If pain or bend in 2 of the 3 locations, 90% chance that Vitamin D is <20 ng
If not, nothing can be said about vitamin D level
Thumb Test for Vitamin D deficiency Dr. Oz video Feb 2017
Test Yourself for "D"eficiency Hawkeshealth Feb 2010
- With your thumb, press on your sternum (breastbone).
Is it tender or painful?
- Now, press on the tibia (shin bone) of both your legs.
Are they sore or tender?
If the answer is "yes" to both of these tests, then you have a 93% chance of being Vitamin D deficient.
83% of people with low back pain were vitamin D deficient
95% of people with chronic pain had the pain go away with vitamin D
May 2003 PDF by Dr. Holick
2003 report generated many letters
Cited 262 times in Google schola as of Jan 2021
Vitamin D deficiency is associated with tibial bone pain and tenderness. A possible contributive role
International Journal of Rheumatic Disease https://doi.org/10.1111/1756-185X.13253
Mansour Babaei Mehdi Esmaeili Jadidi Behzad Heidari Hemmat Gholinia
Background: Vitamin D deficiency is associated with osteomalacia and a variety of musculoskeletal pain. This study aimed to determine the association of vitamin D deficiency with tibial bone pain and tenderness.
Methods: Patients with leg pain, defined as local pain and tenderness over tibial bones for ≥ 6 weeks, were consecutively selected. Secondary causes of pain were excluded by appropriate clinical, radiological, and laboratory examinations. Serum 25‐hydroxyvitamin D (25‐OHD) was assessed by enzyme‐linked immunosorbent assay method, and levels < 20 ng/mL were considered as deficiency. Age‐ and sex‐matched subjects without leg pain served as controls. Multiple logistic regression analysis was used to determine associations.
One hundred and eighteen patients and 114 controls aged 46.8 ± 14.8 and 44.6 ± 14.1 years, respectively (P = 0.93), were analyzed. The mean 25‐OHD level was significantly lower (P = 0.001), and the prevalence of 25‐OHD deficiency was significantly higher in the patients as compared with the controls (75.4% vs. 23.6%), odds ratio (OR) = 9.54 (95% CI, 5.22–17.45, P = 0.001). There was a negative dose‐response relationship between serum 25‐OHD and tibial bone pain by
- OR = 17.33 (95% CI, 6.48–46.3) in subjects with 25‐OHD < 10 ng/mL
- OR = 14.7 (95% CI, 6.35–34.6) in serum 25‐OHD levels at 10–19.9 ng/mL
- OR = 2.58 (95% CI, 1.08–6.1) in those with 25‐OHD at 20–29.9 ng/mL
as compared with 25‐OHD ≥ 30 ng/mL.
After controlling for demographic and biochemical factors, the association reached a stronger level of 19.8 (6.9–56.3) in subjects with serum 25‐OHD < 10 ng/mL and 14.4 (5.8–34.6) in those with serum 25‐OHD at levels of 10–19.9 ng/mL and 1.85 (0.73–4.6) in 20–29 ng/mL.
Conclusion: These findings indicate a possible contributive role for serum 25‐OHD deficiency in the development of pain and tenderness over the tibial bone.
See study in VitaminDWikki Tibia pain (long term) is 20X more likely if low vitamin D (under 10 ng) – Jan 2018
On physical examination the application of minimum pressure with the thumb on the sternum, anterior tibia or radius and ulna will often elicit pain and discomfort, which is a helpful diagnostic sign for osteomalacia. Vitamin D deficiency
Google search web for sternum "vitamin D deficiency" 80,400 hits Jan 2021
Just as I started taking vitamin D, I checked and had pain in all three locations.
No pain since then in any of my bones.
Works for me!
Breastbone test in Germany is becoming quantitative
Guess: pain if less than 15 nanograms
Free Vitamin D evaluation service same German Dr.
The online free test asks about the frequency of the following:
My fingernails have small white spots, dots, or cross lines ...
Weakness, Sadness, Listlessness, Tiredness, Muscle-Pain, Eyelid twitching, Arm twitching, Legs twitching
Cramps, Cramps at Night, Circulation problems, Dizzy - standing up, Dizzyness on Exercise, Dizziness that disappears when lying down
Headache, Headache - Standing up, Headache - Sport, Headache it disappears, when I lie down ...
Standing causes backpain; Standing causes hip pain; standing causes groin pain; standing causes leg pain. Standing for a long time, I feel pain in my legs ...
Tibial Tenderness Identifies Secondary Hyperparathyroidism Responding to High Dose Vitamin D in Pakistani Women.
Endocr Pract. 2013 Feb 20:1-20. PMID: 23425639
Ali B, Butt A, Fatima A, McDonnell ME, Masud F.; Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Objectives: To assess the utility of anterior tibial tenderness (ATT) measured by visual analog score (VAS) as a clinical diagnostic tool for vitamin D deficiency in a high-risk population of Pakistani women
Methods: ATT using a VAS was assessed in 75 premenopausal women, ages 17-56 (mean 41.3), with generalized aches and pains and calcium of less than 11.0mg/dl (normal: 8-11) at a tertiary care center in Lahore, Pakistan. This was followed by administration of 1.8 million units of vitamin D3 in divided doses. ATT, vitamin D, and parathyroid hormone (PTH) levels were checked before and after the injections. Correlation between ATT, vitamin D, and PTH as well as change in ATT, vitamin D, and (PTH) following supplementation, was determined.
Results: Pre-intervention average calcium and vitamin D were 9.3mg/dl (8-10.3) and 12.1 ng/ml (1.5-32.6) respectively. 74% (53/75) of the participants had vitamin D deficiency and elevated PTH (>60).
The mean PTH was 81.6pg/ml (29.1-370).
Change in ATT correlated strongly (r=0.422, p=0.013) with change in PTH.
Following supplementation, there was a significant improvement in ATT (p<0.01) and vitamin D levels (p<0.01), with a decrease in PTH levels (p<0.01).
Conclusions: Anterior tibial tenderness is a valid clinical diagnostic tool for vitamin D deficiency in South Asian women.
Download the PDF from VitaminDWiki.
- in VitaminDWiki Vitamin D injections of a total of 1,800,000 IU reduced shinbone tenderness – Feb 2013
- Vitamin D deficiency 4X more likely if illiterate or have bone pain – Lahore Pakistan – Oct 2015
- Shin pain in elderly men 36 X more likely if low vitamin D – March 2017
- Leg bone (tibia) grew thicker with 4,000 IU of vitamin D and Calcium – RCT Aug 2016
- Vitamin D deficiency: an unrecognized cause of flank pain – Nov 2017
VitaminDWiki - Predict Vitamin D category contains
It is very difficult to predict the response to supplementation of Vitamin D, or additional sun/UV
There are a huge number of factors involved.
This page also has studies predicting deficiency without Vitamin D tests
- Low Vitamin D screening with just 5 questions (for less than 12 ng) – June 2022
- Top 10 signs of Vitamin D Deficiency (9 minute Video) - Oct 2021
- Estimate Vitamin D levels based on questionnaires (12 studies) – July 2020
- Is a senior Vitamin D insufficient - a 2 minute questionnaire is 85 percent accurate – Nov 2019
- Simple Vitamin D deficiency scoring system – Feb 2016
- Toward predicting vitamin D levels without a blood test. By VitaminDWiki
- Excellent prediction of very low vitamin D in elderly from just 16 questions (analyzed by ML) – June 2017
- How to predict response to a vitamin D dose – RCT April 2014
- Quick, free, self test of vitamin D deficiency 90% chance <20 ng