Hein Minn Tun
Vitamin D is essential for musculoskeletal health, and deficiency is frequently linked to pain and weakness. While low vitamin D levels worsen acute Coronavirus disease 2019 (COVID-19) outcomes, their role in post-COVID symptom recovery remains unclear. The American Diabetes Association recommends diabetes screening from age 35, with earlier screening for overweight adults with risk factors. This case study aims to report an occult case of vitamin D deficiency among post-COVID-19 prediabetes patients through the lens of a case study using the three-stage family medicine approach following the CAse REport (CARE) checklist. A 50-year-old woman presented with right forearm pain for two weeks and intermittent numbness in the same arm for two months after recovering from COVID-19. Through clinical, individual, and contextual assessments, neurological and structural causes were excluded, revealing severe vitamin D deficiency (10 ng/mL) and incidental prediabetes (HbA1c 5.9%). Her symptoms were influenced by sedentary post-pandemic behaviour, emotional stress, and limited local healthcare access. Management included non-steroidal anti-inflammatory drugs for symptom relief, high-dose vitamin D supplementation (60,000 IU weekly for 8-12 weeks), lifestyle modification, and psychosocial support, demonstrating the value of holistic care in primary practice. This case illustrates how the three-stage family medicine approach aids in identifying metabolic and nutritional contributors to nonspecific musculoskeletal complaints, addressing patient concerns, and guiding shared management, especially in resource-limited settings. Despite being a single case, it highlights the importance of holistic, patient-centred care and early detection of modifiable risks such as vitamin D deficiency and prediabetes in post-COVID-19 patients.