Vitamin D Deficiency, Prevention and Treatment

Casea 35 year female born and residing in esfahan presents to thephysician due to fatigue and sense of weakness. the patient refersthat she has been having bilateral low back pain accompanied bythrobbing bone pain in the lower extremities since 5 months ago.in past history menses is regular and 3 pregnancy followed bylactating the newborns. the patient denies use of any medication,except regular use of sunscreen. she also denies history of dm.in the physical examination:bp: 120/80bmi: 30 kg/m2cranial nerves are intactexamination of nerves system is within normal limitthere is no proximal myopathy.laboratory examination revealed:• tsh and t4 within normal limits• serum calcium 9.5 mg/dl (8.5-10.5)• phosphate: 3.5 mg/d (2.5-4)• albumin: 4 g/dl• 25(oh) d: 4 ng/ml• pth: 84 pg/ml (8-51).