There is broad agreement that optimal vitamin D status is necessary for bones, muscles, and one’s general health, as well as for the efficacy of antiresorptive and anabolic bone-forming treatments. Food supplementation with vitamin D, or the use of vitamin D supplements, are current strategies to improve vitamin D levels and treat deficiency.
How is vitamin D deficiency treated?
How to Treat Vitamin D Deficiency. The first step in treating vitamin D deficiency is to obtain a baseline 25(OH)D blood level and then decide on the target replacement level and how quickly that target must be reached (Table 1). Each 1,000 IU of vitamin D3 daily in addition to what the patient is currently ingesting will raise the level of 25 ...
When should I be tested for vitamin D deficiency?
Vitamin D Deficiency. Getting enough, but not too much, vitamin D is needed to keep your body functioning well. Vitamin D helps with strong bones and may help prevent some cancers. Symptoms of vitamin D deficiency can include muscle weakness, pain, fatigue and depression. To get enough D, look to certain foods, supplements, and carefully ...
How can I get enough vitamin D?
Sep 21, 2016 · A 25 (OH)D level of 9 ng/mL shows evidence of severe vitamin D deficiency and is likely responsible for some or all of her symptoms. In this case, the 25 (OH)D level should be increased as quickly as possible with either 4,000 IU vitamin D3 daily or 30,000 IU weekly, checking the level again at 6 and 12 weeks.
How much vitamin D3 do you need to treat vitamin D deficiency?
Three treatment modalities exist: sunlight, artificial ultraviolet B radiation or supplementation. All treatment modalities have their potential risks and benefits. Benefits of all treatment...
What class of drugs is most appropriate for treating hyperparathyroidism?
Doctors commonly treat hyperparathyroidism using a class of prescription drugs called bisphosphonates, including alendronate and ibandronate, which are supposed to strengthen bones.
What is the first line treatment for hypocalcemia?
In severe hypocalcemia, IV calcium is used initially, with transition to oral calcium. For mild hypocalcemia, oral calcium could be used for initial treatment. 1 gram calcium chloride (if central access) or 2-3 grams calcium gluconate (via peripheral line). Either may be infused over 10-20 minutes.Jun 25, 2021
What is the most common treatment for hypercalcemia?
Aggressive intravenous rehydration is the mainstay of management in severe hypercalcemia, and antiresorptive agents, such as calcitonin and bisphosphonates, frequently can alleviate the clinical manifestations of hypercalcemic disorders.May 1, 2003
How is hypocalcaemia treated?
In patients with acute symptomatic hypocalcemia, intravenous (IV) calcium gluconate is the preferred therapy, whereas chronic hypocalcemia is treated with oral calcium and vitamin D supplements.Mar 12, 2021
What is the best evidence for appropriate treatment in the event of severe hypocalcemia?
A calcium infusion is indicated for severe acute and or symptomatic hypocalcemia, while the standard mainstays of oral therapy are calcium supplements and activated vitamin D metabolites.Jan 3, 2016
What level of calcium needs treatment?
SEVERE HYPERCALCEMIA Patients with total albumin-corrected calcium >14 mg/dL (>3.5 mmol/L) require more aggressive therapy. As described immediately above, patients with an acute rise in serum calcium to more moderate levels who have changes in sensorium (eg, lethargy, stupor) also require aggressive therapy.Apr 8, 2022
What medication is used to lower calcium levels?
Calcitonin (Miacalcin, Osteocalcin) Lowers elevated serum calcium in patients with multiple myeloma, carcinoma, or primary hyperparathyroidism.Feb 17, 2021
What is calcitonin used to treat?
Calcitonin nasal spray is used together with calcium and vitamin D to treat bone loss in women with postmenopausal osteoporosis who have been postmenopause for at least 5 years. This medicine is available only with your doctor's prescription.Feb 1, 2022
How do bisphosphonates treat hypercalcemia?
Bisphosphonates inhibit osteoclastic bone resorption and are effective in the treatment of hypercalcemia due to conditions causing increased bone resorption and malignancy-related hypercalcemia. Pamidronate and etidronate can be given intravenously, while risedronate and alendronate may be effective as oral therapy.Feb 17, 2021
How is tetany treated?
How is tetany treated? Severe tetany generally requires urgent intravenous (IV) calcium replacement. It is important to check magnesium levels during calcium repletion, as magnesium deficiency is a common cause of treatment-resistant hypocalcemia.
How is hypocalcemia treated after thyroidectomy?
Patients who have symptomatic hypocalcemia in the early postoperative period or whose calcium levels continue to fall rapidly require treatment. In symptomatic patients, replace calcium with intravenous calcium gluconate. Ten milliliters of 10% solution (1 g) may be administered over 10 minutes.
Can hypocalcemia be cured?
How's hypocalcemia treated? Calcium deficiency is usually easy to treat. It typically involves adding more calcium to your diet. Do not self-treat by taking a lot of calcium supplements.
What is the best way to determine vitamin D adequacy?
Vitamin D adequacy is best determined by measurement of the 25-hydroxyvitamin D concentration in the blood.
What is the role of vitamin D in calcium?
As previously noted, vitamin D plays a critical role in each of these processes.
What is the best test to assess body stores of vitamin D?
Thus, measurement of the total 25(OH)D level is the best test to assess body stores of vitamin D.
How is vitamin D obtained?
Therefore, for most people, vitamin D is primarily obtained by cutaneous production from sun exposure. However, many variables influence the amount of UVB from sunlight that reaches the skin and its effectiveness. These include time of day, season, latitude, altitude, clothing, sunscreen use, pigmentation, and age.
What is the best calcium supplement for achlorhydria?
For patients with achlorhydria due to gastric reduction or bariatric surgery, or during gastric acid suppressive therapy (eg, protein pump inhibitor use), calcium supplementation with the more acidic calcium citrate is preferred over calcium carbonate.
Where does vitamin D3 come from?
Vitamin D3(D3), also known as cholecalciferol, is obtained primarily from skin exposure to ultraviolet B (UVB) radiation in sunlight, ingestion of food sources such as oily fish and variably fortified foods (milk, juices, margarines, yogurts, cereals, and soy), and oral supplements.
Can you get vitamin D from diet alone?
Many patients and physicians think that adequate vitamin D intake can be obtained via diet alone. This assumption is erroneous. With the exception of fatty fish, the vitamin D content of most foods, including fortified dairy products, is relatively low to nonexistent.
How to know if you have vitamin D deficiency?
Symptoms of vitamin D deficiency can include muscle weakness, pain, fatigue and depression. To get enough D, look to certain foods, supplements, and carefully planned sunlight. Appointments & Access. Contact Us. Overview. Symptoms and Causes. Diagnosis and Tests. Management and Treatment. Prevention.
How much vitamin D should I take daily?
For many older patients, a vitamin D supplement containing anywhere between 800 to 2000 IUs daily, which can be obtained without a prescription, can be both safe and beneficial.
Why is vitamin D important for obese people?
Obesity often makes it necessary to take larger doses of vitamin D supplements in order to reach and maintain normal D levels. Kidney and liver diseases: These diseases reduce the amount of an enzyme needed to change vitamin D to a form that is used in the body.
What does it mean when you don't have enough vitamin D?
Vitamin D deficiency means that you do not have enough vitamin D in your body. Vitamin D is unique because your skin actually produces it by using sunlight. Fair-skinned individuals and those who are younger convert sunshine into vitamin D far better than those who are darker-skinned and over age 50.
What is the function of vitamin D?
This vitamin has many functions, including: Keeping bones strong: Having healthy bones protects you from various conditions, including rickets. Rickets is a disorder that causes children to have bones that are weak and soft.
How much sun exposure is needed to absorb vitamin D?
Getting some exposure to sunshine—but not too much: Exactly how much sun exposure is needed isn’t clear. 10 to 15 minutes of sun exposure two to three times a week to the face, arms, legs or back may be all that is needed to absorb a suitable amount of vitamin D.
Is vitamin D in breast milk?
Skin color : Dark-colored skin is less able to make vitamin D than fair-colored skin. Human breast milk: A woman's breast milk only contains a small amount of vitamin D. Often infant formulas also only include a small amount of D also. Therefore infants are at risk of not receiving enough vitamin D.
What is the incidence of vitamin D deficiency in the US?
The incidence of vitamin D deficiency (ie, 25 (OH)D < 20 ng/mL) in US adults is approximately 25% for men and approximately 35% for women. 38 Postmenopausal women with osteoporosis are especially likely to exhibit deficiency. 1, 63 The problem is not limited to older women. Seventy-four percent of a cohort of newly diagnosed premenopausal patients with breast cancer from the New York City area 66 and 50% of a cohort of premenopausal women from the Kansas City area at high risk for the disease were reported as exhibiting vitamin D deficiency. 67
Why is vitamin D important?
Vitamin D is important in a number of physiologic processes, including calcium absorption, innate and adaptive immunity, and homeostasis of a number of organs. Chronic vitamin D deficiency in adults results in osteoporosis, osteomalacia, muscle weakness, and increased risk of falls. 1 – 4 Poor vitamin D intake and low blood levels ...
What is the role of vitamin D in the body?
Vitamin D plays an important role in the homeostasis of a variety of organ systems, but its role in prevention of cancer and recurrence—along with necessary blood levels —has yet to be defined.
What is the active form of vitamin D?
The active form of vitamin D—1,25 (OH) 2 D —may function in an endocrine fashion, as in the case of 1,25 (OH) 2 D produced in the kidney, or an autocrine/paracrine manner, as in the case of 1,25 (OH) 2 D produced in several other organs in which vitamin D plays an important role in homeostasis ( Fig 1 ).
What is the best level of 25OHD?
At the present time, 25 (OH)D levels in the range of 30 to 60 ng/mL are considered optimal, but higher levels up to 100 ng/mL are often seen in individuals with outdoor occupations receiving intense sun exposure without ill effects. 55 Correlative studies of 25 (OH)D with muscle strength or risk of breast or colon cancer have prompted several investigators to suggest that the optimal 25OHD target for multiple health outcomes is 40 to 50 ng/mL. 19, 20 Garland et al 23 suggest that increasing 25 (OH)D to a range of 40 to 60 ng/mL from the current US average could reduce risk of breast cancer by 25% and colon cancer by 27%. Intakes of at least 4,000 IU daily from all sources would be needed to maintain 25 (OH)D levels of 40 to 60 ng/mL. Practically speaking, supplements of 2,000 IU daily plus some sun exposure would probably be required to maintain a 25 (OH)D level of 40 to 60 ng/mL year round. 23
Is vitamin D3 more potent than vitamin D2?
At similar doses, vitamin D3 may be more potent than vitamin D2 (ergocalciferol), which is obtained from plants. 61 The Institute of Medicine lists 2,000 IU/d as the upper tolerable limit, but in fact, there is little evidence of toxicity unless doses of 10,000 IU of vitamin D3/d are exceeded. 53, 62.
Does vitamin D help with cancer?
Not only are such deficiencies common, probably the rule, vitamin D deficiency stands implicated in a host of diseases other than cancer. The metabolic product of vitamin D is a potent, pleiotropic, repair and maintenance, secosteroid hormone that targets > 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. A common misconception is that government agencies designed present intake recommendations to prevent or treat vitamin D deficiency. They did not. Instead, they are guidelines to prevent particular metabolic bone diseases. Official recommendations were never designed and are not effective in preventing or treating vitamin D deficiency and in no way limit the freedom of the physician--or responsibility--to do so. At this time, assessing serum 25-hydroxy-vitamin D is the only way to make the diagnosis and to assure that treatment is adequate and safe. The authors believe that treatment should be sufficient to maintain levels found in humans living naturally in a sun-rich environment, that is, > 40 ng/ml, year around. Three treatment modalities exist: sunlight, artificial ultraviolet B radiation or supplementation. All treatment modalities have their potential risks and benefits. Benefits of all treatment modalities outweigh potential risks and greatly outweigh the risk of no treatment. As a prolonged 'vitamin D winter', centred on the winter solstice, occurs at many temperate latitudes, < or = 5000 IU (125 microg) of vitamin D/day may be required in obese, aged and/or dark-skinned patients to maintain adequate levels during the winter, a dose that makes many physicians uncomfortable.
Is vitamin D good for NF1?
Simple Summary: We herein describe the relevance of Vitamin D for human health, with a special focus on its role in Neurofibromatosis type 1 (NF1) disease. Indeed, epidemiological studies revealed that low circulating vitamin D levels inversely correlate with cutaneous manifestations and bone abnormalities, clinical hallmarks of NF1. NF1 is an autosomal dominant syndrome with a severe predisposition in developing tumors and for which limited treatment options are thus far available. In this context, vitamin D or its analogues has been used to treat both skin and bone lesions in NF1 patients, alone or in association with other therapeutic agents. We provide an exhaustive and detailed analysis of the most relevant preclinical and clinical studies aimed at analyzing the correlation between vitamin D deficiency and NF1 lesion progression. This review can add a valuable contribution to the current knowledge of NF1 disease investigating possible therapeutic strategies to ameliorate NF1 conditions. Abstract: Vitamin D is a fat-soluble steroid hormone playing a pivotal role in calcium and phosphate homeostasis as well as in bone health. Vitamin D levels are not exclusively dependent on food intake. Indeed, the endogenous production-occurring in the skin and dependent on sun exposure-contributes to the majority amount of vitamin D present in the body. Since vitamin D receptors (VDRs) are ubiquitous and drive the expression of hundreds of genes, the interest in vitamin D has tremendously grown and its role in different diseases has been extensively studied. Several investigations indicated that vitamin D action extends far beyond bone health and calcium metabolism, showing broad effects on a variety of critical illnesses, including cancer, infections, cardiovascular and autoimmune diseases. Epidemiological studies indicated that low circulating vitamin D levels inversely correlate with cutaneous manifestations and bone abnormalities, clinical hallmarks of neurofibromatosis type 1 (NF1). NF1 is an autosomal dominant tumour predisposition syndrome causing significant pain and morbidity, for which limited treatment options are available. In this context, vitamin D or its analogues have been used to treat both skin and bone lesions in NF1 patients, alone or combined with other therapeutic agents. Here we provide an overview of vitamin D, its characteristic nutritional properties relevant for health benefits and its role in NF1 disorder. We focus on preclinical and clinical studies that demonstrated the clinical correlation between vitamin D status and NF1 disease, thus providing important insights into disease pathogenesis and new opportunities for targeted therapy.
Is vitamin D a steroid?
Vitamin D is a fat-soluble steroid hormone playing a pivotal role in calcium and phosphate homeostasis as well as in bone health. Vitamin D levels are not exclusively dependent on food intake. Indeed, the endogenous production—occurring in the skin and dependent on sun exposure—contributes to the majority amount of vitamin D present in the body. Since vitamin D receptors (VDRs) are ubiquitous and drive the expression of hundreds of genes, the interest in vitamin D has tremendously grown and its role in different diseases has been extensively studied. Several investigations indicated that vitamin D action extends far beyond bone health and calcium metabolism, showing broad effects on a variety of critical illnesses, including cancer, infections, cardiovascular and autoimmune diseases. Epidemiological studies indicated that low circulating vitamin D levels inversely correlate with cutaneous manifestations and bone abnormalities, clinical hallmarks of neurofibromatosis type 1 (NF1). NF1 is an autosomal dominant tumour predisposition syndrome causing significant pain and morbidity, for which limited treatment options are available. In this context, vitamin D or its analogues have been used to treat both skin and bone lesions in NF1 patients, alone or combined with other therapeutic agents. Here we provide an overview of vitamin D, its characteristic nutritional properties relevant for health benefits and its role in NF1 disorder. We focus on preclinical and clinical studies that demonstrated the clinical correlation between vitamin D status and NF1 disease, thus providing important insights into disease pathogenesis and new opportunities for targeted therapy.