Diet and nutrition

Ceitanna Cooper, Registered Associate Nutritionist at AXA Health

Vitamin D deficiency symptoms and supplements

Diet and Nutrition

24 September 2019

 720 x 300 vit d

This article was last reviewed in September 2019 by Ashley Leitner Murphy, a Pharmacist in our Health at Hand team.

Government advice on vitamin D recommends that adults, and children over the age of one, should take a daily vitamin D supplement - 10 micrograms (mcg), particularly in autumn and winter, in order to protect our musculoskeletal health.

But what is vitamin D? What happens if you don’t get enough? And who is most in need of a supplement? Ceitanna Cooper, Registered Associate Nutritionist at AXA Health, has the answers.

Why do we need vitamin D?

“We need vitamin D to help our bodies absorb and use calcium and phosphate from our diet. These minerals are important for healthy bones, teeth and muscles.

While we know it’s important for building strong bones, which can ward off the bone thinning disease osteoporosis, vitamin D has other important roles too, including regulating cell growth, neuromuscular function, reducing inflammation and helping to maintain a healthy immune system.”

What are the symptoms of vitamin D deficiency?

“If you’re lacking vitamin D, this can cause bones to become soft and weak, which can lead to bone deformities. In children, a lack of vitamin D can lead to rickets, which increases the likelihood of broken bones. In adults, it can lead to osteomalacia, which causes bone pain and sensitivity. A low vitamin D level has been associated with muscle pain and weakness. Pain and weakness can be tiring and make you feel low, although there is no evidence as yet that a low vitamin D level is directly associated with low mood or depression ”

Where can I get Vitamin D?

1. Being outside in the sun

“Sunlight, specifically UVB rays, is the best source of vitamin D. In the UK, the sunlight is most effective between late March and September. Over the autumn and winter months, sunlight is too weak to allow our skin to make enough vitamin D, which is why the government advises you take a supplement during this time.

Although there is no prescribed amount of sun exposure to produce the right amount of vitamin D as everyone is different, in the UK, 10 – 15 minutes of sun exposure to your bare skin- particularly to the forearms, hands and lower legs – should l help build up your stores of vitamin D (it’s fat-soluble, so can be stored in fatty tissue), but take care not to burn. Redness is a sign of skin damage.”

“Sitting by a window doesn’t count, as UVB rays can’t penetrate glass.”

Never be tempted to stay in the sun for longer than this without sun protection, as exposure increases the risk of skin damage and cancer.

2. Dietary sources

“Few foods contain vitamin D in sufficient quantities, so it can be difficult to get enough from your diet alone. However, you’ll find small amounts in things like oily fish (e.g. herring, salmon, mackerel, and sardines), liver, and egg yolks. Wild mushrooms are one of the richest sources. It’s also added into foods such as cereals, margarine, reduced fat spreads, milk, and some almond milk products. Look for ‘fortified’ on the label. So these foods should make up part of your balanced diet.”

“If you’re a vegan or strict vegetarian, you are at a higher risk of vitamin D deficiency as most of the foods which naturally contain vitamin D are products of animal origin. Speak to your GP, who can may test your vitamin D levels if you are suffering from symptoms.”

3. Supplements

”You should get sufficient vitamin D by following a healthy, well-balanced diet and by getting regular sun exposure, but the Department of Health recommends taking a daily supplement during winter (including pregnant and breastfeeding women).”

Who is at risk?

“Those at greater risk of not getting enough vitamin D are strongly advised to take a daily vitamin D supplement throughout the year. These include:

  • Small children, from birth to 4 years old
  • Older people, or those who are frail, housebound, or have limited sun exposure
  • People who wear skin concealing clothing
  • People with dark skin who have higher melanin (skin pigment) levels, which slows vitamin D production.
  • People with liver disease, malabsorption disorders, cancer and those needing steroids for treatment

“If you’re concerned you may not be getting enough vitamin D, talk to your pharmacist or GP about your symptoms and consider supplementing your diet with a good-quality vitamin D.”

Further information

If you have a question about your nutritional needs or any other aspect of your health and wellbeing, our Health at Hand team are available to support you, at any time of the day and night. Simply post your question online using our Ask the expert service and one of our team of nurses, midwives and pharmacists will get to you with an answer as soon as they are able to. You’ll usually hear back within a couple of hours but it could take up to 24 hours to respond, depending on the nature of your enquiry and availability of appropriately qualified experts.

Alternatively you can find lots more expert-led information on diet and nutrition, plus recipes that pack a healthy punch in our diet and nutrition hub.

Content referenced in this article includes:

Muscles, bones and joints hub - AXA Health
Boost your bone power! - AXA Health
Osteoporosis - NHS factsheet
Rickets - NHS factsheet
Wise up about skin cancer risks - AXA Health
Thinking of going vegan? Here’s what you need to know – AXA Health
Pregnancy hub - AXA Health


The advice in this article is based on recommendations from the government's Scientific Advisory Committee on Nutrition (SACN) following its review of the evidence on vitamin D and health (PDF, 4.2Mb).

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