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8 Ways to Tell if You Are Vitamin D Deficient

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By Franziska Spritzler

Vitamin D is an extremely important vitamin that has powerful effects on several systems throughout the body (1).

Unlike most vitamins, vitamin D actually functions like a hormone and every single cell in your body has a receptor for it.

Your body makes it from cholesterol when your skin is exposed to sunlight.

Vitamin D is an extremely important vitamin that has powerful effects on several systems throughout the body.iStock

It's also found in certain foods such as fatty fish and fortified dairy products, although it's very difficult to get enough from diet alone.

The recommended daily intake is usually around 400-800 IU, but many experts say you should get even more than that.

Vitamin D deficiency is very common. It's estimated that about 1 billion people worldwide have low levels of the vitamin in their blood (2).

According to a 2011 study, 41.6 percent of adults in the U.S. are deficient. This number goes up to 69.2 percent in Hispanics and 82.1 percent in African-Americans (3).

These are common risk factors for vitamin D deficiency:

  • Having dark skin.
  • Being elderly.
  • Being overweight or obese.
  • Not eating much fish or milk.
  • Living far from the equator where there is little sun year-round.
  • Always using sunscreen when going out.
  • Staying indoors.

People who live near the equator and get frequent sun exposure are less likely to be deficient, because their skin produces enough vitamin D to satisfy the body's needs.

Most people don't realize that they are deficient, because the symptoms are generally subtle. You may not notice them easily, even if they are having a significant negative effect on your quality of life.

Here are eight signs and symptoms of vitamin D deficiency.

1. Getting Sick or Infected Often

One of vitamin D's most important roles is keeping your immune system strong so you're able to fight off the viruses and bacteria that cause illness.

It directly interacts with the cells that are responsible for fighting infection (4).

If you become sick often, especially with colds or the flu, low vitamin D levels may be a contributing factor.

Several large observational studies have shown a link between a deficiency and respiratory tract infections like colds, bronchitis and pneumonia (5, 6).

A number of studies have found that taking vitamin D supplements at dosages of up to 4,000 IU daily may reduce the risk of respiratory tract infections (7, 8, 9).

In one study of people with the chronic lung disorder COPD, only those who were severely deficient in vitamin D experienced a significant benefit after taking a high-dose supplement for one year (10).

Bottom Line: Vitamin D plays important roles in immune function. One of the most common symptoms of deficiency is an increased risk of illness or infections.

2. Fatigue and Tiredness

Feeling tired can have many causes and vitamin D deficiency may be one of them.

Unfortunately, it's often overlooked as a potential cause.

Case studies have shown that very low blood levels can cause fatigue that has a severe negative effect on quality of life (11, 12).

In one case, a woman who complained of chronic daytime fatigue and headaches was found to have a blood level of only 5.9 ng/ml. This is extremely low, as anything under 20 ng/ml is considered to be deficient.

When the woman took a vitamin D supplement, her level increased to 39 ng/ml and her symptoms resolved (12).

However, even blood levels that aren't extremely low may have a negative impact on energy levels.

A large observational study looked at the relationship between vitamin D and fatigue in young women.

The study found that women with blood levels under 20 ng/ml or 21–29 ng/ml were more likely to complain of fatigue than those with blood levels over 30 ng/ml (13).

Another observational study of female nurses found a strong connection between low vitamin D levels and self-reported fatigue.

What's more, the researchers found that 89 percent of the nurses were deficient (14).

Bottom Line: Excessive fatigue and tiredness may be a sign of vitamin D deficiency. Taking supplements may help improve energy levels.

3. Bone and Back Pain

Vitamin D is involved in maintaining bone health through a number of mechanisms.

For one, it improves your body's absorption of calcium.

Bone pain and lower back pain may be signs of inadequate vitamin D levels in the blood.

Large observational studies have found a relationship between a deficiency and chronic lower back pain (15, 16, 17).

One study examined the association between vitamin D levels and back pain in more than 9,000 older women.

The researchers found that those with a deficiency were more likely to have back pain, including severe back pain that limited their daily activities (17).

In one controlled study, people with vitamin D deficiency were nearly twice as likely to experience bone pain in their legs, ribs or joints compared to those with blood levels in the normal range (18).

Bottom Line: Low blood levels of the vitamin may be a cause or contributing factor to bone pain and lower back pain.

4. Depression

A depressed mood may also be a sign of deficiency.

In review studies, researchers have linked vitamin D deficiency to depression, particularly in older adults (19, 20).

In one analysis, 65 percent of the observational studies found a relationship between low blood levels and depression.

On the other hand, most of the controlled trials, which carry more scientific weight than observational studies, didn't show a link between the two (19).

However, the researchers who analyzed the studies noted that the dosages of vitamin D in controlled studies were often very low.

In addition, they noted that some of the studies may not have lasted long enough to see the effect of taking supplements on mood.

Some controlled studies have shown that giving vitamin D to people who are deficient helps improve depression, including seasonal depression that occurs during the colder months (21, 22).

Bottom Line: Depression is associated with low vitamin D levels and some studies have found that supplementing improves mood.

5. Impaired Wound Healing

Slow healing of wounds after surgery or injury may be a sign that vitamin D levels are too low.

Results from a test-tube study suggest that the vitamin increases production of compounds that are crucial for forming new skin as part of the wound-healing process (23).

One study on patients who had dental surgery found that certain aspects of healing were compromised by vitamin D deficiency (24).

It's also been suggested that vitamin D's role in controlling inflammation and fighting infection is important for proper healing.

One analysis looked at patients with diabetic foot infections.

It found that those with severe vitamin D deficiency were more likely to have higher levels of inflammatory markers that can jeopardize healing (25).

Unfortunately, at this point there is very little research about the effects of vitamin D supplements on wound healing in people with deficiency.

However, one study found that when vitamin D deficient patients with leg ulcers were treated with the vitamin, ulcer size reduced by 28 percent, on average (26).

Bottom Line: Inadequate vitamin D levels may lead to poor wound healing following surgery, injury or infection.

6. Bone Loss

Vitamin D plays a crucial role in calcium absorption and bone metabolism.

Many older women who are diagnosed with bone loss believe they need to take more calcium. However, they may be deficient in vitamin D as well.

Low bone mineral density is an indication that calcium and other minerals have been lost from bone. This places older people, especially women, at an increased risk of fractures.

In a large observational study of more than 1,100 middle-aged women in menopause or postmenopause, researchers found a strong link between low vitamin D levels and low bone mineral density (27).

However, a controlled study found that women who were vitamin D deficient experienced no improvement in bone mineral density when they took high-dose supplements, even if their blood levels improved (28).

Regardless of these findings, adequate vitamin D intake and maintaining blood levels within the optimal range may be a good strategy for protecting bone mass and reducing fracture risk.

Bottom Line: A diagnosis of low bone mineral density may be a sign of vitamin D deficiency. Getting enough of this vitamin is important for preserving bone mass as you get older.

7. Hair Loss

Hair loss is often attributed to stress, which is certainly a common cause.

However, when hair loss is severe, it may be the result of a disease or nutrient deficiency.

Hair loss in women has been linked to low vitamin D levels, although there is very little research on this so far (29).

Alopecia areata is an autoimmune disease characterized by severe hair loss from the head and other parts of the body. It's associated with rickets, which is a disease that causes soft bones in children due to vitamin D deficiency (30).

Low vitamin D levels are linked to alopecia areata and may be a risk factor for developing the disease (31, 32, 33).

One study in people with alopecia areata showed that lower blood levels tended to be associated with a more severe hair loss (33).

In a case study, topical application of a synthetic form of the vitamin was found to successfully treat hair loss in a young boy with a defect in the vitamin D receptor (34).

Bottom Line: Hair loss may be a sign of vitamin D deficiency in female-pattern hair loss or the autoimmune condition alopecia areata.

8. Muscle Pain

The causes of muscle pain are often difficult to pinpoint.

There is some evidence that vitamin D deficiency may be a potential cause of muscle pain in children and adults (35, 36, 37).

In one study, 71 percent of people with chronic pain were found to be deficient (37).

The vitamin D receptor is present in nerve cells called nociceptors, which sense pain.

One study in rats showed that a deficiency led to pain and sensitivity due to stimulation of nociceptors in muscles (38).

A few studies have found that taking high-dose vitamin D supplements may reduce various types of pain in people who are deficient (39, 40).

One study in 120 children with vitamin D deficiency who had growing pains found that a single dose of the vitamin reduced pain scores by an average of 57 percent (40).

Bottom Line: There is a link between chronic pain and low blood levels of the vitamin, which may be due to the interaction between the vitamin and pain-sensing nerve cells.

Correcting a Vitamin D Deficiency is Simple

Vitamin D deficiency is incredibly common and most people are unaware of it.

That's because the symptoms are often subtle and non-specific, meaning that it's hard to know if they're caused by low vitamin D levels or something else.

If you think you may have a deficiency, then it's important that you speak to your doctor and get your blood levels measured.

Fortunately, a vitamin D deficiency is usually easy to fix. You can either increase your sun exposure, eat more vitamin D rich foods or simply take a supplement.

Fixing your deficiency is simple, easy and can have big benefits for your health.

Reposted with permission from our media associate Authority Nutrition.

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Ola Elvestrun, Norway's environment minister, announced Thursday that it is freezing its contributions to the Amazon Fund, and will no longer be transferring €300 million ($33.2 million) to Brazil. In a press release, the Norwegian embassy in Brazil stated:

Given the present circumstances, Norway does not have either the legal or the technical basis for making its annual contribution to the Amazon Fund.

Brazilian President Jair Bolsonaro reacted with sarcasm to Norway's decision, which had been widely expected. After an official event, he commented: "Isn't Norway the country that kills whales at the North Pole? Doesn't it also produce oil? It has no basis for telling us what to do. It should give the money to Angela Merkel [the German Chancellor] to reforest Germany."

According to its website, the Amazon Fund is a "REDD+ mechanism created to raise donations for non-reimbursable investments in efforts to prevent, monitor and combat deforestation, as well as to promote the preservation and sustainable use in the Brazilian Amazon." The bulk of funding comes from Norway and Germany.

The annual transfer of funds from developed world donors to the Amazon Fund depends on a report from the Fund's technical committee. This committee meets after the National Institute of Space Research, which gathers official Amazon deforestation data, publishes its annual report with the definitive figures for deforestation in the previous year.

But this year the Amazon Fund's technical committee, along with its steering committee, COFA, were abolished by the Bolsonaro government on 11 April as part of a sweeping move to dissolve some 600 bodies, most of which had NGO involvement. The Bolsonaro government views NGO work in Brazil as a conspiracy to undermine Brazil's sovereignty.

The Brazilian government then demanded far-reaching changes in the way the fund is managed, as documented in a previous article. As a result, the Amazon Fund's technical committee has been unable to meet; Norway says it therefore cannot continue making donations without a favorable report from the committee.

Archer Daniels Midland soy silos in Mato Grosso along the BR-163 highway, where Amazon rainforest has largely been replaced by soy destined for the EU, UK, China and other international markets.

Thaís Borges.

An Uncertain Future

The Amazon Fund was announced during the 2007 United Nations Climate Change Conference in Bali, during a period when environmentalists were alarmed at the rocketing rate of deforestation in the Brazilian Amazon. It was created as a way of encouraging Brazil to continue bringing down the rate of forest conversion to pastures and croplands.

Government agencies, such as IBAMA, Brazil's environmental agency, and NGOs shared Amazon Fund donations. IBAMA used the money primarily to enforce deforestation laws, while the NGOs oversaw projects to support sustainable communities and livelihoods in the Amazon.

There has been some controversy as to whether the Fund has actually achieved its goals: in the three years before the deal, the rate of deforestation fell dramatically but, after money from the Fund started pouring into the Amazon, the rate remained fairly stationary until 2014, when it began to rise once again. But, in general, the international donors have been pleased with the Fund's performance, and until the Bolsonaro government came to office, the program was expected to continue indefinitely.

Norway has been the main donor (94 percent) to the Amazon Fund, followed by Germany (5 percent), and Brazil's state-owned oil company, Petrobrás (1 percent). Over the past 11 years, the Norwegians have made, by far, the biggest contribution: R$3.2 billion ($855 million) out of the total of R$3.4 billion ($903 million).

Up till now the Fund has approved 103 projects, with the dispersal of R$1.8 billion ($478 million). These projects will not be affected by Norway's funding freeze because the donors have already provided the funding and the Brazilian Development Bank is contractually obliged to disburse the money until the end of the projects. But there are another 54 projects, currently being analyzed, whose future is far less secure.

One of the projects left stranded by the dissolution of the Fund's committees is Projeto Frutificar, which should be a three-year project, with a budget of R$29 million ($7.3 million), for the production of açai and cacao by 1,000 small-scale farmers in the states of Amapá and Pará. The project was drawn up by the Brazilian NGO IPAM (Institute of Environmental research in Amazonia).

Paulo Moutinho, an IPAM researcher, told Globo newspaper: "Our program was ready to go when the [Brazilian] government asked for changes in the Fund. It's now stuck in the BNDES. Without funding from Norway, we don't know what will happen to it."

Norway is not the only European nation to be reconsidering the way it funds environmental projects in Brazil. Germany has many environmental projects in the Latin American country, apart from its small contribution to the Amazon Fund, and is deeply concerned about the way the rate of deforestation has been soaring this year.

The German environment ministry told Mongabay that its minister, Svenja Schulze, had decided to put financial support for forest and biodiversity projects in Brazil on hold, with €35 million ($39 million) for various projects now frozen.

The ministry explained why: "The Brazilian government's policy in the Amazon raises doubts whether a consistent reduction in deforestation rates is still being pursued. Only when clarity is restored, can project collaboration be continued."

Bauxite mines in Paragominas, Brazil. The Bolsonaro administration is urging new laws that would allow large-scale mining within Brazil's indigenous reserves.

Hydro / Halvor Molland / Flickr

Alternative Amazon Funding

Although there will certainly be disruption in the short-term as a result of the paralysis in the Amazon Fund, the governors of Brazil's Amazon states, which rely on international funding for their environmental projects, are already scrambling to create alternative channels.

In a press release issued yesterday Helder Barbalho, the governor of Pará, the state with the highest number of projects financed by the Fund, said that he will do all he can to maintain and increase his state partnership with Norway.

Barbalho had announced earlier that his state would be receiving €12.5 million ($11.1 million) to run deforestation monitoring centers in five regions of Pará. Barbalho said: "The state governments' monitoring systems are recording a high level of deforestation in Pará, as in the other Amazon states. The money will be made available to those who want to help [the Pará government reduce deforestation] without this being seen as international intervention."

Amazonas state has funding partnerships with Germany and is negotiating deals with France. "I am talking with countries, mainly European, that are interested in investing in projects in the Amazon," said Amazonas governor Wilson Miranda Lima. "It is important to look at Amazônia, not only from the point of view of conservation, but also — and this is even more important — from the point of view of its citizens. It's impossible to preserve Amazônia if its inhabitants are poor."

Signing of the EU-Mercusor Latin American trading agreement earlier this year. The pact still needs to be ratified.

Council of Hemispheric Affairs

Looming International Difficulties

The Bolsonaro government's perceived reluctance to take effective measures to curb deforestation may in the longer-term lead to a far more serious problem than the paralysis of the Amazon Fund.

In June, the European Union and Mercosur, the South American trade bloc, reached an agreement to create the largest trading bloc in the world. If all goes ahead as planned, the pact would account for a quarter of the world's economy, involving 780 million people, and remove import tariffs on 90 percent of the goods traded between the two blocs. The Brazilian government has predicted that the deal will lead to an increase of almost $100 billion in Brazilian exports, particularly agricultural products, by 2035.

But the huge surge this year in Amazon deforestation is leading some European countries to think twice about ratifying the deal. In an interview with Mongabay, the German environment ministry made it very clear that Germany is very worried about events in the Amazon: "We are deeply concerned given the pace of destruction in Brazil … The Amazon Forest is vital for the atmospheric circulation and considered as one of the tipping points of the climate system."

The ministry stated that, for the trade deal to go ahead, Brazil must carry out its commitment under the Paris Climate agreement to reduce its greenhouse gas emissions by 43 percent below the 2005 level by 2030. The German environment ministry said: If the trade deal is to go ahead, "It is necessary that Brazil is effectively implementing its climate change objectives adopted under the [Paris] Agreement. It is precisely this commitment that is expressly confirmed in the text of the EU-Mercosur Free Trade Agreement."

Blairo Maggi, Brazil agriculture minister under the Temer administration, and a major shareholder in Amaggi, the largest Brazilian-owned commodities trading company, has said very little in public since Bolsonaro came to power; he's been "in a voluntary retreat," as he puts it. But Maggi is so concerned about the damage Bolsonaro's off the cuff remarks and policies are doing to international relationships he decided to speak out earlier this week.

Former Brazil Agriculture Minister Blairo Maggi, who has broken a self-imposed silence to criticize the Bolsonaro government, saying that its rhetoric and policies could threaten Brazil's international commodities trade.

Senado Federal / Visualhunt / CC BY

Maggi, a ruralista who strongly supports agribusiness, told the newspaper, Valor Econômico, that, even if the European Union doesn't get to the point of tearing up a deal that has taken 20 years to negotiate, there could be long delays. "These environmental confusions could create a situation in which the EU says that Brazil isn't sticking to the rules." Maggi speculated. "France doesn't want the deal and perhaps it is taking advantage of the situation to tear it up. Or the deal could take much longer to ratify — three, five years."

Such a delay could have severe repercussions for Brazil's struggling economy which relies heavily on its commodities trade with the EU. Analysists say that Bolsonaro's fears over such an outcome could be one reason for his recently announced October meeting with Chinese President Xi Jinping, another key trading partner.

Maggi is worried about another, even more alarming, potential consequence of Bolsonaro's failure to stem illegal deforestation — Brazil could be hit by a boycott by its foreign customers. "I don't buy this idea that the world needs Brazil … We are only a player and, worse still, replaceable." Maggi warns, "As an exporter, I'm telling you: things are getting very difficult. Brazil has been saying for years that it is possible to produce and preserve, but with this [Bolsonaro administration] rhetoric, we are going back to square one … We could find markets closed to us."

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