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Vitamin D and the athlete–patient: state of the art
  1. William J Ribbans1,
  2. Randeep Aujla2,
  3. Seamus Dalton3,
  4. James A Nunley4
  1. 1Faculty of Health, Education and Society, University of Northampton, Northampton, Northamptonshire, UK
  2. 2Perth Orthopaedic and Sports Medicine Centre, West Perth, Western Australia, Australia
  3. 3North Sydney Sports Medicine, Sydney, New South Wales, Australia
  4. 4Duke Orthopedics, Duke University, Durham, North Carolina, USA
  1. Correspondence to Professor William J Ribbans, University of Northampton, Northampton NN1 5PH, UK; billribbans{at}


Vitamin D deficiency is common in athletes. The conventional measurement of vitamin D levels provides a general indicator of body stores. However, there are nuances in its interpretation as values of 25(OH)D do not correlate absolutely with the amount of ‘bioavailable’ vitamin to the cells. Vitamin D should be regarded as a hormone and influences between 5% and 10% of our total genome. Determining the precise effect of the vitamin, isolated from the actions of other cofactors, is not straightforward and restricts our complete understanding of all of its actions. Deficiency has harmful effects on not only bone and muscle but also wider areas, including immunity and respiratory and neurological activities. More caution should be applied regarding the ability of supranormal vitamin D levels to elevate athletic performance. Hopefully, future research will shed more light on optimal levels of vitamin D and supplementation regimes, and improved understanding of its intracellular control of our genetic mechanisms and how extrinsic influences modify its activity.

  • athletic injuries
  • biological factors
  • bone and bones
  • orthopaedic sports medicine

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  • Contributors WR: instigator of article following request from Journal of ISAKOS editor-in-chief, Niek van Dijk; writer of initial draft and investigator of references and production of illustrations. RA: edit of initial draft, contribution to edits and formalisation of final manuscript; checked all references. SD: edit of initial draft, contribution to edits and formalisation of final manuscript, with particular emphasis on Australasian position on vitamin D supplementation. JAN: edit of initial draft, contribution to edits and formalisation of final manuscript, with particular emphasis on North American position on vitamin D supplementation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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