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Your exposure to sunlight is limited. Because the body makes vitamin D when your skin is exposed to sunlight, you may be at risk of deficiency if you are homebound, live in northern latitudes, wear long robes or head coverings for religious reasons, or have an occupation that prevents sun exposure. You have dark skin.
Low Vitamin D levels are caused by two very different reasons. Low vitamin D is common in people without any other health problems, but low vitamin D can also be caused by a parathyroid tumor. The connection between parathyroid disease and low Vitamin D can be confusing, even for many doctors. Parathyroid tumors cause low Vitamin D, not the other way around.