Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
Advertisement
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
Letters

Vitamin D deficiency

Sally Hull
British Journal of General Practice 2007; 57 (543): 836-837.
Sally Hull
Institute of Health Sciences, Barts and the London. E-mail:
Roles: Senior Clinical Lecturer
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: s.a.hull@qmul.ac.uk
  • Article
  • Figures & Data
  • Info
  • eLetters
  • PDF
Loading

The paper by Mytton, et al,1 rightly points to the growing recognition of vitamin D deficiency in the UK, particularly among black and ethnic minority groups. Their study looked at patients with abnormal vitamin D levels, finding high rates of deficiency and musculoskeletal symptoms among Somali populations. They did not include data on clinical follow up, and so causality should not be assumed. There is a very poor correlation between vitamin deficiency and musculoskeletal symptoms, and both conditions are common among adult populations. Our east London practice (population 10 000, 30% from Bangladesh) audited all vitamin D levels taken over an 18-month period (Table 1). The majority of requests were made in response to symptomatic aches and pains, 86% of tests were in women. Results showed deficiency in 50% or more of tests in black and Asian groups, falling to 25% in white groups.

View this table:
  • View inline
  • View popup
Table 1

Ethnicity and age in 257 consecutive Vitamin D levels (2006–2007).

These results draw attention to a number of unresolved problems in testing and treatment. There is continuing debate about the definition of deficiency, insufficiency and replete levels of vitamin D. For example, the Drug and Therapeutics Bulletin quotes <25 nmol/l as deficiency (<10 mcg/l), 30–50 nmol/l as insufficiency, and >50 nmol/l (20 mcg/l) as sufficiency.2 Our local laboratory sets the value for sufficiency considerably higher at 75 nmol/l, with a consequent increase in caseness. But there is no published data to show that long-term health is improved by giving supplements to keep the serum levels at 50 nmol or higher.

Treatment of dietary deficiency remains problematic. As Lambert reports in response to Myttons' study, compliance with oral medication is low due to the unpalatable nature of vitamin D in combination with calcium.3 However, it seems perverse to resort to injections; with the consequence of blood monitoring requirements, over medicalisation, and workload implications for practices.

For such a common and preventable condition, with a health burden which falls disproportionately on inner urban deprived populations, the NHS needs to make a coherent policy response. This should include the re-introduction of freely available vitamin drops for children and mothers, and the production of suitable, and palatable, vitamin D preparations without calcium. What about a new 1000 IU ergocalciferol tablet, safe for daily use without blood monitoring? Extrapolation from our audit suggests a large and growing market for such preparations, which should be commissioned from drug companies by the NHS.

  • © British Journal of General Practice, 2007.

REFERENCES

  1. ↵
    1. Mytton J,
    2. Frater AP,
    3. Oakley G,
    4. et al.
    (2007) Vitamin D deficiency in multicultural primary care: a case series of 299 patients. Br J Gen Pract 57(540):577–579.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    (2006) Primary vitamin D deficiency in adults. Drugs and Therapeutics Bulletin 44(4):26–29, Anonymous.
    OpenUrl
  3. ↵
    1. Lambert J
    (2007) Vitamin D deficiency. Br J Gen Pract 57(541):669.
    OpenUrlFREE Full Text
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 57 (543)
British Journal of General Practice
Vol. 57, Issue 543
October 2007
  • Table of Contents
  • Index by author
Download PDF
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Vitamin D deficiency
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Vitamin D deficiency
Sally Hull
British Journal of General Practice 2007; 57 (543): 836-837.

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Vitamin D deficiency
Sally Hull
British Journal of General Practice 2007; 57 (543): 836-837.
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • REFERENCES
  • Figures & Data
  • Info
  • eLetters
  • PDF

More in this TOC Section

  • Identifying patients at risk of psychosis
  • It wasn’t always rosy …
  • Safety netting and follow-up (of babies’ eyes)
Show more Letters

Related Articles

Cited By...

Advertisement

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers
  • RCGP e-Portfolio

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7679
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2021 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242