Maintain adequate Vitamin D level by Bola Sijuwade, RN, RHIA, CPHRM, BSN, MS

I am a Registered Nurse and I have been in the health care field in both clinical practice and health education for over thirty years.  I am also a registered health information administrator and a certified professional hospital risk manager.  I have a bachelor’s degree in Nursing and health information management and a Master’s degree in Health Care Administration.

About a year ago, for no apparent reason, I started having increasing muscle weakness and muscle pain.  I also had fallen several times because of the muscle weakness in my legs.  After unsuccessful treatment with pain medications, my vitamin D level was checked and was found to be very low.  My physician prescribed Vitamin D replacement and the pain and muscle weakness improved.  Without pain, I was able to enjoy activities of daily living and also able to start exercising on a regular basis

Vitamin D is both a nutrient we eat and a hormone our bodies make.    Calcium and vitamin D have been shown to improve bone density and prevent fractures at all ages.   Vitamin D plays an important role in calcium absorption and bone metabolism.   Vitamin D is directly related to bone mineral density in white, black, and Mexican American men and women.

According to Harvard School of public health, it is estimated that over 1 billion people worldwide have inadequate levels of vitamin D in their blood, and deficiencies can be found in all ethnicities and age groups.

Why do I Need Vitamin D?

Poor vitamin D status affects muscle strength.  Vitamin D deficiency is defined as a 25-hydroxyvitamin D level of less than 20 ng per milliliter (50 nmol per liter).  Adequate vitamin D intake reduces risk for conditions such as stress fracture, total body inflammation, infectious illness, and impaired muscle function.  It also affects musculoskeletal health with increased risk of injuries such as stress fractures.  Vitamin D deficiency may impact training quality, injury and illness frequency and duration and as a result, athletic performance.  Musculoskeletal injury prevention and recovery are potentially affected by sufficient circulating levels of the storage form of vitamin D.

There are two basic types of injuries when discussing sports injury, acute injuries and overuse injuries.  Acute injuries are usually the result of single, traumatic event such as wrist fractures, ankle sprains, shoulder dislocations and hamstring muscle strain.  Overuse injuries are more common in sports than acute injuries, they are subtle and usually overtime, making them challenging to diagnose and treat.

Muscle structure and functions are recognized to play a key role in athletic performance.  There is high risk of injury during gymnastic activities.  Injuries such as stress fractures are of concern.  Stress fractures are small cracks in the bone that typically affect people who do lots of high impact exercise.  Stress fracture are concerning in teen girls because bone strength at that age is tied to the risk of osteoporosis and more serious injuries later in life.

Vitamin D, the “Sunshine Vitamin”

Vitamin D is also known as the “Sunshine Vitamin.”  The body converts sunlight into vitamin D after it hits unprotected skin.  However, be careful to avoid extended exposure to sunlight without sunscreen.   The most common cause of Vitamin D deficiency is inadequate sunlight exposure.   It is recommended that indoor athletes should have their Vitamin D levels measured regularly throughout the year.  They should be advised on appropriate ultraviolet B rays (UVB) exposure.  About 5 to 30 minutes of exposure to sunlight to the skin on the face, arms, back or legs two times every week is enough.

How can I get more Vitamin D Into My Diet?

For all ages, the Institute of Medicine recommends between 400 and 800 IU of Vitamin D per day.  Vitamin D is naturally present in very few foods; therefore, it is added to many foods and it is also available as s dietary supplement.  The best source of Vitamin D is salmon, tuna and mackerel (especially the flesh) and fish liver oils.  Other sources include:

  • Vitamin D fortified Dairy products
  • Cereals
  • Orange juice
  • Soy drinks are fortified with vitamin D
  • Bread


Havard School of Public Health.


Academy of Nutrition and Dietetics