Is Vitamin D Deficiency Dangerous? These Are the Biggest Risks
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Leesduur: 9 min
The latest National Institute for Public Health and the Environment (RIVM) Food Consumption Survey shows that 92% of Dutch people don't get enough vitamin D. And that can be dangerous, because vitamin D is essential for your health.
The survey shows that older adults between 65 and 79, in particular, are not getting enough vitamin D. On average, they only get 3.3 mcg from food, while the recommended daily amount is 20 mcg.
Even with vitamin D supplements (specifically recommended by the Health Council), the average intake does not exceed 11.7 mcg, which is well below the required level. (1)
In this article, I'll tell you why a vitamin D deficiency can be dangerous and how you can avoid these risks.
The RIVM points out various dangers that can arise from a vitamin D deficiency (2) (3):
Many Dutch people have a vitamin D deficiency, which increases the risk of colon cancer, weak bones and infections (source: RIVM)
Deficiency symptoms include fatigue, muscle weakness and bone pain, especially in the elderly with little sunlight and inadequate nutrition.
Solution: Extra sunlight, vitamin D-rich diet and supplementation (75 mcg/day) to normalize and maintain blood levels.
Table of contents
1. Increased risk of (bowel) cancer 2. Weakened immune system 3. Muscle weakness and problems with muscle function 4. Weak bones (bone loss) Symptoms of a vitamin D deficiency Causes of vitamin D deficiency Getting vitamin D from food? Plant sources (D2) are less effective How much vitamin D3 do you need? Solving a vitamin D deficiency (step-by-step plan) Conclusion: Is a vitamin D deficiency dangerous?
1. Higher risk of (bowel) cancer
Recent research suggests a possible link between vitamin D and colon cancer. Results showed that people with higher vitamin D levels were up to 39% less likely to develop colon cancer than those with lower levels. (4)
The exact role of vitamin D in the risk of colon cancer is still being investigated. Although initial results are promising, more research is needed to definitively confirm these findings. (5)
2. Weakened immune system
Vitamin D supports the immune system. A vitamin D deficiency can therefore affect its function, potentially making you more susceptible to infections.
Research shows that if your vitamin D levels are above 50 ng/ml, it can help support your immune system. (6)
3. Muscle weakness and problems with muscle function
Did you know that vitamin D also plays a role in maintaining strong muscles? A vitamin D deficiency is associated with reduced muscle strength, which can increase the risk of falls, especially in the elderly.
While vitamin D supplements help prevent severe deficiencies, studies show that the effects on muscle strength and falls are most noticeable in people who have a significant deficiency. (7) (8)
4. Weak bones (bone loss)
Vitamin D is essential for maintaining strong bones and calcium absorption. A vitamin D deficiency can lead to weaker bones and increases the risk of osteoporosis and fractures, especially in the elderly.
Research shows that people with higher vitamin D levels often have a lower risk of hip fractures.
The Health Council therefore recommends extra vitamin D, especially for seniors and people with dark skin, to strengthen the bones. (9) (10)
Symptoms of a vitamin D deficiency
Symptoms of vitamin D deficiency usually develop slowly. Therefore, it's important to have your blood tested regularly and be alert to symptoms so you can take action quickly.
A vitamin D deficiency can be recognized by the following symptoms:
- Fatigue - A vitamin D deficiency can lead to feelings of fatigue and a lack of energy.
- Muscle pain and weakness - Vitamin D plays a role in maintaining strong muscles, and a deficiency can therefore cause muscle pain and weakness.
- Bone Pain - A vitamin D deficiency can affect bone health, leading to bone pain.
If you have a vitamin D deficiency for a long period of time, this may pose risks to your health.
A serious deficiency can lead to, among other things:
- Weakened Bones – In children, severe deficiency can cause rickets, a condition that weakens and deforms the bones.
- Osteoporosis – In adults and the elderly, vitamin D deficiency can contribute to bone loss (osteoporosis), which increases the risk of fractures, especially in the elderly. (11) (12)
Causes of vitamin D deficiency
Vitamin D deficiency can have various causes, with sunlight, diet and certain health factors playing an important role.
These are the most common reasons why someone might develop a deficiency.
- Little sunlight on your skin – Less exposure to sunlight means less vitamin D production.
- Living in a country with little sunshine – In the Netherlands, the sun is too weak in winter for sufficient vitamin D production.
- Dark skin – People with dark skin have more melanin, which helps protect your skin from UV rays, but it also blocks the production of vitamin D.
- Air pollution and shade in the city – Polluted air and tall buildings can block sunlight, reducing your vitamin D absorption.
- Insufficient healthy fats and magnesium in food – These nutrients are necessary for proper absorption and processing of vitamin D.
- Obesity – Vitamin D is stored in fat tissue, making less available in the blood.
- Liver and kidney problems – Conditions in these organs disrupt the conversion of vitamin D to the active form.
- Use of certain medications – Some medications, such as anti-epileptics and corticosteroids, reduce the absorption or conversion of vitamin D.
- Hormonal fluctuations in women – Pregnancy, menopause, and a drop in estrogen increase vitamin D requirements.
Getting vitamin D from food?
Sunlight is the main way to make vitamin D, but certain foods can also contribute to your vitamin D intake.
Animal products are best for this because they contain vitamin D3—the active form that your body most easily absorbs and uses.
- Oily fish (mackerel, herring, sardines) – Naturally high in vitamin D3, making it one of the best sources.
- Liver (especially beef liver) – Rich in vitamin D3 and other important nutrients such as iron and vitamin A.
- Egg yolk – Contains small amounts of vitamin D3, especially if the chicken has been kept outdoors.
- Butter and full-fat dairy – Natural source of vitamin D3, although the amount is lower than in fish and liver.
- Wild meat (such as venison or wildfowl) – Animals that live in the wild get more sunlight and often have higher vitamin D3 levels in their meat.
Plant sources (D2) are less effective
There aren't many plant-based sources of vitamin D, and they're also less effective than animal sources. This is because vitamin D concentration is much lower in plant foods, and vitamin D2 is less well absorbed by the body than D3.
Some plant-based products, such as certain margarines and plant-based milks, are fortified with vitamin D. However, this is often synthetic and not always easily absorbed.
Animal products such as oily fish, eggs and liver therefore remain the best natural sources of vitamin D from food.
Important : You usually don't get enough vitamin D from food alone. Therefore, sunlight is the most important source, and some people need supplements to maintain their vitamin D levels.
How much vitamin D3 do you need?
To prevent a vitamin D deficiency, it's helpful to know how much you actually need. Your daily needs depend on several factors, the most important of which are your age, skin color, and the amount of time you spend outdoors.
In the Netherlands, it is recommended to get some of your vitamin D from food and the rest from supplements, depending on your exposure to sunlight.
These are the recommended amounts per age group, divided between food and supplements:
- 0 to 3 years - 10 mcg from food + 10 mcg from supplements
- 4 to 69 years - 10 mcg from food + 10 mcg from supplements (in low sunlight or with skin coverage)
- 70 years and older - 10 mcg from food + 20 mcg from supplements
- Pregnant women - 10 mcg from food + 10 mcg from supplements
Good to know : These recommendations are based on average needs, and individual factors such as health, sunlight exposure, and diet influence your actual vitamin D needs. For more information, please refer to my article "How much vitamin D do you need?"[1].
Resolving Vitamin D Deficiency (Step-by-Step Plan)
A vitamin D deficiency can develop unnoticed, but fortunately there are concrete steps you can take to resolve it.
This practical step-by-step plan will help you restore and maintain your vitamin D levels:
Step 1 – Take 75 mcg daily for 3 months - Start with a 75 mcg vitamin D supplement daily to quickly replenish your deficiency. Do this for 3 months.
Step 2 – Eat more vitamin D-rich foods - At the same time, add more foods rich in vitamin D, such as oily fish and eggs.
Step 3 – At least 30 minutes of sunlight daily - Get plenty of sunlight, but be careful: 30 minutes a day in the sun is ideal, but be careful not to burn. Also, don't bundle up completely; the sun needs to be able to reach your skin.
Step 4 – Have your vitamin D levels re-tested - After 3 months, it is important to re-test your vitamin D level.
Step 5 – Adjust supplementation based on vitamin D test results - Are your levels still too low? Discuss further steps with your doctor. A higher prescription D3 dose may be necessary (always consult your doctor if you exceed 100 mcg).
- Under healthy conditions, continue supplementation with 75 mcg per day.
- For values at the upper end of the limit, reduce the dosage to 25 mcg per day.
Step 6 – Continue to test vitamin D levels periodically (annually or bi-annually) - Test your vitamin D level regularly to ensure it remains at the correct level and you are taking the correct supplement.
Conclusion: Is a vitamin D deficiency dangerous?
It is clear that a vitamin D deficiency can be dangerous and can significantly impact your health, especially if the deficiency is not addressed in a timely manner.
Fortunately, there are several ways to prevent and remedy a deficiency, such as taking supplements, eating vitamin D-rich foods, and getting enough sunlight.
Make sure you have your vitamin D levels checked regularly so you can take action in time.
Ebrina van der Bijl
Ebrina is a nutritionist with a deep commitment to healthy eating and a sustainable lifestyle, based in beautiful Portugal. Her passion for natural and organic products is at the heart of her work. With a background in Nutrition & Dietetics and experience in product development and writing, she translates complex scientific information into practical advice for a balanced lifestyle.
Sources used
- VCP 2012-2016, 1-79 years . (undated). RIVM. https://www.rivm.nl/voedselconsumptiepeiling/overzicht-voedselconsumptiepeilingen/vcp-2012-2016-1-79-jaar
- Vitamin D from dietary supplements: intake, personal and use characteristics. In RIVM Brief Report (pp. 2–43). National Institute for Public Health and the Environment. https://www.rivm.nl/bibliotheek/rapporten/2015-0029.pdf
- Verkaik-Kloosterman, J., Dekkers, A.L.M., & Ocké, M.C. (2014). Safe maximum daily dose of vitamin D in dietary supplements. In RIVM, RIVM Brief Report 050421003/2014 (pp. 2–56). RIVM. https://www.rivm.nl/bibliotheek/rapporten/050421003.pdf
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- Boughanem, H., Canudas, S., Hernandez-Alonso, P., Becerra-Tomás, N., Babio, N., Salas-Salvadó, J., & Macias-Gonzalez, M. (2021). Vitamin D Intake and the Risk of Colorectal Cancer: An Updated Meta-Analysis and Systematic Review of Case-Control and Prospective Cohort Studies. Cancers , 13 (11), 2814. https://doi.org/10.3390/cancers13112814
- Wimalawansa, S. J. (2023). Infections and Autoimmunity—The Immune System and Vitamin D: A Systematic Review. Nutrients , 15 (17), 3842. https://doi.org/10.3390/nu15173842
- Gunton, J.E., & Girgis, C.M. (2018). Vitamin D and muscle. Bone Reports , 8 , 163–167. https://doi.org/10.1016/j.bonr.2018.04.004
- Bislev, L. S., Grove-Laugesen, D., & Rejnmark, L. (2020). Vitamin D and Muscle Health: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials. Journal Of Bone And Mineral Research , 36 (9), 1651–1660. https://doi.org/10.1002/jbmr.4412
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- Wang, N., Chen, Y., Ji, J., Chang, J., Yu, S., & Yu, B. (2020). The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis. Journal Of Orthopedic Surgery And Research , 15 (1). https://doi.org/10.1186/s13018-020-01603-y
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