Balancing Altered Calcium Metabolism with Bone Health in Sarcoidosis

2020 ◽  
Vol 41 (05) ◽  
pp. 618-625
Author(s):  
Ying Zhou ◽  
Elyse E. Lower
Keyword(s):  
Kidney Stones ◽  
Bone Health ◽  
Calcium Metabolism ◽  
Bone Fragility ◽  
Vitamin D Supplementation ◽  
Treatment Of Osteoporosis ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Low Levels ◽  
Increased Activity

AbstractAbnormal calcium metabolism in sarcoidosis patients can lead to hypercalcemia, hypercalciuria, and kidney stones. Hypercalcemia in sarcoidosis is usually due to increased activity of 1α-hydroxylase in macrophages of pulmonary granulomata, resulting in low levels of 25-hydroxyvitamin D and high levels of calcitriol. Vitamin D supplementation may be dangerous for some sarcoidosis patients and is recommended only for those with decreased 25-hydroxyvitamin D and reduced or normal calcitriol level. Diagnosis, treatment of osteoporosis, and maintenance of bone health are complex issues for sarcoidosis patients. An approach to diagnosis and treatment of bone fragility is presented.

scholarly journals Vitamin D Supplementation in Sarcoidosis: A Double-Edged Sword

2021 ◽  
Author(s):  
Rishikesh Chandran ◽  
Lakshmi Nagendra ◽  
Shrikrishna Acharya ◽  
Giridhar Belur Hosmane ◽  
Vijith Shetty ◽  
...  
Keyword(s):  
Vitamin D ◽  
Disease Activity ◽  
Bone Health ◽  
Calcium Metabolism ◽  
Vitamin D Supplementation ◽  
Osteoporosis Prevention ◽  
Hydroxyvitamin D ◽  
Severe Hypercalcemia ◽  
25 Hydroxyvitamin D

AbstractSarcoidosis is complicated by disordered vitamin D and calcium metabolism, which has important implications on disease activity and bone health. Although the majority of the patients with sarcoidosis are typically deficient in 25-hydroxyvitamin D, repletion of vitamin D is controversial in light of the hypercalcemia risk. Presently, there are no clear guidelines regarding vitamin D supplementation as a part of osteoporosis prevention in patients with vitamin D deficiency and sarcoidosis. We report a patient with sarcoidosis who presented with severe hypercalcemia following vitamin D supplementation and review the debated role of vitamin D supplementation in vitamin D-deficient sarcoid patients.

scholarly journals Vitamin D supplementation

2017 ◽  
Vol 18 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Ruth Dobson ◽  
Hannah R Cock ◽  
Peter Brex ◽  
Gavin Giovannoni
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Health ◽  
Vitamin D Supplementation ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
25 Hydroxyvitamin D ◽  
The Uk

Vitamin D testing and supplementation is of great interest to neurologists and their patients. Recommended nutritional intakes of vitamin D in the UK remain focused on bone health, despite increasing evidence for a role outside this area. Here we discuss how neurologists might approach vitamin D testing and supplementation, focusing on two conditions associated with vitamin D deficiency that have an increased risk of downstream complications resulting from these: multiple sclerosis and epilepsy. We set out a rationale for testing serum 25-hydroxyvitamin D concentrations and discuss our personal practice in terms of supplementation, with evidence where available.

Vitamin D Level Stability in Dystrophinopathy Patients on Vitamin D Supplementation

2021 ◽  
pp. 1-7
Author(s):  
Naomi Vather-Wu ◽  
Matthew D. Krasowski ◽  
Katherine D. Mathews ◽  
Amal Shibli-Rahhal
Keyword(s):  
Vitamin D ◽  
Retrospective Cohort ◽  
Vitamin D Supplementation ◽  
Hydroxyvitamin D ◽  
Frequent Monitoring ◽  
25 Hydroxyvitamin D ◽  
The Mean ◽  
Stable Maintenance ◽  
Mean Time

Background: Expert guidelines recommend annual monitoring of 25-hydroxyvitamin D (25-OHD) and maintaining 25-OHD ≥30 ng/ml in patients with dystrophinopathies. Objective: We hypothesized that 25-OHD remains stable and requires less frequent monitoring in patients taking stable maintenance doses of vitamin D. Methods: We performed a retrospective cohort study, using the electronic health record to identify 26 patients with dystrophinopathies with a baseline 25-OHD ≥30 ng/mL and at least one additional 25-OHD measurement. These patients had received a stable dose of vitamin D for ≥3 months prior to their baseline 25-OHD measurement and throughout follow-up. The main outcome measured was the mean duration time the subjects spent with a 25-OHD ≥30 ng/mL. Results: Only 19% of patients dropped their 25-OHD to <  30 ng/ml, with a mean time to drop of 33 months and a median nadir 25-OHD of 28 ng/mL. Conclusions: These results suggest that measurement of 25-OHD every 2–2.5 years may be sufficient in patients with a baseline 25-OHD ≥30 ng/mL and who are on a stable maintenance dose of vitamin D. Other patients may require more frequent assessments.

scholarly journals Vitamin D Knowledge, Attitudes and Practices of Polish Medical Doctors

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2443
Author(s):  
Wojciech Stefan Zgliczyński ◽  
Olga Maria Rostkowska ◽  
Beata Sarecka-Hujar
Keyword(s):  
Vitamin D ◽  
Knowledge Score ◽  
Vitamin D Supplementation ◽  
Medical Doctors ◽  
Self Administration ◽  
Hydroxyvitamin D ◽  
Attitudes And Practices ◽  
Study Results ◽  
25 Hydroxyvitamin D ◽  
Knowledge Attitudes And Practices

Background Vitamin D deficiency occurs in as much as 90–95% of the Polish population, although this condition is known to cause negative long-term health implications. The role of medical doctors in advising proper supplementation, monitoring and correcting the levels of 25-hydroxyvitamin D in individuals is of great importance and should be used to help mitigate its common deficits. The aim of this study was to evaluate knowledge, attitudes and practices of Polish physicians regarding vitamin D supplementation in order to identify areas for improvement and determinants for the knowledge gaps. Methods The study group comprised 701 medical doctors aged 32.1 ± 5.3 years on average, mostly women (71.61%). An original survey questionnaire was developed for the purpose of the study. Results The mean vitamin D knowledge score was 6.8 ± 2.3 (in a scale 0–13) and was related to gender (p < 0.001), type of specialization (p = 0.032), D3 supplements use (p < 0.001), recommending supplementation to patients (p = 0.005), to relatives and friends (p < 0.001) and to healthy adults (p < 0.001). In terms of self-administration, 14% of respondents take vitamin D all-year-round while 24% only in autumn and winter. 25% of respondents monitor their vitamin D (25-hydroxyvitamin D) serum concentration. Most participants (61%) did not recommend supplementing vitamin D to their patients on a regular basis. Conclusions The study indicates that medical doctors in Poland need to have more training and education on vitamin D supplementation in order to better address the problem of its deficits in the population.

Optimal Serum Concentration of 25-Hydroxyvitamin D for Bone Health in Older Korean Adults

2012 ◽  
Vol 92 (1) ◽  
pp. 68-74 ◽  
Author(s):  
You-Cheol Hwang ◽  
Hong-Yup Ahn ◽  
In-Kyung Jeong ◽  
Kyu Jeung Ahn ◽  
Ho Yeon Chung
Keyword(s):  
Serum Concentration ◽  
Bone Health ◽  
Hydroxyvitamin D ◽  
Korean Adults ◽  
25 Hydroxyvitamin D

scholarly journals Vitamin D and Risk for Vitamin A Intoxication in an 18-Month-Old Boy

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Valentina Talarico ◽  
Massimo Barreca ◽  
Rossella Galiano ◽  
Maria Concetta Galati ◽  
Giuseppe Raiola
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
High Serum ◽  
Renal Ultrasound ◽  
Once Daily ◽  
Hydroxyvitamin D ◽  
Vitamin D Intoxication ◽  
Intravenous Hydration ◽  
25 Hydroxyvitamin D ◽  
Low Levels

An 18-month-old boy presented with abdominal pain, vomiting, diarrhea, and poor appetite for 6 days. He had been given a multivitamin preparation once daily, containing 50.000 IU of vitamin D and 10.000 IU of vitamin A for a wide anterior fontanelle for about three months. He presented with hypercalcemia, low levels of parathyroid hormone (PTH), and very high serum 25-hydroxyvitamin D (25-OHD) levels. Renal ultrasound showed nephrocalcinosis. He did not have sign or symptom of vitamin A intoxication. Patient was successfully treated with intravenous hydration, furosemide, and prednisolone. With treatment, serum calcium returned rapidly to the normal range and serum 25-OHD levels were reduced progressively. In conclusion the diagnosis of vitamin D deficiency rickets without checking 25-OHD levels may cause redundant treatment that leads to vitamin D intoxication (VDI).

Sign in / Sign up

Export Citation Format

Share Document