Vitamin D deficiency may be on its way to being known in medicine as a grand deceiver, presenting in various guises and imitating different diagnoses. Take a recent case report on rickets mimicking the incurable arthritic disease, ankylosing spondylitis.
Dr. Huseyin Demirbilek and colleagues of the Hacettpe University Faculty of Medicine in Turkey report on a 14-year-old African girl with generalized bone aches referred to their clinic when her symptoms did not improve with treatment. Ankylosing spondylitis was her diagnosis, a disease of the skeleton with variable involvement of other joints. It is a chronic, inflammatory autoimmune disease, which mainly affects joints in the spine and the pelvis, and can cause eventual fusion of the spine.
However, the good doctors noticed she was heavily clothed, had very black skin, and had severe pain on pressure to her sternum. Sure enough, her 25(OH)D was literally 1 nmol/L, her alkaline phosphatase was 2312 (very high), her blood calcium was low with normals between 8.6 and 10.5 (quite different than American normals which often call a calcium of 10 as elevated). Her PTH was 923 (very high). X-rays of her wrists confirmed rickets.
Her disease and her suffering disappeared a month after treatment with a one-time dose of 300,000 IU of vitamin D and 1000 mg/day of calcium. After the one time dose, they very conservatively maintained her on 800 IU/day of vitamin D.
Besides ankylosing spondylitis, vitamin D deficiency may present as frequent infections, chronic pain, heart disease, stroke, multiple autoimmune diseases, fibromyalgia, osteoporosis, gingivitis, diabetes, and in my opinion, sun sensitivity, to name but a few. Vitamin D deficiency is now the grand deceiver.