What is Vitamin D?
Vitamin D, an essential vitamin, is a group of fat-soluble prohormones. There are two major types of Vitamin D: D2 and D3, which are called calciferol.
In the past Vitamin D was only felt to be essential for promoting calcium absorption, maintaining adequate calcium and phosphate in the blood to ensure strong bones and prevent illnesses from low calcium level.
Thousands of new studies have linked low Vitamin D levels to higher risks of chronic illnesses including high blood pressure, heart disease and stroke[1],[2],[3], , diabetes[4],[5],[6] cancers[7],[8],[9] , auto-immune disease, infections, depression, and cognitive impairments.
Sources of Vitamin D?
Vitamin D2 or ergocalciferol is obtained from foods of plant origin and vitamin D3 or cholecalciferol is obtained from foods of animal origin and ultraviolet light-stimulated conversion of 7-dehydrocholestral in the skin. Vitamin D is stored in the human body as calcidiol or 25-hydroxyvitamin D or 25-OH-D. Serum concentration of 25-OH-D is the best indicator of vitamin D status[10].
Causes of Low Vitamin D Levels?
Vitamin D deficiencies are the result of dietary inadequacy, impaired absorption and use, increased requirement, or increased excretion (fat absorption, coeliac disease etc.). Vitamin D deficiency can occur when exposure to sunlight is limited and when sunscreens are continually being used.
People age 50 years old or older[11],[12] where the skin is less efficient in converting Vitamin D to its active form. They are usually are less active[13] in the sun outside and have increased chance of kidney insufficiencies than the younger population.
Obese people are a higher risk[14]. Darker skins means higher amount of the pigment melanin which reduces the skin’s ability to produce Vitamin D from sunlight, thus there is an epidemic of vitamin D deficiency in most Blacks. Vitamin D deficiency can also result from the inability of the kidneys to convert vitamin D to its active form.
Vitamin D Deficiency is reported to be the most common medical condition in the world[15],[16],[17].
Increased Vitamin D levels Improves the Following:
Depression[18], obesity[19], high cholesterol[20], high triglycerides[21], high blood pressure[22], wheezing[23],[24] asthma[25], infections[26], allergies[27], autoimmune disorders[28], prevent/delay disease progression in type 2 diabetes[29], risk of death from any cause[30], reduces inflammatory[31].[32] and hemostatic markers[33].
Vitamin D Test
Vitamin D is determined to be medically necessary by most insurance companies if patient present with many illnesses including kidney insufficiency, generalized bony pain, coeliac disease and osteoporosis.
Recommended Daily Intake of Vitamin D3
Dose of vitamin D depends on your serum levels. So checking the levels is essential and between 30 to 100 ng/ml is within normal range. However, levels between 60 – 80 are ideal.
References
[1] Strange, R.C., et al. Metabolic syndrome: a review of the role of vitamin D in mediating susceptibility and outcome. World J. Diabetes. 2015; 6: 896–911.
[2] Ford, E.S., et al. Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J. Diabetes. 2009; 1: 296–303.
[3] Parker, J., et al. Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas. 2010; 65: 225–236.
[4] Strange, R.C., et al. Metabolic syndrome: a review of the role of vitamin D in mediating susceptibility and outcome. World J. Diabetes. 2015; 6: 896–911.
[5] Ford, E.S., et al. Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J. Diabetes. 2009; 1: 296–303.
[6] Parker, J., et al. Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas. 2010; 65: 225–236.
[7] Li M, et al. 1,25-Dihydroxyvitamin D3 suppresses gastric cancer cell growth through VDR- and mutant p53-mediated induction of p21. Life Sci. 179:88-97, 2017.
[8] Hedlund TE, et al. Stable expression of the nuclear vitamin D receptor in the human prostatic carcinoma cell line JCA-1: evidence that the antiproliferative effects of 1 alpha, 25-dihydroxyvitamin D3 are mediated exclusively through the genomic signaling pathway. Endocrinology. 137(5):1554-61, 1996.
[9] Deuster E, et al. al. Vitamin D and VDR in Gynecological Cancers-A Systematic Review. Int J Mol Sci. 2017 Nov 4;18(11).
[10] Dawson-Hughes, B., et al. Estimates of optimal vitamin D status. Osteoporos. Int. 2005; 16: 713–716.
[11] Mottillo, S., et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J. Am. Coll. Cardiol. 2010; 56: 1113–1132.
[12] Schmitt, E.B. et al. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas, 17:97-102, 2018.
[13] Mottillo, S., et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J. Am. Coll. Cardiol. 2010; 56: 1113–1132.
[14] Mottillo, S., et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J. Am. Coll. Cardiol. 2010; 56: 1113–1132.
[15] Hilger, J., Friedel, A., Herr, R., Rausch, T., Roos, F., Wahl, D.A., Pierroz, D.D., Weber, P., and Hoffmann, K. A systematic review of vitamin D status in populations worldwide. Br. J. Nutr. 2014; 111: 23–45.
[16] Lips, P., Hosking, D., Lippuner, K., Norquist, J.M., Wehren, L., Maalouf, G., Ragi-Eis, S., and Chandler, J. The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J. Inter. Med. 2006; 260: 245–254.
[17] Ford, E.S., Zhao, G., Li, C., and Pearson, W.S. Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J. Diabetes. 2009; 1: 296–303
[18] Wong SK et al. Vitamin D and Depression: The Evidence from an Indirect Clue to Treatment Strategy. Curr Drug Targets. 2018;19(8):888-897.
[19] Schmitt, E.B. et al. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas, 17:97-102, 2018.
[20] Schmitt, E.B. et al. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas, 17:97-102, 2018.
[21] Schmitt, E.B. et al. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas, 17:97-102, 2018.
[22] Schmitt, E.B. et al. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas, 17:97-102, 2018.
[23] Hibbs AM et al.Effect of Vitamin D Supplementation on Recurrent Wheezing in Black Infants Who Were Born Preterm: The D-Wheeze Randomized Clinical Trial. JAMA. 2018 May 22;319(20):2086-2094.
[24] Litonjua AA et al. Effect of Prenatal Supplementation With Vitamin D on Asthma or Recurrent Wheezing in Offspring by Age 3 Years: The VDAART Randomized Clinical Trial. JAMA. 2016 Jan 26;315(4):362-70.
[25] Litonjua AA et al. Effect of Prenatal Supplementation With Vitamin D on Asthma or Recurrent Wheezing in Offspring by Age 3 Years: The VDAART Randomized Clinical Trial. JAMA. 2016 Jan 26;315(4):362-70.
[26] Saggese G et al. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr. 2018 May 8;44(1):51.
[27] Saggese G et al. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr. 2018 May 8;44(1):51.
[28] Saggese G et al. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr. 2018 May 8;44(1):51.
[29] Zarini, GG. Vitamin D3 Supplementation May Prevent/Delay Disease Progression in Type 2 Diabetes through Telomerase Reactivation and Maintenance of DNA. FASEB Journal, April 2016 Supplement.
[30] Chowdhury R et al. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomized intervention studies. BMJ 2014. Apr 1;348:g1903.
[31] de Medeiros MCS. Dietary intervention and health in patients with systemic lupus erythematosus: A systematic review of the evidence. Crit Rev Food Sci Nutr. 2018 Apr 12:1-8.
[32] Zerofsky, M et al. Effects of a Randomized, Controlled Trial of Daily Vitamin D3 Supplementation During Pregnancy on Regulatory Immunity and Inflammation. FASEB Journal, 4/2016 supplement.
[33] Deuster E, et al. Dietary intervention and health in patients with systemic lupus erythematosus: A systematic review of the evidence. Crit Rev Food Sci Nutr. 2018 Apr 12:1-8.