scholarly journals Vitamin D dosage

2021 ◽  
Vol 17 (5) ◽  
pp. 435-442
Author(s):  
O.V. Kaminsky
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Bone Mineralization ◽  
Muscle Metabolism ◽  
Optimal Level ◽  
The Body ◽  
Maximum Effect ◽  
Endocrine Society ◽  
Increased Risk ◽  
The Usa

Despite its historical name, vitamin D is not a vitamin at all but a hormone that, when activated, is a metabolically active steroid fat-soluble hormone that acts on cellular receptors. Vitamin D hormone is synthesized endogenously and then metabolized in the body, provi-ding that there are the necessary precursors and some factors — the effects of ultraviolet light on the skin. At the same time, vitamins themselves are nutrients, co-factors of biochemical reactions that are not synthesized in the body and cannot interact with receptors, consumed with food, so the hormone D is not a vitamin. Disputes about its use and dosage continue throughout the study period of vitamin D hormone. Most reputable experts in Europe and the USA support the need to replenish and maintain a normal level of vitamin D, believing it to be completely safe and useful. In 2011, the US Endocrine Society issued clinical practice guidelines for vitamin D, indicating that the desired serum concentration of 25(OH)D is > 75 nmol/l (> 30 ng/ml) to achieve the maximum effect of this vitamin on calcium metabolism, bone, and muscle metabolism. According to them, for a consistent increase in serum 25(OH)D above 75 nmol/l (30 ng/ml), adults may require at least 1,500-2,000 IU/day of additional vitamin D, at least 1,000 IU/day in children and adolescents. The most common form of thyroid dysfunction is secondary hyperparathyroidism, which develops due to vitamin D defect/deficiency (80–90 %). Non-optimal serum concentrations of 25(OH)D lead to secondary hyperparathyroidism, potentially leading to decreased bone mineralization and, ultimately, to an increased risk of osteopenia, osteoporosis and fractures, cardiac arrhythmia, and increased blood pressure. Vitamin D is most commonly used at a star-ting dose of 5,000 IU daily for 2–3 months, then transferring patients to maintenance doses of 2,000–4,000 IU/day daily that are consi-dered safe. However, it should be noted that some patients will need constant administration of 5,000 IU of vitamin D per day for a long time (years) to maintain the target optimal level of 25(OH)D in the blood, especially in patients with normocalcemic forms of secondary hyperparathyroidism.

Vitamin D Deficiency and Intoxication - A concern either way

JMS SKIMS ◽  
2011 ◽  
Vol 14 (2) ◽  
pp. 40-42
Author(s):  
Muzafar Maqsood Wani ◽  
Imtiaz Ahmed Wani
Keyword(s):  
Vitamin D ◽  
Cell Growth ◽  
Bone Turnover ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Bone Mineralization ◽  
Normal Blood ◽  
Blood Levels ◽  
Calcium And Phosphorus ◽  
Biologic Function

Major biologic function of activated vitamin D is to maintain normal blood levels of calcium and phosphorus, thus regulating bone mineralization. Research suggests that vitamin D may help in immunomodulation, regulating cell growth and 1,4 differentiation as well as some diverse unspecified functions. Overt vitamin D deficiency leads to hypocalcaemia, secondary hyperparathyroidism and increased bone turnover, which in prolonged and severe cases may cause rickets in children and osteomalacia in elderly.... JMS 2011;14(2):40-42

scholarly journals Implications of Vitamin D Research in Chickens can Advance Human Nutrition and Perspectives for the Future

2021 ◽  
Author(s):  
Matthew F Warren ◽  
Kimberly A Livingston
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
The Body ◽  
Human Nutrition ◽  
Vitamin D Metabolites ◽  
Vitamin D Metabolism ◽  
Related Research ◽  
Vitamin D Intake ◽  
Increased Risk

Abstract The risk of vitamin D insufficiency in humans is a global problem that requires improving ways to increase vitamin D intake. Supplements are a primary means for increasing vitamin D intake, but without a clear consensus on what constitutes vitamin D sufficiency, there is toxicity risk with taking supplements. Chickens have been used in many vitamin D-related research studies, especially studies involving vitamin D supplementation. Our state-of-the-art review evaluates vitamin D metabolism and how the different hydroxylated forms are synthesized. We provide an overview with how vitamin D is absorbed, transported, excreted, and what tissues in the body store vitamin D metabolites. We also discuss a number of studies involving vitamin D supplementation with broilers and laying hens. Vitamin D deficiency and toxicity are also described and how they can be caused. The vitamin D receptor (VDR) is important for vitamin D metabolism. However, there is much more that can be understood with VDR in chickens. Potential research aims involving vitamin D and chickens should explore VDR mechanisms which could lead to newer insights with VDR. Utilizing chickens in future research to help with elucidating vitamin D mechanisms has great potential to advance human nutrition. Finding ways to increase vitamin D intake will be necessary because the coronavirus 2019 disease (COVID-19) pandemic is leading to increased risk of vitamin D deficiency in many populations. Chickens can provide a dual purpose with addressing pandemic-caused vitamin D deficiency: 1) vitamin D supplementation gives chickens added value with possibly leading to vitamin D-enriched meat and egg products; and 2) chickens’ use in research provides data for translational research. Expanding vitamin D-related research in chickens to include more nutritional aims in vitamin D status has great implications with developing better strategies to improve human health.

Vitamin D therapy: problems and prospects

1975 ◽  
Vol 13 (8) ◽  
pp. 29-31
Keyword(s):  
Vitamin D ◽  
Ultraviolet Irradiation ◽  
The Body ◽  
Natural Vitamin ◽  
The Usa ◽  
Solar Ultraviolet ◽  
Regular Intake ◽  
Children Under 5

Natural vitamin D (D3, cholecalciferol) reaches the body from animal sources in the diet and from endogenous skin synthesis by the action of solar ultraviolet irradiation. Vitamin D2 (ergocalciferol) is used for fortifying proprietary foods such as margarine (and milk in the USA and Canada). These compounds have equal potency in man. A regular intake of 2.5 micrograms (100 i.u.) daily for adults and about 10 micrograms (400 i.u.) daily for children under 5 years old is usually recommended to prevent nutritional osteomalacia and rickets.

Management of bone metabolism in epilepsy

2021 ◽  
Vol 74 (7-8) ◽  
pp. 257-265
Author(s):  
Firdevs Ezgi Uçan Tokuç ◽  
Fatma Genç ◽  
Abidin Erdal ◽  
Yasemin Biçer Gömceli
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Outpatient Clinic ◽  
Bone Mineralization ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Increased Risk ◽  
Significant Difference

Many systemic problems arise due to the side effects of antiepileptic drugs (AEDs) used in epilepsy patients. Among these adverse effects are low bone mineral density and increased fracture risk due to long-term AED use. Although various studies have supported this association with increased risk in recent years, the length of this process has not been precisely defined and there is no clear consensus on bone density scanning, intervals of screening, and the subject of calcium and vitamin D supplementation. In this study, in accordance with the most current recommendations, our applications and data, including the detection of possible bone mineralization disorders, treatment methods, and recommendations to prevent bone mineralization disorders, were evaluated in epilepsy patients who were followed up at our outpatient clinic. It was aimed to draw attention to the significance of management of bone metabolism carried out with appropriate protocols. Epilepsy patients were followed up at the Antalya Training and Research Hospital Department of Neurology, Epilepsy Outpatient Clinic who were at high risk for osteoporosis (use of valproic acid [VPA] and enzyme-inducing drugs, using any AED for over 5 years, and postmenopausal women) and were evaluated using a screening protocol. According to this protocol, a total of 190 patients suspected of osteoporosis risk were retrospectively evaluated. Four patients were excluded from the study due to secondary osteoporosis. Of the 186 patients who were included in the study, 97 (52.2%) were women and 89 (47.8%) were men. Prevalence of low bone mineral density (BMD) was 42%, in which osteoporosis was detected in 11.8% and osteopenia in 30.6% of the patients. Osteoporosis rate was higher at the young age group (18-45) and this difference was statistically significant (p=0.018). There was no significant difference between male and female sexes according to osteoporosis and osteopenia rates. Patients receiving polytherapy had higher osteoporosis rate and lower BMD compared to patients receiving monotherapy. Comparison of separate drug groups according to osteoporosis rate revealed that osteoporosis rate was highest in patient groups using VPA+ carbamazepine (CBZ) (29.4%) and VPA polytherapy (19.4%). Total of osteopenia and osteoporosis, or low BMD, was highest in VPA polytherapy (VPA+ non-enzyme-inducing AED [NEID]) and CBZ polytherapy (CBZ+NEID) groups, with rates of 58.3% and 55.1%, respectively. In addition, there was no significant difference between drug groups according to bone metabolism markers, vitamin D levels, and osteopenia-osteoporosis rates. Assuming bone health will be affected at an early age in epilepsy patients, providing lifestyle and diet recommendations, avoiding polytherapy including VPA and CBZ when possible, and evaluating bone metabolism at regular intervals are actions that should be applied in routine practice.

scholarly journals Vitamin D Status and Components of Metabolic Syndrome in Older Subjects from Northern Finland (Latitude 65°North)

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1229 ◽  
Author(s):  
Shivaprakash Jagalur Mutt ◽  
Jari Jokelainen ◽  
Sylvain Sebert ◽  
Juha Auvinen ◽  
Marjo-Riitta Järvelin ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Vitamin D ◽  
Dietary Habits ◽  
Lifestyle Factors ◽  
Vitamin D Status ◽  
Endocrine Society ◽  
Northern Latitudes ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
Older Subjects

Introduction: Vitamin D deficiency has been linked to the increased risk of several chronic diseases, especially in people living in the Northern Latitudes. The aim of this study was to assess the vitamin D status in older subjects born in 1945 in Northern Finland (latitude 65°North), and to examine its associations to components of metabolic syndrome (MetS). Methods: In this cross-sectional study, we invited 904 subjects born in 1945 from the Oulu region (Oulu45 cohort), out of an original cohort of 1332 subjects. In the cohort, plasma 25 hydroxyvitamin D (25OHD) levels were determined by an enzyme immunoassay of 263 men and 373 women, with a mean age baseline of 69±0.5 years old. We assessed the participants’ usage of vitamin D supplements, as well as their lifestyle factors, using a questionnaire. Results: Nearly 80% of the subjects had low vitamin D levels [either vitamin D deficient (<50 nmol/L) or insufficient (50 – 75 nmol/L)], and only 20% of the participants had sufficient vitamin D levels (>75 nmol/L) (based on the American Endocrine Society guidelines). The low vitamin D status was associated with a high prevalence of MetS; a significantly higher number of subjects with MetS (41%) had low vitamin D levels in comparison to the non-MetS subjects (38%) (p ≤ 0.05). The subjects under vitamin D supplementation had a significantly lower incidence of MetS (42.6% vs 57.4%) and its components in comparison to the non-supplemented subjects (p ≤ 0.05). Conclusions: Low vitamin D levels are a risk factor for MetS amongst other lifestyle factors, such as dietary habits and physical inactivity, among older subjects in the Northern Latitudes (65°North). Optimal supplementation of vitamin D, along with rich dietary sources of vitamin D, are highly recommended for older subjects as a means to positively affect, e.g., hypertension, insulin resistance, and obesity, as components of the MetS.

scholarly journals Reducing hypovitaminosis D among Somali immigrants in Minnesota: a narrative review

2019 ◽  
Vol 12 (1) ◽  
pp. 50-59
Author(s):  
Leah Qubty ◽  
Basil Aboul-Enein ◽  
Lori Bechard ◽  
Joshua Bernstein ◽  
Joanna Kruk
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Light Exposure ◽  
Hypovitaminosis D ◽  
Narrative Review ◽  
Future Health ◽  
Somali Refugees ◽  
Content Type ◽  
Increased Risk ◽  
The Usa

PurposeSomalia is an East African nation with a history of civil unrest that produced a significant influx of refugees in the USA in the last 25 years. Between 2000 and 2010, 40 percent of all US Somali refugees settled in Minnesota, which produces new cultural and health challenges for local communities and the state government. One such challenge is vitamin D deficiency, or hypovitaminosis D (Hv-D). Hv-D is developed through insufficient exposure to sunlight and low nutrient intake leading to increased risk for weakness and inflammation, oral health problems, diabetes, cardiovascular and autoimmune diseases and malignancies. The paper aims to discuss these issues.Design/methodology/approachIn this narrative review, demographic, geographic and cultural information about Somali immigration are discussed.FindingsRecent data suggest Somalis living in northern climates (Minnesota, the USA, Helsinki, Finland, Sweden and the UK) experience significant deficiencies in vitamin D. Vitamin D is stimulated by ultraviolet light exposure, a balanced and healthy diet, and dietary supplementation. High unemployment rates affecting access to health information and clinical services, significant cultural differences and climate differences pre-dispose this population to Hv-D. Health education and health promotion programming at the community and state levels in Minnesota should recognize the risk factors associated with Hv-D and the vulnerability of Somali refugees.Originality/valueCurrent and future health programming should be re-assessed for adequate attention to vitamin D deficiency and cultural competency associated with the Somali immigrant population.

scholarly journals Severity of Vitamin D Deficiency Predicts Mortality in Ischemic Stroke Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Jarosław Wajda ◽  
Maciej Świat ◽  
Aleksander J. Owczarek ◽  
Aniceta Brzozowska ◽  
Magdalena Olszanecka-Glinianowicz ◽  
...  
Keyword(s):  
Vitamin D ◽  
Ischemic Stroke ◽  
Secondary Hyperparathyroidism ◽  
Functional Status ◽  
Fibroblast Growth Factor 23 ◽  
Mortality Rates ◽  
Mortality Data ◽  
Risk Of Death ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

Background. Vitamin D (VD) deficiency is considered an independent risk factor for death due to cardiovascular events including ischemic stroke (IS). We assessed the hypothesis that decreased levels of 25-hydroxyvitamin D (25-OH-D) are associated with increased risk of mortality in patients with IS. Methods. Serum 25-OH-D, intact parathyroid hormone (iPTH), and intact fibroblast growth factor 23 (iFGF23) levels were assessed in serum of 240 consecutive patients admitted within the 24 hours after the onset of IS. Mortality data was obtained from the local registry office. Results. Only three subjects (1.3%) had an optimal 25-OH-D level (30-80 ng/mL), 25 (10.4%) had a mildly reduced (insufficient) level, 61 (25.4%) had moderate deficiency, and 151 (62.9%) had a severe VD deficiency. 20% subjects had secondary hyperparathyroidism. The serum 25-OH-D level was significantly lower than that in 480 matched subjects (9.9±7.1 vs. 21.0±8.7 ng/mL). Of all the patients, 79 (32.9%) died during follow-up observation (44.9 months). The mortality rates (per year) were 4.81 and 1.89 in a group with and without severe VD deficiency, respectively (incidence rate ratio: 2.52; 95% CI: 1.44–4.68). There was no effect of secondary hyperparathyroidism and iFGF23 levels on mortality rates. Age, 25−OH−D<10 ng/mL, and functional status (modified Rankin scale) were significant factors increasing the risk of death in multivariable Cox proportional hazard regression test. Conclusions. Severe VD deficiency is an emerging, strong negative predictor for survival after IS, independent of age and functional status. VD supplementation in IS survivals may be considered due to high prevalence of its deficiency. However, it is uncertain whether it will improve their survival.

scholarly journals Role of Vitamin D in Cardiometabolic Diseases

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Chaoxun Wang
Keyword(s):  
Metabolic Syndrome ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vascular Inflammation ◽  
Left Ventricular ◽  
Bone Diseases ◽  
The Body ◽  
Cvd Risk ◽  
Increased Risk ◽  
Vitamin D Levels

Vitamin D deficiency is a highly prevalent condition. Low vitamin D levels have long been associated with bone diseases, such as rickets in children and osteomalacia and osteoporosis in adults. However, it has become apparent in recent years that adequate vitamin D levels are also important for optimal functioning of many organs and tissues throughout the body, including the cardiovascular system. Evolving data indicate that vitamin D deficiency is associated with an increased risk of cardiovascular disease (CVD). Studies have shown that low vitamin D levels are associated with hypertension, diabetes, metabolic syndrome, left ventricular hypertrophy, and chronic vascular inflammation, all of which are risk factors for CVD. This paper reviews the definition and pathophysiology of vitamin D deficiency, clinical evidence linking vitamin D and CVD risk, diabetes and its complications, and metabolic syndrome.

Impaired bone mineralization accompanied by low vitamin D and secondary hyperparathyroidism in patients with femoral neck fracture

2012 ◽  
Vol 24 (2) ◽  
pp. 641-649 ◽  
Author(s):  
S. Seitz ◽  
T. Koehne ◽  
C. Ries ◽  
A. De Novo Oliveira ◽  
F. Barvencik ◽  
...  
Keyword(s):  
Vitamin D ◽  
Femoral Neck ◽  
Secondary Hyperparathyroidism ◽  
Femoral Neck Fracture ◽  
Bone Mineralization ◽  
Neck Fracture

scholarly journals Parycalcitol + J131 - A New Route to Treatment Secondary Hyperparathyroidism in Patients with Chronic Kidney Disease on Long-term Dialysis?

2019 ◽  
Vol 3 (3) ◽  
pp. 1-4
Author(s):  
Radosław Drozd ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Bone Metabolism ◽  
Soft Tissues ◽  
Bone Mineralization ◽  
The Body ◽  
Calcium Deposition ◽  
Phosphate Binding

Two cases with the dramatic course of secondary hyperparathyroidism in patients with chronic kidney disease on long-term dialysis. Has anything possible been done in management of these patients? Complications associated with impaired bone mineralization among patients with chronic kidney disease on long-term dialysis are observed frequently with an array of pathologic processes being found. Kidney osteodystrophy may be associated with either increased or decreased (adynamic bone disease, osteomalacia, aluminum-induced osteopenia) bone metabolism, as well as mixed forms related to the B2 microglobulin amyloidosis. Differential diagnosis of various types of osteopathy is difficult and is usually based on the histologic assessment of the bone biopsy. The most typical bone complication in patients with impaired kidney function is osetodistophy with increased bone metabolism, caused by secondary hyperparathyroidism clinically manifesting as osteitis fibrosa. High serum levels of PTH induce osteoclast and osteoblast activity. Early changes, with characteristic increase in the woven osteoid suggesting early, increased osteoplastic bone resorption may be found in a significant percentage of patients with GFR>60ml/min/1,73m2 of the body surface. Lower values of the GFR are associated with both faster bone synthesis and more active resorption with progressive increase in the intraosseous fibrosis and decreased bone mineralization. As the abnormalities progress, which is especially marked in patients on long-term dialysis, a rage of clinical symptoms, such as: severe bone and joint pain, bone deformation, pathological fractures, especially in the spinal region, calcifications of the soft tissues and vessels, including heart valves and lungs. In children, the most common abnormality is growth impairment. In some patient’s skin calcifications, with subsequent necrosis, due to increased calcium deposition in small and medium arteries. The diagnosis is based on the typical clinical picture, biochemical parameters (calcium and phosphate ratio, parathormone levels, characteristic radiologic charges and sometimes, bone histology. Prevention and treatment of these complications includes effective dialysis, appropriate low-phosphate diet with limitation of the protein supply to the 0.8g/kg of the body mass, adequate calcium and active Vitamin D3 supply, introduction of the phosphate binding medications (sevelamer or lantan) as well as calcimimetic use (substances activating parathyroid gland calcium receptors inhibiting both its up-regulation and PTH secretion). In the severe cases, with insufficient effect of the treatment described above, parathyroidectomy is required after close ultrasound and scintigraphy-based assessment of these glands. However, even such treatment may be insufficient in some cases, as presented below.

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