Vitamin D Deficiency

Overview

Vitamin D deficiency is extremely common in refugees, particularly those from tropical countries who have recently arrived in Canada, and those who wear covering clothing.

Screening

We do not routinely screen asymptomatic refugees for vitamin D deficiency. However, testing should be considered in:

• Patients with symptoms (bone pain, muscle weakness)
• Patients with risk factors for severe deficiency
• Pregnant and breastfeeding women

Risk Factors

• Dark skin pigmentation
• Covering clothing
• Limited sun exposure
• Northern latitude residence
• Obesity

Treatment

Deficiency (<30 nmol/L)

• Vitamin D3 2000-4000 IU daily, or
• 50,000 IU weekly for 8-12 weeks, then maintenance

Insufficiency (30-50 nmol/L)

• Vitamin D3 1000-2000 IU daily

Maintenance

Most refugees will benefit from ongoing supplementation of 1000-2000 IU daily, especially during winter months.