Vitamin Deficiencies

Vitamin D is made in the skin from sunlight and is needed to absorb calcium. Deficiency is common in people who spend their days indoors, who cover up, or who have darker skin, and it shows as aching bones, weak thigh muscles and difficulty rising from a chair.

Vitamin B12 comes only from animal foods and needs a healthy stomach lining to be absorbed. It runs low in long-standing vegetarians, in older people, after stomach surgery and in anyone on long-term metformin or acid-suppressing tablets. Its shortage affects the nerves and the blood.

Your doctor asks about diet, sun exposure, gut surgery and the medicines you take, because those answers usually identify which vitamin is likely before any blood is drawn.

The examination looks for bone tenderness and weakness of the hip muscles in suspected vitamin D deficiency, and for loss of vibration and position sense in the feet where B12 is suspected. Levels are then measured, along with calcium and a blood count.

Vitamin D is given as a weekly loading dose for six to eight weeks, and the aches usually ease in the second month. A maintenance dose follows, since the level falls again once loading stops.

B12 given by injection corrects the blood picture within weeks. Nerve symptoms recover more slowly and may not recover completely if they have been present for a long time, which is the reason for not delaying treatment.