mackerel, tuna)	Fatty fish are excellent sources of Vitamin D, particularly wild-caught species.
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.
Canned tuna	Canned tuna, especially if it's canned with bones, can be a source of Vitamin D.
Trout	Trout can provide Vitamin D, particularly when caught in the wild.
Almond milk	Some almond milk products are fortified with Vitamin D.
Herring	Herring is a fatty fish that can contribute to Vitamin D intake.
Sardines	Sardines are a good source of Vitamin D, especially when consumed with the bones.
Canned salmon	Canned salmon, especially with bones, provides a convenient source of Vitamin D.
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
Strict vegan or vegetarian diet	Limited intake of animal products, which are sources of Vitamin D, can contribute to deficiency.
Living in high latitudes	At higher latitudes, the angle of sunlight is lower, leading to reduced Vitamin D synthesis in the skin.
Limited sunlight exposure	Insufficient exposure to sunlight, which is necessary for the skin to produce Vitamin D.
Gastric bypass surgery	Surgical procedures that alter the digestive system can limit the absorption of nutrients, including Vitamin D.
Older age	As people age, their skin becomes less efficient at converting sunlight into Vitamin D.
Certain genetic factors	Certain genetic variations can impact how the body processes and uses Vitamin D.
Use of sunscreen	Sunscreen blocks UV rays that are needed for Vitamin D production when exposed to sunlight.
Celiac disease	An autoimmune disorder that damages the small intestine and impairs nutrient absorption.
Multiple sclerosis	People with multiple sclerosis often have lower Vitamin D levels, although the relationship is complex.
Premature birth	Premature infants may have underdeveloped systems for producing and utilizing Vitamin D.

What symptoms will I experience with a Vitamin D of 23.3 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 23.3 the symptoms are enlisted in the table below:

Vitamin D level 23.3 Symptoms in Children

Symptom	Description
Weak or Soft Bones	Rickets can cause bones to become weak and soft, leading to an increased risk of fractures.
Delayed Puberty	In severe cases, rickets can delay the onset of puberty due to its impact on bone and overall development.
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.
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.
Enlarged Joints	Swelling and tenderness in the joints can occur as a result of rickets.
Delayed Walking	Some children with rickets may experience delays in achieving developmental milestones, like walking.
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.
Wide Fontanelles	The soft spots on a baby's skull, known as fontanelles, might take longer to close in cases of rickets.

Vitamin D level 23.3 Symptoms in Adults

Symptom	Description
Fractures	Brittle and weak bones due to osteomalacia increase the risk of fractures even with minor injuries.
Tingling or Numbness	Nerve-related symptoms such as tingling or numbness can occur as a result of osteomalacia.
Chest Deformities	In severe cases, osteomalacia can lead to deformities in the ribs and chest.
Muscle Weakness	Muscle weakness can result from the lack of proper mineralization in the bones caused by osteomalacia.
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.
Difficulty Walking	Muscle and bone weakness can make walking and moving difficult for individuals with osteomalacia.
Muscle Cramps	Deficiencies in bone mineralization and electrolytes can lead to muscle cramps and spasms.
Bone Deformities	Osteomalacia can lead to bone deformities, such as bowed legs or a curvature of the spine.
Joint Pain	Osteomalacia-related muscle and bone weakness can result in joint pain and discomfort.

What additional risks do I face with a Vitamin D level of 23.3?

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

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

Since your value of Vitamin D 23.3 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 : 23.3

• You get less than 1.75 hours of sunlight per day
• OR
• Insufficient Physical Activity + Insufficient Dietary Intake + Obesity
• Score : Your Vitamin D Insufficiency Score ranges between 9 and 13.

What is the treatment plan for a Vitamin D level of 23.3?

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 23.3 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.	1596 IU/d **(Represents a value in the range of 1000 - 2000, must be adjusted as per patient.)	2 months
Children 11–18 yrs.	3109 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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