Vitamin D supplementation for women before and during pregnancy: an update of the guidelines, evidence, and role of GPs and practice nurses

Abstract. Vitamin D is a secosteroid hormone that plays a pivotal role in several metabolic and reproductive pathways in humans. Increasing evidence supports the role of vitamin D deficiency in metabolic disturbances and infertility in women with polycystic ovary syndrome (PCOS). Indeed, supplementation with vitamin D seems to have a beneficial role on insulin resistance and endometrial receptivity. On the other hand, exceedingly high levels of vitamin D appear to play a detrimental role on oocytes development and embryo quality. In the current review, we summarize the available evidence about the topic, aiming to suggest the best supplementation strategy in women with PCOS or, more generally, in those with metabolic disturbances and infertility. Based on the retrieved data, vitamin D seems to have a beneficial role on IR, insulin sensitivity and endometrial receptivity, but high levels and incorrect timing of administration seem to have a detrimental role on oocytes development and embryo quality. Therefore, we encourage a low dose supplementation (400–800 IU/day) particularly in vitamin D deficient women that present metabolic disturbances like PCOS. As far as the reproductive health, we advise vitamin D supplementation in selected populations, only during specific moments of the ovarian cycle, to support the luteal phase. However, ambiguities about dosage and timing of the supplementation still emerge from the clinical studies published to date and further studies are required.

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Does vitamin D supplementation prevent SARS-CoV-2 infection in military personnel? Review of the evidence

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001686 ◽

2021 ◽

pp. bmjmilitary-2020-001686

Author(s):

Iain T Parsons ◽

R M Gifford ◽

M J Stacey ◽

L E Lamb ◽

M K O'Shea ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Military Studies ◽

Vitamin D Receptors ◽

Area Of Interest ◽

Military Populations ◽

Tract Infections ◽

Recruit Training

For most individuals residing in Northwestern Europe, maintaining replete vitamin D status throughout the year is unlikely without vitamin D supplementation and deficiency remains common. Military studies have investigated the association with vitamin D status, and subsequent supplementation, with the risk of stress fractures particularly during recruit training. The expression of nuclear vitamin D receptors and vitamin D metabolic enzymes in immune cells additionally provides a rationale for the potential role of vitamin D in maintaining immune homeostasis. One particular area of interest has been in the prevention of acute respiratory tract infections (ARTIs). The aims of this review were to consider the evidence of vitamin D supplementation in military populations in the prevention of ARTIs, including SARS-CoV-2 infection and consequent COVID-19 illness. The occupational/organisational importance of reducing transmission of SARS-CoV-2, especially where infected young adults may be asymptomatic, presymptomatic or paucisymptomatic, is also discussed.

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Vitamin D supplementation, COVID-19 and disease severity: a meta-analysis

QJM ◽

10.1093/qjmed/hcab009 ◽

2021 ◽

Cited By ~ 1

Author(s):

K Shah ◽

D Saxena ◽

D Mavalankar

Keyword(s):

Vitamin D ◽

Randomized Controlled Trials ◽

Usual Care ◽

Odds Ratio ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Hospitalized Patients ◽

Controlled Trials ◽

Randomized Controlled

Abstract Objective: Current meta-analysis aims to understand the effect of oral supplementation of vitamin D on intensive care unit (ICU) requirement and mortality in hospitalized COVID-19 patients. Methods: Databases PubMed, preprint servers, and google scholar were searched from December 2019 to December 2020. Authors searched for the articles assessing role of vitamin D supplementation on COVID-19. Cochrane RevMan tool was used for quantitative assessment of the data, where heterogeneity was assessed using I2 and Q statistics and data was expressed using odds ratio with 95% confidence interval. Results: Final meta-analysis involved pooled data of 532 hospitalized patients (189 on vitamin D supplementation and 343 on usual care/placebo) of COVID-19 from three studies (Two randomized controlled trials, one retrospective case-control study). Statistically (p<0.0001) lower ICU requirement was observed in patients with vitamin D supplementation as compared to patients without supplementations (odds ratio: 0.36; 95% CI: 0.210-0.626). However, it suffered from significant heterogeneity, which reduced after sensitivity analysis. In case of mortality, vitamin D supplements has comparable findings with placebo treatment/usual care (odds ratio: 0.93; 95% CI: 0.413-2.113; p=0.87). The studies did not show any publication bias and had fair quality score. Subgroup analysis could not be performed due to limited number of studies and hence dose and duration dependent effect of vitamin D could not be evaluated. Conclusions: Although the current meta-analysis findings indicate potential role of vitamin D in improving COVID-19 severity in hospitalized patients, more robust data from randomized controlled trials are needed to substantiate its effects on mortality.

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Using genetic variants to evaluate the causal effect of serum vitamin D concentration on COVID-19 susceptibility, severity and hospitalization traits: a Mendelian randomization study

Journal of Translational Medicine ◽

10.1186/s12967-021-02973-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Zhiyong Cui ◽

Yun Tian

Keyword(s):

Vitamin D ◽

Fixed Effects ◽

Mendelian Randomization ◽

Causal Effect ◽

Serum Vitamin ◽

Vitamin D Supplementation ◽

Sensitivity Analyses ◽

Global Test ◽

Serum Vitamin D

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has struck globally and is exerting a devastating toll on humans. The pandemic has led to calls for widespread vitamin D supplementation in public. However, evidence supporting the role of vitamin D in the COVID-19 pandemic remains controversial. Methods We performed a two-sample Mendelian randomization (MR) analysis to analyze the causal effect of the 25-hydroxyvitamin D [25(OH)D] concentration on COVID-19 susceptibility, severity and hospitalization traits by using summary-level GWAS data. The causal associations were estimated with inverse variance weighted (IVW) with fixed effects (IVW-fixed) and random effects (IVW-random), MR-Egger, weighted edian and MR Robust Adjusted Profile Score (MR.RAPS) methods. We further applied the MR Steiger filtering method, MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) global test and PhenoScanner tool to check and remove single nucleotide polymorphisms (SNPs) that were horizontally pleiotropic. Results We found no evidence to support the causal associations between the serum 25(OH)D concentration and the risk of COVID-19 susceptibility [IVW-fixed: odds ratio (OR) = 0.9049, 95% confidence interval (CI) 0.8197–0.9988, p = 0.0473], severity (IVW-fixed: OR = 1.0298, 95% CI 0.7699–1.3775, p = 0.8432) and hospitalized traits (IVW-fixed: OR = 1.0713, 95% CI 0.8819–1.3013, p = 0.4878) using outlier removed sets at a Bonferroni-corrected p threshold of 0.0167. Sensitivity analyses did not reveal any sign of horizontal pleiotropy. Conclusions Our MR analysis provided precise evidence that genetically lowered serum 25(OH)D concentrations were not causally associated with COVID-19 susceptibility, severity or hospitalized traits. Our study did not provide evidence assessing the role of vitamin D supplementation during the COVID-19 pandemic. High-quality randomized controlled trials are necessary to explore and define the role of vitamin D supplementation in the prevention and treatment of COVID-19.

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Erratum: Title Correction. The Role of The Effects of Vitamin D Supplementation on Bone Mineral Density and Bone Mineral Content in Ovariectomized Rats Compensation in Rats

Journal of Nutrition and Health ◽

10.4163/jnh.2013.46.6.597 ◽

2013 ◽

Vol 46 (6) ◽

pp. 597

Author(s):

Mi-Ja Choi ◽

Sang-Mi Kim

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Mineral Content ◽

Bone Mineral ◽

Mineral Content ◽

Vitamin D Supplementation ◽

Ovariectomized Rats ◽

Mineral Density

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Role of Vitamin D in Reducing the Frequency of Asthma Attacks in Patients with Frequent Exacerbation of Asthma

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i53b33675 ◽

2021 ◽

pp. 11-16

Author(s):

Mubeen Ahmed Memon ◽

Sheeba Faryal Ansari ◽

Mumtaz Ali Lakho ◽

Mukhtiar Hussain Jaffery ◽

Syed Zulfiquar Ali Shah ◽

...

Keyword(s):

Vitamin D ◽

Corticosteroid Treatment ◽

Vitamin D Supplementation ◽

The Body ◽

P Value ◽

Care Hospital ◽

Asthma Exacerbations ◽

Vitamin D Levels ◽

Interventional Group

Introduction: Vitamin D deficiency is common among asthmatics with literature suggesting that its low levels in the body may trigger exacerbations and decrease the response to corticosteroid treatment. It has also shown to inhibit the production of cytokines, which in turn enhances the body’s response to corticosteroid treatment during an exacerbation. Therefore, maintenance of adequate levels of vitamin D in patients with asthma may reduce the risk of exacerbation and improve their general health. This study aims to explore the role of vitamin D supplementation in preventing asthma exacerbations. Methods: This single blind parallel arm interventional study was conducted in the pulmonology ward in a tertiary care hospital from June 2018 to April 2020. Two hundred (n= 200) participants with a history of frequent acute exacerbation of asthma were enrolled in the study via consecutive convenient non-probability technique. Participants were divided into two groups; the placebo and the interventional group that received 200,000 IU of vitamin D capsule. Results: Compared to day 0, mean episodes of exacerbation in the interventional group were significantly lower after 180 days (1.1 ± 0.4 vs. 0.61 ± 0.3; p-value <0.0001). Similarly, number of asthma attacks in past 7 days was significantly lower in intervention group after 180 days (4.4 ± 2.7 vs. 3.1 ± 1.5; p-value 0.0001) Conclusion: Vitamin D supplementation is a safe and cost-friendly approach to reducing asthma exacerbations. It may also help to improve the condition in severe asthmatics with low vitamin D levels.

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Assessment of vitamin D among Sudanese Patients with Hypothyroidism

10.30574/ijbpsa.2021.1.2.0024 ◽

2021 ◽

Vol 1 (2) ◽

pp. 057-061

Author(s):

Hasna Osman Fadalla Mohamed ◽

Omer Fadol Edris ◽

Gad Allah Modawe ◽

Suhair Abdelrahman Ahmed

Keyword(s):

Vitamin D ◽

Autoimmune Diseases ◽

Vitamin D Deficiency ◽

Vitamin D Supplementation ◽

Control Hospital ◽

Study Population ◽

Thyroid Profile ◽

Methods Analytical ◽

The Relationship

Background: Vitamin D deficiency is a worldwide health issue and its role as an immune modulator has recently been emphasized. Evidence increasingly indicates the important role of vitamin D in reducing the incidence of autoimmune diseases. However, at this time the search for its role in autoimmune diseases and thyroid is not critical. Objectives: The study aimed to assess the relationship between vitamin D deficiency in Sudanese patients with hypothyroidism. Methods: Analytical case control hospital based study, conducted in Fadil Hospital and Police Hospital, Khartoum city, Khartoum state. The study carried out from March 2018 to September 2018. A total of 100 subjects were enrolled in the study. Vitamin D deficiency was set at levels below 20 ng / ml. Thyroid hormones (TSH, T3 and T4) were assessed in all participants using auto analyzer TOSOH AIA 313,while vitamin D was estimated using ELIZA. The data were analyzed using SPSS version (21). Results: The study included 76(76%) females and 24(24%) males, no significance differences between thyroid profile among study population.75 (75%) deficiency of vitamin D and 25(25%) normal vitamin D. vitamin D deficiency was significantly lower in female than male with( p =0.001). Conclusion: The results indicated that patients with hypothyroidism suffer from vitamin D deficiency significantly associated with the degree and severity of hypothyroidism. This encourages the desirability of vitamin D supplementation and recommends the detection of vitamin D deficiency for all hypothyroidism patients.

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PREVALENCE, ASSOCIATED FACTORS AND ROLE OF VITAMIN D AND GLUTATHIONE REDUCTASE OF PRE-ECLAMPSIA IN PREGNANT WOMEN

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1435 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Simerpreet Kukreja

Keyword(s):

Fatty Acids ◽

Vitamin D ◽

Pregnant Women ◽

Glutathione Reductase ◽

Gestational Hypertension ◽

Multiple Pregnancy ◽

Vitamin D Supplementation ◽

Research Centre ◽

Biochemical Basis

Introduction: In maternal and neonatal cases, preeclampsia is a multi-organ, heterogeneous pregnancy condition associated with significant morbidity and mortality. Since preeclampsia is a progressive disease, in some cases, delivery is necessary to stop the progression to the benefit of the mother and foetus. However, the need for early delivery has adverse effects on significant neonatal outcomes that are not limited to the most premature babies. The results include oxidative stress in the disease and invoke the biochemical basis for antioxidant clinical trials to prevent and treat hypertension caused by pregnancy. In the management of preeclampsia, supplementation of antioxidants along with polyunsaturated fatty acids, particularly omega-3 fatty acids, may be useful. This describes vitamin Ds potential role in the pathogenesis of preeclampsia. However, the role of vitamin D supplementation and dosing is controversial in preventing preeclampsia. Method: The study was carried out from March 2019 to April 2020 at Shalinitai Meghe Hospital and Research Centre using institutional-based cross-sectional study design among women whose age was greater than or equal to eighteen. Data were collected using a standardised and pretested questionnaire from 150 participants by face-to - face interview technique. Using Chemiluminiscent Immunoassay (CLIA), vitamin D estimation was performed. The behaviour of Glutathione Reductase was calculated according to the Goldberg et al 1983 procedure. To classify the factors associated with the development of preeclampsia, logistic regression analysis was used. Result: With a mean age of 30.28, a total of 150 participants were enrolled in the study. Evaluation of vitamin D and glutathione levels The prevalence of preeclampsia among current pregnant women attending ANC at Shalinitai Meghe Hospital was 16 with a 95 % CI. The current preeclampsia was significantly correlated with predictive variables such as the age of the respondents, current multiple pregnancy, and history of diabetes mellitus. Conclusion: The findings of this study showed that preeclampsia was present in a large proportion of women. For both urban and rural residents, health seeking actions towards pregnant women should be promoted, offering an opportunity to detect preeclampsia as early as possible and preventing the coming complication of preeclampsia. The role of antioxidants is controversial in the prevention of preeclampsia. Vitamin D deficiency is associated with preeclampsia in a major way. To document the role of vitamin D supplementation in the prevention of preeclampsia, further studies are required. Keywords: Gestational hypertension, Pre-eclampsia, Vitamin D, GSH

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