Vitamin D 4.2 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 4.2 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 4.2 mean?

A vitamin d level of 4.2 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 4.2 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 4.2 is 10.5 nmol/L

Is a Vitamin D value of 4.2 considered low or high?

Based on your Vitamin D value of 4.2. you are classified as having a severe Vitamin D deficiency.

Vitamin D Levels

Category	Level (ng/mL)	Description
Severe Deficiency	< 10	Severely low vitamin D levels **You are here**
Moderate Deficiency	10 - 20	Moderate Vitamin D Deficiency
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.
Fortified plant-based milk	Non-dairy milk alternatives (e.g., almond, soy) are often fortified with Vitamin D.
Canned salmon	Canned salmon, especially with bones, provides a convenient source of Vitamin D.
Canned tuna	Canned tuna, especially if it's canned with bones, can be a source of Vitamin D.
Pork	Pork contains Vitamin D, particularly when sourced from pasture-raised animals.
Egg yolks	Egg yolks contain small amounts of Vitamin D, especially if the hens are raised on Vitamin D-enriched feed.
Fortified orange juice	Certain brands of orange juice are fortified with Vitamin D to increase its nutritional value.
Mushrooms	Some mushrooms exposed to UV light can produce Vitamin D2.
Lamb	Lamb meat contains small amounts of Vitamin D.
Cheese	Certain types of cheese, like Swiss and cheddar, contain small amounts of Vitamin D.

What are the causes of Vitamin D deficiency?

Cause	Description
Certain genetic factors	Certain genetic variations can impact how the body processes and uses Vitamin D.
Limited sunlight exposure	Insufficient exposure to sunlight, which is necessary for the skin to produce Vitamin D.
Crohn's disease	An inflammatory bowel disease that can lead to malabsorption and nutrient deficiencies.
Use of sunscreen	Sunscreen blocks UV rays that are needed for Vitamin D production when exposed to sunlight.
Chronic kidney disease	Kidney dysfunction can disrupt the activation of Vitamin D, leading to deficiency.
Limited outdoor activities	A sedentary lifestyle with minimal outdoor time can result in reduced sunlight exposure.
Certain autoimmune diseases	Autoimmune disorders may interfere with Vitamin D metabolism and utilization.
Being homebound or institutionalized	Limited exposure to sunlight due to confinement indoors can lead to deficiency.
Chronic obstructive pulmonary disease (COPD)	People with COPD may have limited outdoor activities and altered Vitamin D metabolism.
Strict vegan or vegetarian diet	Limited intake of animal products, which are sources of Vitamin D, can contribute to deficiency.

What symptoms will I experience with a Vitamin D of 4.2 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 4.2 the symptoms are enlisted in the table below:

Vitamin D level 4.2 Symptoms in Children

Symptom	Description
Brittle Nails	Rickets can cause nails to become brittle and prone to breaking.
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.
Vision Problems	Rickets can affect the eyes, leading to problems such as night blindness and other visual disturbances.
Curvature of the Spine	Rickets can contribute to spinal deformities, such as scoliosis or kyphosis (excessive forward curvature of the upper spine).
Dental Problems	Rickets can affect the development of teeth, leading to dental issues such as delayed eruption and enamel defects.
Muscle Cramps	Vitamin D deficiency associated with rickets can lead to muscle cramps and spasms.
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.
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.

Vitamin D level 4.2 Symptoms in Adults

Symptom	Description
Depression	Chronic pain and physical limitations in osteomalacia can contribute to feelings of depression.
Muscle Cramps	Deficiencies in bone mineralization and electrolytes can lead to muscle cramps and spasms.
Bone Pain	Osteomalacia often leads to bone pain, particularly in the hips, lower back, and legs.
Fractures	Brittle and weak bones due to osteomalacia increase the risk of fractures even with minor injuries.
Joint Pain	Osteomalacia-related muscle and bone weakness can result in joint pain and discomfort.
Muscle Weakness	Muscle weakness can result from the lack of proper mineralization in the bones caused by osteomalacia.
Frequent Infections	Impaired bone health can weaken the immune system, leading to an increased susceptibility to infections.
Chest Deformities	In severe cases, osteomalacia can lead to deformities in the ribs and chest.
Difficulty Standing	Weak bones and muscles can make it challenging to stand for prolonged periods.
Difficulty Climbing Stairs	Muscle weakness and bone pain can make climbing stairs difficult for those with osteomalacia.

What additional risks do I face with a Vitamin D level of 4.2?

Level	Risk
Your value is Less Than 25	Increased risk of fallsBischoff-Ferrari
Your value is Less Than 10	40% more risk of mortality compared to those with vitamin d above 40Ginde AA
Your value is Less Than 8	More risk of cardiovascular mortality than those with a median vitamin d of 28Dobnig H
Your value is Less Than 15	Two fold higher risk of having high blood pressure as those with Vitamin D above 26Reis JP
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 4.2 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 : 4.2

• You get less than 1.75 hours of sunlight per day
• AND
• Insufficient Dietary Intake
• AND
• Obesity
• AND
• Insufficient Exercise
• Score : Your Vitamin D Insufficiency Score ranges between 14 - 18.

What is the treatment plan for a Vitamin D level of 4.2?

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 4.2 the relevant supplement dosages are indicated below.^{Pawel Pludowski}

Recommended Daily Dosing for Vitamin D in cases where the Vitamin D Level is < 10 ng/dl

Age Group	Vitamin D Intake Per Day	Duration
Infants < 1 month	1000 IU/d	3 months
Infants 1–12 months	2000 IU/d	3 months
Children 1–11 yrs.	4130 IU/d**(Represents a value in the range of 3000 - 6000, must be adjusted as per patient.)	3 months
Children 11–18 yrs.	6000 IU/d	3 months
Adults	6000 IU/d	3 months

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