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Vitamin D deficiency FAQs

Vitamin D deficiency does not always have obvious symptoms but without treatment there can be significant health effects. Some people may experience bone and muscle pain, and softening of the bones.

It is important to achieve a good peak bone mass early in life. Vitamin D deficiency can result in a decline in bone density, increasing the risk of:

  • osteoporosis
  • falls and bone fractures (especially for older people)
  • rickets(in infants and children) – a preventable bone disease, and osteomalacia (in adults)
  • Vitamin D deficiency can also be associated with low levels of calcium.

Who is at risk of vitamin D deficiency?

You may be at greater risk of vitamin D deficiency if you:

  • have naturally very dark skin – this is because the pigment (melanin) in dark skin can partially block UV radiation from being absorbed
  • avoid the sun due to previous skin cancers or sensitive skin
  • spend a long time indoors and have limited sun exposure (such as nightshift workers, or those who are housebound or in residential care)
  • wear a covering to conceal your body (such as for religious or cultural reasons)
  • are obese
  • have a disability or condition that affects vitamin D metabolism – such as end stage liver disease, kidney (renal) disease or fat malabsorption syndromes (such as cystic fibrosiscoeliac disease and inflammatory bowel disease)
  • take medication that affects vitamin D absorption
  • are a breastfed baby of a mother who is vitamin D deficient (formula milk is fortified with vitamin D).

If you are at risk of vitamin D deficiency you should seek advice from your GP.

Treating vitamin D deficiency

Treatment options for vitamin D deficiency include improved sunlight exposure, diet, and exercise.

If you are concerned about your vitamin D levels, seek advice from your GP.

Your GP may suggest a blood test to check your vitamin D levels. If you are found to have a deficiency, your doctor may recommend vitamin D supplements, which should be taken strictly as directed.

Your doctor may also give advice on ensuring you have sufficient calcium intake. Once your vitamin D deficiency is treated, the aim is to maintain normal vitamin D levels.

Sources of vitamin D

Vitamin D is important for strong bones, muscles and overall health. Ultraviolet (UV) radiation from the sun is necessary for the production of vitamin D in the skin and is the best natural source of vitamin D.

It is important to have some sun exposure to help with adequate levels of vitamin D, however too much exposure to the sun’s UV radiation can cause skin and eye damage, sunburn and skin cancer.

The body can only absorb a limited amount of vitamin D at a time. Spending extra time in the sun will not increase vitamin D levels but will increase your risk of skin cancer.

Other sources of vitamin D include:

Vitamin D in food

Small amounts of vitamin D can be obtained through food (about 5–10 per cent). However, it is difficult to obtain enough vitamin D from diet alone.

Food sources include:

  • fatty fish(such as salmon)
  • eggs
  • margarine and some milkshave added vitamin D
  • some cereals have added vitamin D.

Sun protection

UV levels vary depending on the time of year, time of day and location. Sun protection is recommended whenever UV levels reach 3 and above. In some parts of Australia, UV levels are 3 and above every day throughout the year. In southern regions, UV levels are usually below 3 during winter months.

During these times use a combination of sun protection measures, including:

  • SPF30 (or higher) broad-spectrum, water-resistant sunscreen
  • a wide-brimmed hat
  • cool, covering clothing
  • sunglasses (labelled AS1067)
  • shade.

UV levels in Victoria

From mid-August to the end of April, average UV levels in Victoria are 3 and above for much of the day so sun protection (clothing, sunscreen, hats, shade and sunglasses) is recommended. During these summer months, most people only need a few minutes outside on most days to absorb sufficient vitamin D.

Sensible sun protection measures should not put people at risk of vitamin D deficiency.

From May to mid-August, average UV levels in Victoria are typically low (below 3). During this time sun protection is not recommended unless you work outdoors, are near highly reflective surfaces (like snow), or are outside for extended periods. During these months, people should spend time outside in the middle of the day with some skin uncovered to maintain vitamin D levels.

Overexposure to UV is never recommended, even for people who have vitamin D deficiency.

Intravenous (IV) iron infusions

Why iron given by a drip into a vein is sometimes needed…
This leaflet answers some common questions about IV iron infusions. It does not contain all available information and does not take the place of talking to your doctor about why IV iron has been recommended in your particular case.

What is an IV iron infusion?

“Intravenous” or “IV” means giving something directly into the blood stream of the body through a vein. A needle placed into a vein (usually in the back of the hand or arm) is attached to a drip that contains iron mixed with saline (a sterile salt water solution). This fluid is slowly “dripped” (infused) into the vein and mixes with the blood in your body.

Why is iron important?

Iron is essential for the body to make haemoglobin (Hb), a pigment that makes red blood cells red. When the amount of iron in the body gets too low, the haemoglobin level falls below normal. This is known as “iron deficiency anaemia”.

Haemoglobin is very important as it carries oxygen from the lungs to the rest of the body. If your haemoglobin or iron levels are low this may make you feel tired and not able to carry out your normal routine.

Why might I need IV iron?

The most common way to treat iron deficiency anaemia is to take iron by mouth as a tablet or liquid. This works well for most people and is usually tried first.

IV iron might be needed if you are:

  • Unable to tolerate iron taken by mouth
  • Unable to absorb iron through the gut
  • Unable to absorb enough iron due to the amount of blood the body is losing
  • In need of a rapid increase in iron levels to help avoid important complications or a blood transfusion (such as, before or after major surgery, significant anaemia late in pregnancy or after delivery)
  • Not responding to iron tablets (such as due to chronic health problems)
  • Have chronic kidney or heart failure

Risks & benefits of IV iron

Your doctor will explain the risks, benefits & available alternatives to IV iron in your particular case. The most significant risk of IV iron is a small chance of having an allergic reaction which can, in rare cases, be life threatening. IV iron is prescribed for iron deficiency anaemia when oral iron is not tolerated, effective or likely to work quickly enough & the benefits of IV iron outweigh the risks in your particular case. If there is a chance you could be pregnant, inform your doctor, as IV iron should be avoided in the first trimester in pregnancy.

Alternatives to IV iron

    • ORAL IRON: If you are able to tolerate and absorb iron taken by mouth this is the first option that should be tried (unless a more rapid increase in your Hb level is needed). If you get stomach (tummy) upset with iron tablets, a lower dose of iron as syrup can be tried and increased slowly as tolerated or iron tablets can be taken 2 or 3 times a week instead of daily– discuss this with your doctor as it is important that the right amount of iron is given. Many iron tablets claim to be gentle on the stomach but don’t have enough iron in them to treat anaemia.
    • IM IRON: Injection of iron into muscle (IM) is not recommended as it is painful & can cause permanent skin scarring & discolouration.
    • BLOOD TRANSFUSION: Transfusion can be life saving when severe anaemia or bleeding is present. It carries greater risks than IV iron & should be avoided unless an immediate increase in Hb level is needed (when benefits outweigh risks).
    • DIET: Once a person has already become low in iron and anaemic it is difficult to get enough iron back into the body even with a diet that is high in iron.

Before you have IV iron

Tell your doctor if you:

  • Are pregnant or trying to get pregnant
  • Have a history of asthma, eczema or other allergies
  • Have had a reaction to any type of iron injection or infusion in the past
  • Have a history of high iron levels, haemochromatosis or liver problems
  • Are on any medications (including over the counter or herbal supplements)

After the iron infusion

Sometimes side effects can start 1 to 2 days after the infusion and include headache, mild fever, joint and muscle aches. These generally settle down by themselves over the next few days. If they are worrying you or interfere with your daily activities contact your doctor or infusion centre for advice. If you have chest pain, difficulty breathing, dizziness or neck/mouth swelling SEEK URGENT MEDICAL ATTENTION / CALL AN AMBULANCE (000).

Day of the iron infusion

  • Have your breakfast/lunch. You do not need to fast for an iron infusion.
  • Take all of your regular medications
  • You can drive home after the infusion and resume usual activities (unless there is an unexpected reaction)
  • The iron will be given through a small IV drip which will be put in your arm
  • If you experience any side effects, inform your nurse immediately

Side effects of IV iron

Patients receiving iron infusions can experience side effects including:

  • Temporary changes in taste (eg metallic) > Headache, feeling sick or vomiting
  • Muscle and joint pain
  • Shortness of breath
  • Itchiness, rash
  • Changes to blood pressure or pulse
  • Burning and swelling at injection site

Severe side effects are rare. You will be closely monitored for any signs of these side effects by nursing staff.

Iron Infusions


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