Absorption occurs by simple passive diffusion and by a mechanism that involves intestinal membrane carrier proteins [4]. [, Robien K, Oppeneer SJ, Kelly JA, Hamilton-Reeves JM. Interventions to prevent falls in older adults: Updated evidence report and systematic review for the US Preventive Services Task Force. In the 54 participants who completed the study, vitamin D supplementation did not improve insulin sensitivity or insulin secretion in comparison with placebo. Vitamin D and calcium: A systematic review of health outcomes. It helps the bones absorb calcium, supports the immune system and may aid strength gain and fat loss. Some vitamin D3 is also converted to nonactive forms [1]. Prolonged exclusive breastfeeding without vitamin D supplementation can cause rickets in infants, and, in the United States, rickets is most common among breastfed Black infants and children [47]. Daily supplementation with 15 g vitamin D2 compared with vitamin D3 to increase wintertime 25-hydroxyvitamin D status in healthy South Asian and white European women: A 12-wk randomized, placebo-controlled food-fortification trial. Both vitamins D2 and D3 raise serum 25(OH)D levels, and they seem to have equivalent ability to cure rickets [4]. Women with 25(OH)D levels of less than 30 nmol/L (12 ng/mL) had a 43% higher MS risk than women with levels of 50 nmol/L (20 ng/mL) or higher. Gratuit Vitamin C Wikipedia Vitamin C, also known as ascorbi. The Dietary Guidelines for Americans describes a healthy dietary pattern as one that: This fact sheet by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. Hypercalcemia, in turn, can lead to nausea, vomiting, muscle weakness, neuropsychiatric disturbances, pain, loss of appetite, dehydration, polyuria, excessive thirst, and kidney stones. 25-hydroxyvitamin D assays: Standardization, guidelines, problems, and interpretation. beef brisket wine pairing. Use of unstandardized 25(OH)D measures can raise questions about the accuracy of the results and about the validity of conclusions drawn from studies that use such measures and, especially, from meta-analyses that pool data from many studies that use different unstandardized measures [5,9,70]. The groups showed no significant differences in the incidence and recurrent rates of depression, clinically relevant depressive symptoms, or changes in mood scores. It is also found in some animal foods and supplements. doi: 10.1001/jamanetworkopen.2019.17789. Circulating 25-hydroxyvitamin D concentration and risk of breast, prostate, and colorectal cancers: The Melbourne Collaborative Cohort Study. Obes Rev 2014;15:528-37. Add. In addition, high intakes of vitamin D, especially from supplements, might reduce the potency of atorvastatin (Lipitor), lovastatin (Altoprev and Mevacor), and simvastatin (FloLipid and Zocor), because these statins and vitamin D appear to compete for the same metabolizing enzyme [167-170]. Similarly, in a review of data from nearly 250 studies published between 2009 and 2013, the Agency for Healthcare Research and Quality concluded that no relationship could be firmly established between vitamin D and health outcomes other than bone health [69]. Similarly, the VITAL clinical trial described above found that vitamin D supplements did not significantly decrease rates of heart attacks, strokes, coronary revascularization, or deaths from cardiovascular causes [93]. Osteoporos Int 2018;29:1697-1711. The fortification of milk (a good source of calcium) and other staples, such as breakfast cereals and margarine, with vitamin D beginning in the 1930s along with the use of cod liver oil made rickets rare in the United States [28,50]. J Clin Endorcinol Metab 2015;100:2339-46. JAMA 2018;319:1600-12. The trials administered different amounts of vitamin D (ranging from 10 mcg [400 IU]/day to 1,000 mcg [40,000 IU]/week). Horm Metab Res 2019;51:11-21. Breastfed infants Nutr Rev 2019;77:890-902. In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy).". Diets low in vitamin D are more common in people who have milk allergy or lactose intolerance and those who consume an ovo-vegetarian or vegan diet [1]. Curr Opin Gastroenterol 2008;24:176-83. Circulating vitamin D concentrations and risk of breast and prostate cancer: A Mendelian randomization study. Vitamin D alone did not significantly affect the development of new serrated polyps, but the combination of vitamin D with calcium increased the risk almost fourfold. Int J Obes Relat Metab Disord 1997;21:S24-30. Observational studies have linked lower serum 25(OH)D levels to an increased risk of diabetes, but their results might have been confounded by the fact that many participants were overweight or had obesity and were therefore more predisposed to developing diabetes and having lower 25(OH)D levels [1]. Serum vitamin D (25-hydroxyvitamin D) levels over 150 ng/ml (375 nmol/l) are a sign of vitamin D toxicity. In serum, 25(OH)D has a fairly long circulating half-life of 15 days [1]. For example, a meta-analysis of 9 trials with a total of 4,923 adult participants diagnosed with depression or depressive symptoms found no significant reduction in symptoms after supplementation with vitamin D [131]. doi: 10.1002/14651858.CD007469.pub2. J Natl Cancer Inst 2019;111:158-69. Relative effectiveness of oral 25-hydroxyvitamin D3 and vitamin D3 in raising wintertime serum 25-hydroxyvitamin D in older adults. Circulating vitamin D and colorectal cancer risk: An international pooling project of 17 cohorts. [, Zhou R, Wang M, Huang H, Li W, Hu Y, Wu T. Lower vitamin D status is associated with an increased risk of ischemic stroke: A systematic review and meta-analysis. [, Quesada-Gomez JM, Bouillon R. Is calcifediol better than cholecalciferol for vitamin D supplementation? alert icon. Vitamin D might also have anti-inflammatory, immunomodulatory, proapoptotic, and antiangiogenic effects [1,87]. Just to mention its most important functions. The amount of increase varies, for example, by baseline serum levels and duration of supplementation. Supplemental vitamin D and incident fractures in midlife and older adults. In contrast to 25(OH)D, circulating 1,25(OH)2D is generally not a good indicator of vitamin D status because it has a short half-life measured in hours, and serum levels are tightly regulated by parathyroid hormone, calcium, and phosphate [1]. Homebound individuals; people who wear long robes, dresses, or head coverings for religious reasons; and people with occupations that limit sun exposure are among the groups that are unlikely to obtain adequate amounts of vitamin D from sunlight [62]. The U.S. Department of Agricultures (USDAs) FoodData Central lists the nutrient content of many foods and provides a comprehensive list of foods containing vitamin D arranged by nutrient content and by food name. Skin wounds that take a long time to heal. Pages 939-57 in Feldman D, Pike JW, Bouillon R, Giovannucci E, Goltzman D, Hewison M, eds. Pediatr Clin North Am 2001;48:53-67. The combination of high intakes of calcium (about 2,100 mg/day from food and supplements) with moderate amounts of vitamin D (about 19 mcg [765 IU]/day from food and supplements) increased the risk of kidney stones by 17% over 7 years among 36,282 postmenopausal women who were randomly assigned to take 1,000 mg/day calcium and 10 mcg (400 IU)/day vitamin D or a placebo [161]. Levels of 75 to less than 87.5 nmol/L (30 to less than 35 ng/mL) and 87.5 to less than 100 nmol/L (35 to less than 40 ng/mL) were associated with a 19% and 27% lower risk, respectively. Hansen D, Bazell C, Pelizzari P, Pyenson B. Chung M, Balk EM, Brendel M, Ip S, Lau J, Lee J, et al. In children, vitamin D deficiency is manifested as rickets, a disease characterized by a failure of bone tissue to become properly mineralized, resulting in soft bones and skeletal deformities [44]. [, Keum N, Lee DH, Greenwood DC, Manson JE, Giovannucci E. Vitamin D supplementation and total cancer incidence and mortality: A meta-analysis of randomized controlled trials. Another recent systematic review also found that vitamin D and calcium supplements had no beneficial effects on fractures, falls, or bone mineral density [79,80]. Assessing the vitamin D status of the US population. [, Helzlsouer KJ for the VDPP Steering Committee. In addition, inadequate vitamin D levels can adversely affect muscle strength and lead to muscle weakness and pain (myopathy) [1]. In addition, studies provided different amounts of nutrients and used different dosing schedules. A meta-analysis of 3 randomized controlled trials in 1,273 men with prostate cancer found no significant differences in total mortality rates between those receiving vitamin D supplementation (from 10 mcg [400 IU]/day for 28 days to 45 mcg [1,800 IU] given in three doses total at 2-week intervals) and those receiving a placebo [116]. Proportions at risk of deficiency were lowest among children aged 15 years (0.5%), peaked at 7.6% in adults aged 2039 years, and fell to 2.9% among adults aged 60 years and older; patterns were similar for risks of inadequacy. Association of glucocorticoid use and low 25-hydroxyvitamin D levels: Results from the National Health and Nutrition Examination Survey (NHANES): 2001-2006. Possible explanations for this increase include genetic differences in vitamin D metabolism, dietary preferences, and behaviors that lead to less sun exposure [45,46]. However, more than 20 mcg (800 IU)/day vitamin D3, when taken with calcium supplements, significantly increased blood pressure in participants with overweight and obesity. Positive association between circulating 25-hydroxyvitamin D levels and prostate cancer risk: New findings from an updated meta-analysis. They also had different study durations (5 days to 5 years), mean participant ages (range, 22 years to 75 years), and baseline 25(OH)D levels; furthermore, some but not all studies administered concurrent antidepressant medications. A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. Yao P, Bennett D, Mafham M, Lin X, Chen Z, Armitage J, Clarke R. Vitamin D and calcium for the prevention of fracture: A systematic review and meta-analysis. Laboratory and animal studies suggest that vitamin D might inhibit carcinogenesis and slow tumor progression by, for example, promoting cell differentiation and inhibiting metastasis. One study comparing 738 men who developed pancreatic cancer to 738 matched controls found no relationship between serum 25(OH)D levels and risk of pancreatic cancer [105]. Lancet Diabetes-Endocrinol 2014;2:719-29. However, many factors affect this process. Statins Am J Clin Nutr 2004;80:1697S-705S. Nutr Clin Pract 2013;28:194-208. In foods and dietary supplements, vitamin D has two main forms, D2 (ergocalciferol) and D3 (cholecalciferol), that differ chemically only in their side-chain structures. The 'sunshine vitamin': benefits beyond bone? Individuals with a body mass index (BMI) of 30 or more have lower serum 25(OH)D levels than individuals without obesity. Cancer Neurology 2017;89: 1578-83. Individuals taking these and other medications on a regular basis should discuss their vitamin D intakes and status with their health care providers. products like plain whole cow's milk (for children 12 months and older), yogurt, cereals, and some 100% juices. Intake recommendations for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by expert committees of NASEM [1]. Very high levels of vitamin D in your blood (greater than 375 nmol/L or 150 ng/mL) can cause nausea, vomiting, muscle weakness, confusion, pain, loss of appetite, dehydration, excessive urination and thirst, and kidney stones. In addition to bone deformities and pain, severe rickets can cause failure to thrive, developmental delay, hypocalcemic seizures, tetanic spasms, cardiomyopathy, and dental abnormalities [45,46]. Facebook. N Engl J Med 2019:380:33-44. The vitamin D reduced insulin resistance to a small but significant degree, especially in people taking more than 50 mcg (2,000 IU)/day who were vitamin D deficient at baseline, had good glycemic control, did not have obesity, and were of Middle Eastern ethnicity. One might expect a large proportion of the U.S. population to have vitamin D inadequacy on the basis of vitamin D intakes from foods, beverages, and even dietary supplements. However, most evidence indicates that vitamin D3 increases serum 25(OH)D levels to a greater extent and maintains these higher levels longer than vitamin D2, even though both forms are well absorbed in the gut [33-36]. A study of cohorts that included 5,313 participants who developed lung cancer and 5,313 matched controls found no association between serum 25(OH)D levels and risk of subsequent lung cancer, even when the investigators analyzed the data by sex, age, race and ethnicity, and smoking status [104]. [, Rajakumar K. Vitamin D, cod-liver oil, sunlight, and rickets: A historical perspective. Research to date provides mixed evidence on whether levels of 25(OH)D are associated with the development of prostate cancer. 290-2007-10055-I. [, Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, et al. For these reasons, vitamin D has been linked to heart health and risk of CVD. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. In a subsequent investigation for 4.9 years after the study's end, women who had taken the vitamin D and calcium supplements (many of whom continued to take them) had an 18% lower risk of in situ (noninvasive) breast cancer [100]. [, Pittas A, Dawson-Hughes B, Staten M. The authors reply: Vitamin D supplementation and prevention of type 2 diabetes. In the most recent meta-analysis, 10 randomized clinical trials (including the VITAL trial described below) that included 6,537 cancer cases provided 10 to 50 mcg (400 to 2,000 IU) vitamin D3 daily (six trials) or 500 mcg (20,000 IU)/week to 12,500 mcg (500,000 IU)/year boluses of vitamin D3 (four trials) [91]. Of course, as I state elsewhere on the site, it is somewhat of a disservice to discuss one nutrient alone and not discuss the vast array of nutrients required and the complex systems in So Many Ailments are Helped with Proper C Intake As has become clear from the other areas of Cforyourself, there isn't a lot that enough vitamin C won't help. Further research is needed to determine whether vitamin D inadequacy increases cancer risk, whether greater exposure to the nutrient can prevent cancer, and whether some individuals could have an increased risk of cancer because of their vitamin D status over time. The vitamin D3 and calcium supplements did not reduce breast cancer incidence, and 25(OH)D levels at the start of the study were not associated with breast cancer risk [99]. Studies examining the effects of supplemental vitamin D on muscle strength and on rate of decline in muscle function have had inconsistent results [55]. Moreover, the effects did not vary by baseline serum 25(OH)D levels or whether participants took the trials omega-3 supplement in addition to vitamin D. However, another clinical trial designed to investigate bone fracture risk found that 800 IU/day vitamin D3 (with or without calcium) or a placebo in 5,292 adults aged 70 years and older for a median of 6.2 years offered protection from cardiac failure, but not myocardial infarction or stroke [125]. [, Yao S, Kwan ML, Ergas IJ, Roh JM, Cheng T-YD, Hong C-C, et al. Cancer Epidemiol Biomarkers Prev 2014;23:1494-504. Nutr Rev 2018;76:60-76. [, de Koning EJ, Lips P, Penninx BWJH, Elders PJM, Heijboer AC, den Heijer M, et al. However, the supplementation had no significant effects on fasting blood glucose, hemoglobin A1c, or fasting insulin levels. Home; ABOUT; LEARN ABOUT C . Vitamin D status and supplementation before and after bariatric surgery: A comprehensive literature review. IOM committee members respond to Endocrine Society vitamin D guidelines. The analysis of 20152016 data also showed that 28% of all individuals aged 2 years and older in the United States took a dietary supplement containing vitamin D [39]. Vitamin D toxicity, otherwise known as hypervitaminosis D, can result in dehydration, fatigue, muscle weakness, vomiting, and calcification of tissues (68, 69). [, Travis RC, Perez-Cornago A, Appleby PN, Albanes D, Joshu CE, Lutsey PL, et al. One study included 1,119 men treated for prostate cancer whose plasma 25(OH)D levels were measured 4.9 to 8.6 years after their diagnosis. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults. Vitamin D is a fat-soluble vitamin that is found in some animal food products and is also synthesized in the human body via exposure to the sun. In addition, older adults are likely to spend more time than younger people indoors, and they might have inadequate dietary intakes of the vitamin [1]. Vitamin D is essential for healthy bones and teeth. Consumption of human milk alone does not ordinarily enable infants to meet vitamin D requirements, because it provides less than 0.6 to 2.0 mcg/L (25 to 78 IU/L) [1,56,57]. Several forms of vitamin D exist.The two major forms are vitamin D 2 or ergocalciferol, and vitamin D 3 or cholecalciferol. Federal agencies and national organizations advise taking photoprotective measures to reduce the risk of skin cancer, including using sunscreen with a sun protection factor (SPF) of 15 or higher, whenever people are exposed to the sun [28,30]. The FNB committee also noted that serum concentrations greater than 125 nmol/L (50 ng/mL) can be associated with adverse effects [1] (Table 1). Nutr Metab Cardiovasc Dis 2016;26:663-73. Lancet 2014;383:1665-76. Weight loss [. Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults. Am J Clin Nutr 2019;110:150-7. Vitamin D helps you absorb calcium and phosphate from food. Cancer Res 2019;79:274-85. Vitamin D synthesis following a single bout of sun exposure in older and younger men and women. [, Skaaby T, Husemoen LLN, Thuesen BH, Pisinger C, Jorgensen T, Roswall N, et al. upper neuadd reservoir history 1; downtown dahlonega webcam 1; permeated by a sense of longing. Pancreatic cancer Screening for vitamin D status is becoming a more common part of the routine laboratory bloodwork ordered by primary-care physicians, irrespective of any indications for this practice [6,52-54]. In practice, however, people usually do not apply sufficient amounts of sunscreen, cover all sun-exposed skin, or reapply sunscreen regularly. One trial included 206 adults (mean age 52 years) who were randomized to take a bolus dose of 2,500 mcg (100,000 IU) vitamin D3 followed by 500 mcg (20,000 IU)/week or a placebo for 4 months [132]. In addition, the USPSTF recommended against supplementation with 10 mcg (400 IU) or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in this population, but it could not determine the balance of benefits and harms from higher doses. J Natl Cancer Inst 2007;99:1563-5. In contrast to water-soluble vitamins, the body has no easy way of getting rid of fat-soluble vitamins. Cancer Epidemiol Biomarkers Prev 2014;23:1484-93. The results showed no significant differences in rates of progression to type 2 diabetes; in serum glucose, insulin, or hemoglobin A1c levels; or in measures of insulin resistance. Vitamin D is essential for bone strength and may support the immune system and other functions. Best drops: Thorne Vitamin D/K2. Int J Cancer 2018;142:1189-201. Salmon. Public Health Nutrition 2020;23:1153-64. Scientific Advisory Committee on Nutrition. Over time, bone density can decline, and osteoporosis can eventually develop [71]. For example, a meta-analysis included 34 observational studies that followed 180,667 participants (mean age greater than 50 years) for 1.3 to more than 32 years. 13-05183-EF-1. Most of the studies described in this section measured serum 25(OH)D levels using various methods that were not standardized by comparing them to the best methods. [, O'Brien KM, Sandler DP, Taylor JA, Weinberg CR. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010. Limits foods and beverages higher in added sugars, saturated fat, and sodium. Most people in the world meet at least some of their vitamin D needs through exposure to sunlight [1]. pii: E493. Below are brief descriptions of studies of vitamin D and its association with, or effect on, breast, colorectal, lung, pancreatic, and prostate cancers. Vitamin D without a subscript refers to either D 2 or D 3, or both, and is known collectively as calciferol.. Vitamin D 2 was chemically characterized in 1931. This is an extremely positive and safe course to take in that it promotes an increased state of wellness and experience shows that high levels of vitamin C act as a chemotherapy potentiator. Rates of breast, prostate, and colorectal cancer did not differ significantly between the vitamin D and placebo groups. As you are aware, an Iodine solution is the best way to test for the presence of starch. Vitamin D deficiency is associated with vascular dysfunction, arterial stiffening, left ventricular hypertrophy, and hyperlipidemia [119]. Studies of the effects of vitamin D supplements on hypertension have also had mixed findings. Questions about vitamin D for primary care practice: Input from an NIH conference. Report / Delete 3 Reply andreaalvarez kristine98132 Posted 4 years ago Cforyourself is dedicated to the dissemination of information about vitamin C . Vitamin D supplementation and risk of toxicity in pediatrics: A review of current literature. Borel P, Caillaud D, Cano NJ. If the deficiency continues unresolved, then more noticeable symptoms may occur, such as bone fractures, rickets, or osteomalacia. The combination of these diuretics with vitamin D supplements (which increase intestinal calcium absorption) might lead to hypercalcemia, especially among older adults and individuals with compromised renal function or hyperparathyroidism [167,175,176]. The USPSTF also reviewed the seven published studies on the effects of vitamin D supplementation (two of them also included calcium supplementation) on the risk of falls in community-dwelling adults aged 65 years or older who did not have osteoporosis or vitamin D deficiency. The study reports included 310 years of followup data. In fact, up to 40% of U.S. adults are considered to have insufficient levels (not enough) of vitamin D, while around 6% are considered deficient in. I produce this site out of my passionate desire to inform as many people as possible about the nature of our body's need for the proper nutrients in adequate amounts. People aged 1-70 years should aim to get at least 15 mcg or 600 IU of vitamin D per day. [, Cashman KD, Seamans KM, Lucey AJ, Stocklin E, Weber P, Kiely M, Hill TR. Food Your doctor may recommend a vitamin D tablet for you. Clinical trials, however, do not support these findings. Having produced a solution of this blue indicator, some researchers suggest its use as an indicator for the presence of Vitamin C. The USPSTF stated that, due to insufficient evidence, it was unable to assess the balance of benefits and harms of supplemental vitamin D to prevent cancer [117]. These values, which vary by age and sex, include: An FNB committee established RDAs for vitamin D to indicate daily intakes sufficient to maintain bone health and normal calcium metabolism in healthy people. Vitamin D did not significantly prevent the development of diabetes in comparison with placebo. Neurology 2017;89:1538-9. Vitamin D, Volume 2: Health, Disease and Therapeutics, Fourth Edition. National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. In fact, 20132016 NHANES data showed that 92% of men, more than 97% of women, and 94% of people aged 1 year and older ingested less than the EAR of 10 mcg (400 IU) of vitamin D from food and beverages [40]. Individuals with obesity who have undergone gastric bypass surgery can also become vitamin D deficient. [, Mheid IA, Quyyumi AA. International Journal of Epidemiology 2019;48:1416-24. N Eng J Med 2022;387:299-309. Greater amounts of the pigment melanin in the epidermal layer of the skin result in darker skin and reduce the skins ability to produce vitamin D from sunlight [1]. J Am Coll Cardiol 2017;70:89-100. Vitamin D testing can let you know if you need to increase your vitamin D levels. Assessing vitamin D status by measuring serum 25(OH)D concentrations is complicated by the considerable variability of the available assays (the two most common ones involve antibodies or chromatography) used by laboratories that conduct the analyses [5,6]. Taylor CL, Sempos CT, Davis CD, Brannon PM. People who avoid all animal-sourced products can contact dietary supplement manufacturers to ask about their sourcing and processing techniques. and some exceptional products like: Butterfat Keto, Advanced Collagen and Altrient C, Neutrient put a group of #CForYourself volunteers onto the 5C Reset and achieved outstanding results. OVERVIEW; PRIMER; IN THE NEWS Observational studies support an association between higher serum 25(OH)D levels and a lower risk of CVD incidence and mortality. The weight-loss drug orlistat (Xenical and alli), together with a reduced-fat diet, can reduce the absorption of vitamin D from food and supplements, leading to lower 25(OH)D levels [164-167]. Black Americans, for example, typically have lower serum 25(OH)D levels than White Americans. Some people take very high doses of vitamin D supplements. Am J Clin Nutr 2012;95:1357-64. [, Zhang R, Li B, Gao X, Tian R, Pan Y, Jiang Y, et al. Experts have reached no firm consensus on whether vitamin D can help prevent MS given the lack of clinical trial evidence [142]. Am J Clin Nutr 2004;80:1710S-6S. Levels of 1,25(OH)2D do not typically decrease until vitamin D deficiency is severe [2]. A systematic review and meta-analysis of 15 weight-loss intervention studies that used caloric restriction, exercise, or both, but not necessarily vitamin D supplementation or other treatments, found that people who lost weight had significantly greater increases in serum 25(OH)D levels than those who maintained their weight [152]. Am J Clin Nutr 2012;95:1350-6. Hossein-nezhad A, Holick MF. J Nutr 2016;146:855-6. My name is Rusty Hoge. Adherence to vitamin D intake guidelines in the United States. 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