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D-vitaminbrist

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Definition:
D-vitaminbrist är 25-hydroxyvitamin D lägre än <25 nmol/L. 25-hydroxyvitamin mellan 25–50 nmol/L kallas för D-vitamininsufficiens. D-vitaminbrist beror på för lite solexponering och/eller för lågt intag av D-vitamin.
Förekomst:
Oklar förekomst i Sverige. Riskgrupper är bland annat mörkhyade boende i Skandinavien och äldre personer med lite utomhusvistelse.
Symtom:
Långvarig D-vitaminbrist kan ge trötthet, muskelsvaghet, bensmärtor och osteomalaci hos vuxna eller rakit hos barn.
Kliniska fynd:
Kliniska fynd kan vara minskad muskelkraft i benen.
Diagnostik:
Mätning av 25-hydroxyvitamin D i serum eller plasma.
Behandling:
Förebyggande behandling är solexponering under sommarhalvåret och intag av D-vitamin via kosten (fet fisk och D-vitaminberikade livsmedel). D-vitamin tillskott bör tas av vissa riskgrupper. Peroralt D-vitamin ges allltid vid D-vitaminbrist, men även vid D-vitamininsufficiens om symtom och/eller påverkad biokemi (hypokalcemi, högt P/S-PTH och S/P-ALP) finns. Eventuellt kalciumtillskott.
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  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet

Tidigare sakkunniga

  • Maria Sääf, med dr och överläkare, Kliniken för endokrinologi, metabolism och diabetes, Karolinska universitetssjukhuset
  • Åke Rundgren, docent och överläkare, Enheten för geriatrik, Göteborgs universitet