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| ==Overview== | | ==Overview== |
| Common causes of [[vitamin D]] deficiency are inadequate [[vitamin D]] skin production, less dietary [[vitamin D]] intake and impaired absorption. Other causes of [[vitamin D]] deficiency include [[vitamin D]] loss, abnormal metabolism, resistance to [[vitamin D]] and medication. <ref name="pmid23790560">{{cite journal| author=Hossein-nezhad A, Holick MF| title=Vitamin D for health: a global perspective. | journal=Mayo Clin Proc | year= 2013 | volume= 88 | issue= 7 | pages= 720-55 | pmid=23790560 | doi=10.1016/j.mayocp.2013.05.011 | pmc=3761874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23790560 }} </ref>
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| ==Causes== | | ==Screening== |
| [[Vitamin D]] deficiency may be caused by: <ref name="pmid23790560">{{cite journal| author=Hossein-nezhad A, Holick MF| title=Vitamin D for health: a global perspective. | journal=Mayo Clin Proc | year= 2013 | volume= 88 | issue= 7 | pages= 720-55 | pmid=23790560 | doi=10.1016/j.mayocp.2013.05.011 | pmc=3761874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23790560 }} </ref>
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| * Inadequate [[vitamin D]] skin production
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| * Inadequate [[vitamin D]] dietary intake
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| * [[Vitamin D]] loss
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| * [[Malabsorption]]
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| * Impaired metabolism
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| * Resistance to [[Vitamin D]]
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| * Medication
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| ===Common causes===
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| * [[Antiepileptic]] medication <ref name="pmid15123008">{{cite journal| author=Pack AM, Morrell MJ| title=Epilepsy and bone health in adults. | journal=Epilepsy Behav | year= 2004 | volume= 5 Suppl 2 | issue= | pages= S24-9 | pmid=15123008 | doi=10.1016/j.yebeh.2003.11.029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15123008 }} </ref>
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| * [[Glucocorticoid]] <ref name="pmid16691293">{{cite journal| author=Zhou C, Assem M, Tay JC, Watkins PB, Blumberg B, Schuetz EG et al.| title=Steroid and xenobiotic receptor and vitamin D receptor crosstalk mediates CYP24 expression and drug-induced osteomalacia. | journal=J Clin Invest | year= 2006 | volume= 116 | issue= 6 | pages= 1703-12 | pmid=16691293 | doi=10.1172/JCI27793 | pmc=1459072 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16691293 }} </ref>
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| * Inadequate sun exposure including dark skin <ref name="pmid10566638">{{cite journal| author=Kyriakidou-Himonas M, Aloia JF, Yeh JK| title=Vitamin D supplementation in postmenopausal black women. | journal=J Clin Endocrinol Metab | year= 1999 | volume= 84 | issue= 11 | pages= 3988-90 | pmid=10566638 | doi=10.1210/jcem.84.11.6132 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10566638 }} </ref> and clothing <ref name="pmid22525849">{{cite journal| author=Holick MF| title=Vitamin D: extraskeletal health. | journal=Rheum Dis Clin North Am | year= 2012 | volume= 38 | issue= 1 | pages= 141-60 | pmid=22525849 | doi=10.1016/j.rdc.2012.03.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22525849 }} </ref>
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| * Inadequate [[vitamin D]] dietary intake
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| ===Less common cause===
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| * [[Autosomal-dominant hypophosphatemic rickets]]
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| * [[Celiac disease]]
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| * [[Chronic kidney disease]]: impaired renal [[1α-hydroxylation]] <ref name="pmid19255004">{{cite journal| author=Ali FN, Arguelles LM, Langman CB, Price HE| title=Vitamin D deficiency in children with chronic kidney disease: uncovering an epidemic. | journal=Pediatrics | year= 2009 | volume= 123 | issue= 3 | pages= 791-6 | pmid=19255004 | doi=10.1542/peds.2008-0634 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19255004 }} </ref>
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| * [[Crohn disease]] <ref name="pmid17079566">{{cite journal| author=Pappa HM, Gordon CM, Saslowsky TM, Zholudev A, Horr B, Shih MC et al.| title=Vitamin D status in children and young adults with inflammatory bowel disease. | journal=Pediatrics | year= 2006 | volume= 118 | issue= 5 | pages= 1950-61 | pmid=17079566 | doi=10.1542/peds.2006-0841 | pmc=3205440 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17079566 }} </ref><ref name="pmid4050723">{{cite journal| author=Lo CW, Paris PW, Clemens TL, Nolan J, Holick MF| title=Vitamin D absorption in healthy subjects and in patients with intestinal malabsorption syndromes. | journal=Am J Clin Nutr | year= 1985 | volume= 42 | issue= 4 | pages= 644-9 | pmid=4050723 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4050723 }} </ref>
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| * [[Cystic fibrosis]]
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| * [[Highly active antiretroviral therapy]] ([[HAART]])
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| * [[Hyperthyroidism]]
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| * Impaired [[enterohepatic circulation]]
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| * [[Nephrotic syndrome]]
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| * Post [[gastric bypass surgery]]
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| * [[Primary hyperparathyroidism]]
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| * [[Rifampin]]
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| * [[Sarcoidosis]]
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| * Severe [[liver failure]]: impaired [[hepatic 25-hydroxylation]]
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| * [[Short bowel syndrome]]
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| * [[St John's wort]]
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| * [[Tuberculosis]]
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| * [[Type I hereditary vitamin D–dependent rickets]]
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| * [[Type II hereditary vitamin D–dependent rickets]]
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| * [[Vitamin D-resistant rickets]]
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| * [[Whipple disease]]
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| * [[X-linked familial hypophosphatemia]]
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| ===Causes by organ system===
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| {| style="width:80%; height:100px" border="1"
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| | style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
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| | style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
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| |-
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| | bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
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| | bgcolor="Beige" | [[St John's wort]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Dental'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Dermatologic'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Drug Side Effect'''
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| | bgcolor="Beige" | [[Glucocorticoid]], [[Highly Active Antiretroviral Therapy]] ([[HAART]]), [[Phenobarbital]], [[Phenytoin]], [[Primidone]], [[Rifampin]], [[Valproate]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Ear Nose Throat'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| | bgcolor="Beige" | [[Autosomal-dominant hypophosphatemic rickets]], [[Hyperthyroidism]], [[Primary hyperparathyroidism]], [[Type I hereditary vitamin D–dependent rickets]], [[Type II hereditary vitamin D–dependent rickets]], [[Vitamin D-resistant rickets]], [[X-linked familial hypophosphatemia]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Gastroenterologic'''
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| | bgcolor="Beige" | [[Celiac disease]], [[Crohn disease]], [[Cystic fibrosis]], [[Liver failure]], Post [[gastric bypass surgery]], [[Short bowel syndrome]], [[Whipple disease]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Genetic'''
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| | bgcolor="Beige" | [[Autosomal-dominant hypophosphatemic rickets]], [[Type I hereditary vitamin D–dependent rickets]], [[Type II hereditary vitamin D–dependent rickets]], [[Vitamin D-resistant rickets]], [[X-linked familial hypophosphatemia]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Hematologic'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Iatrogenic'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Infectious Disease'''
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| | bgcolor="Beige" | [[Tuberculosis]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Musculoskeletal/Orthopedic'''
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| | bgcolor="Beige" | [[Autosomal-dominant hypophosphatemic rickets]], [[Type I hereditary vitamin D–dependent rickets]], [[Type II hereditary vitamin D–dependent rickets]], [[Vitamin D-resistant rickets]], [[X-linked familial hypophosphatemia]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Neurologic'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Nutritional/Metabolic'''
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| | bgcolor="Beige" | Inadequate [[vitamin D]] dietary intake
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Obstetric/Gynecologic'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Ophthalmologic'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Overdose/Toxicity'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Psychiatric'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Pulmonary'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Renal/Electrolyte'''
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| | bgcolor="Beige" | [[Chronic kidney disease]], [[Nephrotic syndrome]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Rheumatology/Immunology/Allergy'''
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| | bgcolor="Beige" | [[Sarcoidosis]]
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |- bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| | bgcolor="Beige" | No underlying causes
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| |-
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| |}
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| ===Causes in alphabetical order===
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| {{columns-list|3|
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| * Autosomal-dominant hypophosphatemic rickets
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| * Carbamazepine
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| * Celiac disease
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| * Chronic kidney disease
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| * Crohn disease
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| * Cystic fibrosis
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| * Glucocorticoid
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| * Highly active antiretroviral therapy (HAART)
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| * Hyperthyroidism
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| * Impaired enterohepatic circulation
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| * Inadequate sun exposure
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| * Inadequate vitamin D dietary intake
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| * Nephrotic syndrome
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| * Phenobarbital
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| * Phenytoin
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| * Post gastric bypass surgery
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| * Primary hyperparathyroidism
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| * Primidone
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| * Rifampin
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| * Sarcoidosis
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| * Severe liver failure
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| * Short bowel syndrome
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| * St John's wort
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| * Tuberculosis
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| * Type I hereditary vitamin D–dependent rickets
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| * Type II hereditary vitamin D–dependent rickets
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| * Valproate
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| * Vitamin D-resistant rickets
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| * Whipple disease
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| * X-linked familial hypophosphatemia
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| }}
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| ==References== | | ==References== |