Vitamin D 4.6 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 4.6 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 4.6 mean?

A vitamin d level of 4.6 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 4.6 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 4.6 is 11.5 nmol/L

Is a Vitamin D value of 4.6 considered low or high?

Based on your Vitamin D value of 4.6. 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
Mackerel	Mackerel is a fatty fish with high Vitamin D content.
Pork chops	Pork chops contain Vitamin D, particularly if they include the bone.
Pork	Pork contains Vitamin D, particularly when sourced from pasture-raised animals.
Lamb	Lamb meat contains small amounts of Vitamin D.
Bluefin tuna	Bluefin tuna is a fatty fish that contains high levels of Vitamin D.
Fortified cereals	Many cereals are enriched with Vitamin D to improve nutritional content.
Sardines	Sardines are a good source of Vitamin D, especially when consumed with the bones.
Fatty fish (salmon, mackerel, tuna)	Fatty fish are excellent sources of Vitamin D, particularly wild-caught species.
Canned mackerel	Canned mackerel, like fresh mackerel, is a good source of Vitamin D.
Tofu	Some tofu products are fortified with Vitamin D, especially those made from soy milk.

What are the causes of Vitamin D deficiency?

Cause	Description
Living in high latitudes	At higher latitudes, the angle of sunlight is lower, leading to reduced Vitamin D synthesis in the skin.
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.
Cystic fibrosis	Individuals with cystic fibrosis are at a higher risk of Vitamin D deficiency due to malabsorption.
Chronic kidney disease	Kidney dysfunction can disrupt the activation of Vitamin D, leading to deficiency.
Certain medications (e.g., anticonvulsants)	Some medications interfere with Vitamin D metabolism and absorption.
Alcoholism	Excessive alcohol consumption can affect nutrient absorption and metabolism, including Vitamin D.
Osteoporosis	Vitamin D is essential for bone health, and deficiency can contribute to conditions like osteoporosis.
Malabsorption disorders	Conditions like celiac disease can affect the body's ability to absorb Vitamin D from the digestive tract.
Limited outdoor activities	A sedentary lifestyle with minimal outdoor time can result in reduced sunlight exposure.

What symptoms will I experience with a Vitamin D of 4.6 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 4.6 the symptoms are enlisted in the table below:

Vitamin D level 4.6 Symptoms in Children

Symptom	Description
Irritability	Children with rickets might exhibit increased irritability and discomfort due to the physical pain they experience.
Muscle Cramps	Vitamin D deficiency associated with rickets can lead to muscle cramps and spasms.
Curvature of the Spine	Rickets can contribute to spinal deformities, such as scoliosis or kyphosis (excessive forward curvature of the upper spine).
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.
Brittle Nails	Rickets can cause nails to become brittle and prone to breaking.
Wide Fontanelles	The soft spots on a baby's skull, known as fontanelles, might take longer to close in cases of rickets.
Fatigue	Chronic pain and muscle weakness can result in increased fatigue and reduced activity levels.
Delayed Puberty	In severe cases, rickets can delay the onset of puberty due to its impact on bone and overall development.
Delayed Healing	Fractures and other injuries may take longer to heal in children with rickets.

Vitamin D level 4.6 Symptoms in Adults

Symptom	Description
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.
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.
Easy Bruising	Weakened bones and blood vessels can lead to easy bruising in individuals with osteomalacia.
Bone Deformities	Osteomalacia can lead to bone deformities, such as bowed legs or a curvature of the spine.
Difficulty Walking	Muscle and bone weakness can make walking and moving difficult for individuals with osteomalacia.
Dental Problems	Osteomalacia can affect the teeth, leading to enamel defects and other dental issues.
Depression	Chronic pain and physical limitations in osteomalacia can contribute to feelings of depression.

What additional risks do I face with a Vitamin D level of 4.6?

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 4.6 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 : 4.6

• 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 4.6?

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 4.6 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.	5517 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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