Overview
Vitamin D holds a special position among vitamins: the body produces most of it itself when sunlight reaches the skin. In Germany, the intensity of sunlight from October to March is usually insufficient for this, which is why low vitamin D levels are widespread in this country. A deficiency develops gradually and often goes unnoticed for a long time; possible consequences include tiredness, muscle weakness and, in the long term, reduced bone stability. Whether a deficiency is actually present can only be reliably determined by a blood test of the 25-OH vitamin D value. In an OpenClinic24 video consultation, you can have your existing laboratory value assessed by a doctor. Following the doctor's assessment, a private prescription for a prescription-only high-dose vitamin D preparation can be issued – with no waiting room and no physical examination required. Billing is transparent and based on the German medical fee schedule (GOÄ) for privately insured and self-paying patients. This makes the consultation a particularly straightforward option for prevention and follow-up monitoring.
Common causes
By far the most common cause of vitamin D deficiency is too little sunlight on uncovered skin. Those particularly affected include people who work mainly indoors, older people whose skin produces less vitamin D, and people with darker skin types living at northern latitudes. Consistent sun protection and clothing that covers the body also reduce the body's own production. Dietary intake can only cover the requirement to a limited extent, as only a few foods – such as oily sea fish or egg yolk – contain significant amounts. Less frequently, medical causes are involved: chronic gastrointestinal diseases with impaired fat absorption, pronounced obesity, liver or kidney disease, and certain medications, for example some anti-epileptic drugs. In these cases, further medical evaluation is advisable, as simply taking a preparation is then often not sufficient.
When to see a doctor
A medical consultation is advisable if a laboratory result shows a low vitamin D level, or if you have persistent complaints such as pronounced tiredness, muscle weakness or recurrent infections for which no other explanation can be found. You should also seek medical advice before taking high-dose preparations, as vitamin D can be overdosed. Warning signs that go beyond a purely preventive question and should be evaluated promptly in a practice include unintended weight loss, persistent bone pain, fractures without an apparent cause, or pronounced muscle weakness with unsteady gait. If impaired consciousness, seizures, cardiac arrhythmias or signs of paralysis occur, this may be an emergency – in that case, call the emergency number 112 immediately. Such situations do not belong in a video consultation, but in emergency care.