What Causes A Vitamin D Deficiency?

Crohn's Disease

Crohn's disease is a chronic health condition that inflames portions of the digestive tract, causing patients to have trouble processing fats. Since vitamin D is a fat-soluble vitamin that requires fat for proper absorption, individuals with Crohn's disease could develop a deficiency. Symptoms include abdominal pain, blood in the stool, weight loss, reduced appetite, diarrhea, and fatigue. Symptoms tend to occur intermittently, and patients typically have symptomatic episodes interspersed with symptom-free periods (remission). Inflammation of the joints, skin, liver, and eyes could occur in cases of severe Crohn's disease, and pediatric patients might have delays in growth and sexual development. To diagnose this condition, doctors may need to perform a colonoscopy and a capsule endoscopy, and some patients may need to undergo CT or MRI scans. Crohn's disease is usually treated with medications that reduce inflammation or suppress the immune system, and surgery to remove damaged tissue may be necessary. Patients are often advised to take calcium and vitamin D supplements since they are at an increased risk of osteoporosis.

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Certain Medications

Patients who take certain medications may be at a higher risk of a vitamin D deficiency. Several anticonvulsants, including carbamazepine, phenytoin, oxcarbazepine, and phenobarbital, are known to reduce vitamin D levels in the blood. These medications may be used to treat seizures, bipolar disorder, migraines, and trigeminal neuralgia. Patients who use the antibiotics rifampin and isoniazid to treat tuberculosis are also at an increased risk of lower vitamin D. In addition, medications used in the treatment of HIV and AIDS can impact vitamin D levels. Protease inhibitors and non-nucleoside reverse transcriptase inhibitors are two classes of HIV and AIDS drugs that are known to reduce vitamin D. All of these medicines interfere with vitamin D by turning on a liver enzyme called P450. This enzyme breaks active vitamin D down into inactive components. Patients who take these medicines should ask their doctor about whether they need to have regular blood tests to monitor their vitamin D levels, and they should also ask about how much vitamin D they need to take each day. It may be useful to ask whether there are any alternative medications for the patient's condition that are not associated with a reduction in vitamin D.

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