A Cross-Sectional Study on the Clinical Presentation of Vitamin D Deficiency at a Family Medicine Specialist Center in Kenya

Abstract

Background and Aims: The pandemic of vitamin D deficiency bears many an enigma. Clinically, many a primary care clinician prescribes vitamin D to
anyone suspect of the deficiency, whilst the exact range of symptoms associated with the deficiency is yet to be fully defined. Newly associated symptoms have been proposed, and the most clinically relevant normal reference range for the deficiency and insufficiency of the vitamin is a question that is yet to be satisfactorily answered in the Kenyan population. The local populations with higher risk despite sunlight exposure is an additional question that warrants further looking into.

Method: Considering the above we conducted a cross-sectional study at a family medicine specialty center in Nairobi over a period of 3 months from 15th April 2023 to 15th July 2021, and the clinical findings of newly proposed symptoms by family physicians to be associated with vitamin D deficiency were correlated to the respective serum vitamin D levels in 168 patients with informed consent. They were then called in 3 months after supplementation to confirm resolution of symptoms through Vitamin D supplementation.

Results: Overall deficiency prevalence was 37%. It was a female-dominated study representing mainly the African and Indian-Asian ethnicity. Symptoms strongly associated were undue fatigue, bowel irregularities, hormone imbalance, myalgia, and arthralgia. Urolithiasis had a weaker association and mood disorders were not associated significantly. Most associations persisted till around the serum level of 75 ng/ml, thereby implying higher optimal levels of vitamin D rather than the current globally accepted reference range.

Definitions: For Vitamin D, 30ng/ml is equivalent to 75 nmol/L