Vitamin D 4.4 ng/ml means : causes, sources, risks, treatment

In this article we discuss what a Vitamin D value of 4.4 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 4.4 mean?

A vitamin d level of 4.4 is considered to be deficient.

What is my Vitamin D level in SI units, for value of 4.4 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 4.4 is 11.0 nmol/L

Is a Vitamin D value of 4.4 considered low or high?

Based on your Vitamin D value of 4.4. 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
Tofu	Some tofu products are fortified with Vitamin D, especially those made from soy milk.
Trout	Trout can provide Vitamin D, particularly when caught in the wild.
Fatty fish (salmon, mackerel, tuna)	Fatty fish are excellent sources of Vitamin D, particularly wild-caught species.
Herring	Herring is a fatty fish that can contribute to Vitamin D intake.
Halibut	Halibut is a fish that contains moderate levels of Vitamin D.
Bluefin tuna	Bluefin tuna is a fatty fish that contains high levels of Vitamin D.
Caviar	Fish roe, or caviar, can provide small amounts of Vitamin D.
Mushrooms	Some mushrooms exposed to UV light can produce Vitamin D2.
Mackerel	Mackerel is a fatty fish with high Vitamin D content.
Canned salmon	Canned salmon, especially with bones, provides a convenient source of Vitamin D.

What are the causes of Vitamin D deficiency?

Cause	Description
Chronic obstructive pulmonary disease (COPD)	People with COPD may have limited outdoor activities and altered Vitamin D metabolism.
Certain types of cancer	Some cancers and their treatments can impact Vitamin D levels and metabolism.
Limited outdoor activities	A sedentary lifestyle with minimal outdoor time can result in reduced sunlight exposure.
Certain medications (e.g., anticonvulsants)	Some medications interfere with Vitamin D metabolism and absorption.
Premature birth	Premature infants may have underdeveloped systems for producing and utilizing Vitamin D.
Kidney disorders	Kidney diseases can reduce the activation of Vitamin D in the body, affecting its functions.
Osteoporosis	Vitamin D is essential for bone health, and deficiency can contribute to conditions like osteoporosis.
Crohn's disease	An inflammatory bowel disease that can lead to malabsorption and nutrient deficiencies.
Certain genetic factors	Certain genetic variations can impact how the body processes and uses Vitamin D.
Living in high latitudes	At higher latitudes, the angle of sunlight is lower, leading to reduced Vitamin D synthesis in the skin.

What symptoms will I experience with a Vitamin D of 4.4 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 4.4 the symptoms are enlisted in the table below:

Vitamin D level 4.4 Symptoms in Children

Symptom	Description
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.
Enlarged Joints	Swelling and tenderness in the joints can occur as a result of rickets.
Curvature of the Spine	Rickets can contribute to spinal deformities, such as scoliosis or kyphosis (excessive forward curvature of the upper spine).
Vision Problems	Rickets can affect the eyes, leading to problems such as night blindness and other visual disturbances.
Irritability	Children with rickets might exhibit increased irritability and discomfort due to the physical pain they experience.
Fractures	Due to weakened bones, children with rickets are more prone to fractures even with minor injuries.
Difficulty Breathing	In severe cases, rickets can cause deformities of the ribcage, leading to difficulty in breathing and increased susceptibility to respiratory infections.
Weak or Soft Bones	Rickets can cause bones to become weak and soft, leading to an increased risk of fractures.
Delayed Healing	Fractures and other injuries may take longer to heal in children with rickets.

Vitamin D level 4.4 Symptoms in Adults

Symptom	Description
Depression	Chronic pain and physical limitations in osteomalacia can contribute to feelings of depression.
Difficulty Climbing Stairs	Muscle weakness and bone pain can make climbing stairs difficult for those with osteomalacia.
Difficulty Walking	Muscle and bone weakness can make walking and moving difficult for individuals with osteomalacia.
Tingling or Numbness	Nerve-related symptoms such as tingling or numbness can occur as a result of osteomalacia.
Bone Pain	Osteomalacia often leads to bone pain, particularly in the hips, lower back, and legs.
Bone Tenderness	Bones affected by osteomalacia can become tender to the touch.
Short Stature	In childhood cases, untreated osteomalacia can result in short stature and growth delays.
Difficulty Standing	Weak bones and muscles can make it challenging to stand for prolonged periods.
Muscle Cramps	Deficiencies in bone mineralization and electrolytes can lead to muscle cramps and spasms.
Delayed Healing	Fractures and injuries may take longer to heal due to impaired bone mineralization in osteomalacia.

What additional risks do I face with a Vitamin D level of 4.4?

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 4.4 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 : 4.4

• 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 4.4?

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 4.4 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.	5273 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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