Vitamin D is essential for healthy bones, muscles and many other normal functions in the body. Yet vitamin D deficiency can be difficult to recognise because some people have no obvious symptoms at all.
Others may experience problems such as tiredness, muscle weakness, muscle aches or bone pain. Unfortunately, these symptoms can also occur with many other health conditions, which means symptoms alone cannot confirm that you have low vitamin D.
Your body can obtain vitamin D from sunlight exposure, certain foods and supplements. However, factors including limited sunlight, darker skin, older age, problems absorbing nutrients and certain medical conditions can increase the likelihood of deficiency.
The most reliable way to determine your vitamin D status when testing is appropriate is through a blood test.
Here are important signs, symptoms and risk factors to understand — and what you should do if you think your vitamin D level may be too low.
Related reading: Why Am I Always Tired? 15 Common Causes of Fatigue and When to See a Doctor
What Is Vitamin D Deficiency?
Vitamin D deficiency means that your body does not have enough vitamin D to support its normal requirements.
One of vitamin D's best-established functions is helping your body absorb calcium and supporting healthy bones.
Long-term or severe deficiency can contribute to osteomalacia, a condition in which bones become soft and weak in adults. In children, severe vitamin D deficiency can cause rickets.
Vitamin D is unusual because your body can produce it when your skin is exposed to sunlight. It can also be obtained from foods and supplements.
Deficiency can develop when vitamin D intake or production is insufficient, when absorption is impaired or when certain health conditions interfere with the way the body processes vitamin D.
10 Possible Signs and Symptoms of Vitamin D Deficiency
Not everyone with vitamin D deficiency develops symptoms.
When symptoms do occur, they can be vague and easily mistaken for other problems.
1. Fatigue
Feeling unusually tired can occur with vitamin D deficiency.
However, fatigue is extremely common and can have many other causes, including insufficient sleep, anaemia, thyroid problems, infections, stress and other medical conditions.
Therefore, tiredness alone should not be interpreted as proof of vitamin D deficiency.
2. Muscle Weakness
Vitamin D plays an important role in normal muscle and bone health.
Severe deficiency can be associated with muscle weakness.
You might notice difficulty with activities that previously felt easier, although muscle weakness has many possible causes and deserves medical assessment if it is persistent or worsening.
3. Muscle Aches
Some people with low vitamin D experience aching or uncomfortable muscles.
Again, muscle pain is not specific to vitamin D deficiency. Exercise, injuries, infections, medications and numerous medical conditions can produce similar symptoms.
4. Muscle Cramps
Muscle cramps may occur in people with significant vitamin D deficiency, particularly when mineral balance is also affected.
Persistent or severe cramping should not simply be treated with vitamin supplements without investigating the cause.
5. Bone Pain
Vitamin D helps the body absorb calcium and maintain healthy bones.
Severe or prolonged deficiency can result in weakened bones and bone discomfort.
Bone pain that persists or occurs without an obvious explanation should be professionally assessed.
6. Lower Back or Skeletal Discomfort
Because significant vitamin D deficiency can affect bone health, some people may experience general skeletal discomfort.
However, back pain is extremely common and usually cannot be attributed to vitamin D based on symptoms alone.
7. Difficulty With Physical Strength
Muscle weakness and discomfort can sometimes make everyday physical activities more difficult.
Someone with significant deficiency may notice reduced physical strength, but this symptom also occurs with numerous other health conditions.
8. Mood Changes
Mood changes have sometimes been reported among people with vitamin D deficiency.
However, feeling low or experiencing depression should never automatically be attributed to vitamin D.
Mental health conditions are complex and may require appropriate professional support and treatment.
9. Weak or Soft Bones
Long-term severe vitamin D deficiency can cause osteomalacia in adults.
Osteomalacia causes bones to become softer and weaker than normal and may lead to bone pain and muscle weakness.
10. No Symptoms at All
This is one of the most important points about vitamin D deficiency.
You can have low vitamin D without feeling noticeably unwell.
For that reason, trying to diagnose deficiency from an online symptom checklist is unreliable.
Whether testing is appropriate depends on your symptoms, health conditions and risk factors.
Who Is More Likely to Develop Vitamin D Deficiency?
Anyone can develop vitamin D deficiency, but some people have a greater risk.
Risk factors can include:
- Limited exposure to sunlight
- Darker skin
- Older age
- Spending most of your time indoors
- Wearing clothing that covers most of the skin
- Certain digestive conditions that reduce nutrient absorption
- Obesity
- Previous gastric bypass or some other weight-loss surgeries
- Certain kidney or liver conditions
- Some medications
Having one of these risk factors does not automatically mean that you are deficient.
It simply means that discussing your individual risk with a healthcare professional may be worthwhile.
Why Does Darker Skin Increase the Risk?
Melanin is the pigment that gives skin its colour.
Higher levels of melanin reduce the skin's ability to produce vitamin D from the same amount of sunlight exposure.
As a result, people with darker skin may have a greater risk of low vitamin D, particularly when combined with limited sunlight exposure.
This does not mean people with darker skin should deliberately expose themselves to unsafe amounts of ultraviolet radiation.
Sun exposure also contributes to skin damage and skin cancer risk, so vitamin D needs should be balanced with appropriate sun-safety practices.
Can You Get Enough Vitamin D From Food?
Relatively few foods naturally contain large amounts of vitamin D.
Food sources can include:
- Fatty fish such as salmon, sardines, trout and mackerel
- Egg yolks
- Some mushrooms
- Certain fortified foods
- Fortified dairy products
- Fortified plant-based drinks
- Some fortified breakfast cereals
The availability of fortified foods differs between countries, so check food labels where appropriate.
A varied diet can contribute to vitamin D intake, but food alone may not provide enough for everyone.
Related reading: How Much Protein Do You Need a Day? Protein Needs by Age, Weight and Activity Level
What About Sunlight?
Your skin can produce vitamin D when exposed to ultraviolet B radiation from sunlight.
However, the amount produced varies considerably according to factors including:
- Where you live
- Season
- Time of day
- Skin pigmentation
- Age
- Clothing
- Time spent outdoors
- Weather and atmospheric conditions
This means there is no single amount of sunlight that can safely guarantee adequate vitamin D for every person around the world.
Excessive ultraviolet exposure increases the risk of skin damage and skin cancer.
Therefore, trying to treat suspected vitamin D deficiency through prolonged unprotected sun exposure is not a good substitute for appropriate medical advice.
How Is Vitamin D Deficiency Diagnosed?
When testing is medically appropriate, vitamin D status is generally assessed using a blood test measuring 25-hydroxyvitamin D, commonly written as 25(OH)D.
A healthcare professional can interpret the result alongside your health history and circumstances.
Not everyone needs routine vitamin D testing.
Testing may be considered when someone has symptoms, medical conditions or risk factors that make deficiency more likely.
Should You Take a Vitamin D Supplement?
Vitamin D supplements can be useful when someone is not obtaining enough vitamin D or when deficiency has been identified.
However, the appropriate amount is not necessarily the same for everyone.
Requirements can vary according to factors including:
- Age
- Current vitamin D level
- Diet
- Sun exposure
- Pregnancy
- Medical conditions
- Problems absorbing nutrients
- Certain medications
If you believe you may be deficient, particularly if you have an underlying medical condition, discuss supplementation with an appropriate healthcare professional.
Vitamin D2 vs Vitamin D3: What's the Difference?
The two major supplemental forms are:
Vitamin D2 — ergocalciferol
and
Vitamin D3 — cholecalciferol
Both can increase vitamin D levels.
Vitamin D3 is widely used in supplements, but the best form and dose for an individual depends on the circumstances.
The presence of “D3” on an expensive supplement bottle does not automatically make it necessary or appropriate for everyone.
Can You Take Too Much Vitamin D?
Yes.
Although vitamin D deficiency receives considerable attention online, too much vitamin D can also be harmful.
Vitamin D is fat-soluble, meaning excessive supplemental amounts can accumulate in the body.
Vitamin D toxicity can lead to excessively high calcium levels in the blood.
Possible symptoms can include:
- Nausea
- Vomiting
- Poor appetite
- Constipation
- Increased thirst
- Frequent urination
- Weakness
- Confusion
Severe toxicity can cause serious health complications.
Vitamin D toxicity is generally associated with excessive supplementation rather than normal sunlight exposure.
This is why taking very large doses simply because you believe “more is better” can be dangerous.
Can Vitamin D Deficiency Cause Tiredness?
Vitamin D deficiency can be associated with fatigue, but tiredness is a very nonspecific symptom.
Other common possibilities include:
- Poor-quality sleep
- Sleep apnoea
- Anaemia
- Iron deficiency
- Vitamin B12 deficiency
- Thyroid disorders
- Infections
- Depression
- Certain medications
- Other medical conditions
If you are constantly tired despite adequate rest, don't assume vitamin D is automatically responsible.
Related reading: Why Am I Always Tired? 15 Common Causes of Fatigue and When to See a Doctor
Can Vitamin D Deficiency Cause Hair Loss?
Some types of hair loss have been studied in relation to vitamin D status, but hair loss has numerous possible causes.
These include genetics, hormonal changes, iron deficiency, thyroid disease, autoimmune conditions, significant weight loss, medications and physical or emotional stress.
Hair loss therefore should not be used by itself to diagnose vitamin D deficiency.
Related reading: GLP-1 Hair Loss: Why It Happens, How Long It Lasts and What You Can Do
Can Vitamin D Deficiency Cause Weight Gain?
The relationship between vitamin D and body weight is complicated.
People with obesity are more likely to have lower measured vitamin D levels, but this does not mean that vitamin D deficiency is necessarily the cause of weight gain.
Taking vitamin D should not be promoted as a weight-loss treatment unless there is another medically appropriate reason for supplementation.
How Can You Reduce Your Risk of Vitamin D Deficiency?
Depending on your circumstances, maintaining adequate vitamin D may involve a combination of:
- Eating foods containing vitamin D
- Choosing appropriately fortified foods
- Spending appropriate time outdoors while considering sun safety
- Taking a suitable supplement when recommended
- Managing medical conditions that affect nutrient absorption
- Discussing risk factors with a healthcare professional
The best approach depends on where you live, your diet, skin type, age and health.
When Should You Speak to a Healthcare Professional?
Consider seeking medical advice if you have persistent symptoms that could indicate a nutritional or medical problem, particularly if you also have risk factors for vitamin D deficiency.
Professional advice is particularly useful if:
- You have persistent bone pain
- You have unexplained muscle weakness
- You have frequent fractures
- You have a condition affecting nutrient absorption
- You have kidney or liver disease
- You have undergone certain types of weight-loss surgery
- You take medications that can affect vitamin D
- You are considering taking high-dose vitamin D
- You have symptoms that continue despite lifestyle changes
Do not assume unexplained symptoms are caused by a vitamin deficiency without appropriate assessment.
Frequently Asked Questions
What Are the Most Common Symptoms of Vitamin D Deficiency?
Many people experience no obvious symptoms. When symptoms occur, they may include fatigue, bone pain, muscle weakness, muscle aches or cramps.
Because these symptoms have many possible causes, they cannot confirm deficiency by themselves.
How Do I Know If My Vitamin D Is Low?
When testing is appropriate, a blood test measuring 25-hydroxyvitamin D can assess vitamin D status.
A healthcare professional can determine whether testing is appropriate and interpret the result.
Can I Have Vitamin D Deficiency Without Symptoms?
Yes.
Some people with low vitamin D do not notice any obvious symptoms.
Does Vitamin D Help Your Immune System?
Vitamin D participates in normal immune function, but that does not mean taking increasingly large doses will make your immune system progressively stronger.
Adequate nutrition is important; excessive supplementation is not automatically beneficial.
Can Vitamin D Deficiency Affect Your Bones?
Yes.
Severe or prolonged vitamin D deficiency can impair bone mineralisation. In adults, this can result in osteomalacia, while severe deficiency in children can cause rickets.
Can I Get Too Much Vitamin D From Sunlight?
The body regulates vitamin D production from sunlight, so vitamin D toxicity does not generally result from sun exposure.
However, excessive ultraviolet exposure can damage the skin and increase skin-cancer risk.
Should Everyone Take Vitamin D?
Recommendations vary between countries and according to individual circumstances.
Age, diet, sunlight exposure, skin pigmentation, pregnancy and medical conditions can influence requirements.
Follow appropriate health guidance for where you live and discuss individual concerns with a healthcare professional.
The Bottom Line
Vitamin D plays a crucial role in maintaining healthy bones and muscles, but deficiency can be surprisingly difficult to recognise.
Possible symptoms include fatigue, bone pain, muscle weakness, aches and cramps — yet many people with low vitamin D have no noticeable symptoms at all.
People with limited sunlight exposure, darker skin, older age, certain digestive conditions, obesity and some other health conditions may have an increased risk.
The important message is not to diagnose yourself from symptoms or start taking extremely high-dose supplements.
If you have persistent symptoms or significant risk factors, speak with an appropriate healthcare professional about whether vitamin D testing or supplementation is suitable for you.
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Sources and Further Reading
National Institutes of Health Office of Dietary Supplements — Vitamin D Fact Sheet
https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
National Institutes of Health Office of Dietary Supplements — Vitamin D Consumer Information
https://ods.od.nih.gov/factsheets/VitaminD-Consumer/
Cleveland Clinic — Vitamin D Deficiency
https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency
MedlinePlus — Vitamin D Deficiency
https://medlineplus.gov/vitaminddeficiency.html
Medical Disclaimer
This article is for general educational and informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Speak with an appropriate healthcare professional before using high-dose vitamin D supplements or changing treatment for a medical condition.
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