Too little vitamin D in premenopausal women: why should we care?,

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Abstract
Nesby-O'Dell et al (1) report compelling data that provide irrefutable evidence that vitamin D deficiency is a major unrecognized epidemic in adult women of childbearing age (15–49 y). Not surprisingly, the prevalence of vitamin D deficiency was 42% in African American women and 4.2% in white women. It is likely that the prevalences would have been much higher if the survey had also been performed in the winter for both groups of women in the North. Tangpricha et al (2) reported that 36% of healthy men and women in Boston aged 18–29 y were vitamin D insufficient, with 25-hydroxyvitamin D [25(OH)D] < 50 nmol/L (20 ng/mL). Thus, although Nesby-O'Dell et al studied only females, it is likely that vitamin D deficiency is equally prevalent among males of the same age. Nesby-O'Dell et al note that the third National Health and Nutrition Examination Survey (which provided the data for their study) did not measure either parathyroid hormone (PTH) or the active metabolite of vitamin D, 1,25-dihyroxyvitamin D [1,25(OH)2D]. It was unfortunate that the PTH concentrations were not measured because PTH is the most sensitive indicator of calcium homeostasis and vitamin D deficiency (3–5). It would not have been helpful, however, to have had 1,25(OH)2D concentrations, which are often misleading because they can be low, normal, or even elevated in vitamin D deficiency as a result of secondary hyperparathyroidism (3).