VITAMIN D DEFICIENCY IN ADULT WOMEN IN INDIAN PRIMARY CARE: CLINICAL PRESENTATION, RISK FACTORS AND RATIONAL THERAPEUTIC MANAGEMENT — A NARRATIVE REVIEW

Abstract

Vitamin D deficiency is a common yet frequently under-recognised clinical problem among adult women, particularly in primary care settings. Although vitamin D is best known for its role in calcium absorption, bone mineralisation and prevention of osteomalacia, its clinical relevance also extends to muscle function, falls, frailty, pregnancy, lactation and postmenopausal bone health. Women often present with nonspecific symptoms such as fatigue, diffuse body pain, low backache, leg pain, cramps, proximal muscle weakness and reduced physical confidence. These complaints may be wrongly attributed to ageing, stress, anaemia, thyroid disease, menopause or lifestyle strain. Adult women are vulnerable because of limited sunlight exposure, darker skin pigmentation, indoor lifestyle, vegetarian dietary habits, obesity, pregnancy, lactation, menopause, ageing, malabsorption and long-term use of certain medicines. In India, vitamin D deficiency remains widely reported despite abundant sunlight, reflecting the combined impact of urbanisation, pollution, clothing patterns, diet and low food fortification. This narrative review discusses the clinical presentation, risk factors, diagnostic approach, pharmacology and therapeutic management of vitamin D deficiency in adult women. A rational primary care strategy should focus on targeted testing, appropriate vitamin D3 supplementation, calcium and diet assessment, safe sunlight exposure, exercise, monitoring and avoidance of unnecessary prolonged high-dose therapy.