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                                                                                  Vitamin D


Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults . Together with calcium, vitamin D also helps protect older adults from osteoporosis.

Vitamin D is a hormone that controls calcium levels in the blood. It is crucial for bone and muscle development, and for preventing osteoporosis. Vitamin D deficiency may not result in any obvious symptoms, but without treatment it can have significant health effects and increase a person’s risk of musculoskeletal conditions, such as:

Bone and muscle pain

Rickets (soft, weakened bones) in children

Osteopenia (weak, fragile bones) in older adults.

As well as maintaining your vitamin D levels, you also need adequate calcium in your diet to help prevent these conditions.

Many genes encoding proteins that regulate cell proliferation, differentiation, and apoptosis are modulated in part by vitamin D


Where does it come from:

It is also occurs naturally in a few foods -- including some fish, fish liver oils, and egg yolks -- and in fortified dairy and grain products.


Deficiency:

Low vitamin D has also been linked to an increased risk of:

Multiple sclerosis

Diabetes (type1 and type 2)

Various types of cancers (particularly colon cancer)

Heart disease

Mental health conditions (including schizophrenia)

Worse outcomes in stroke

Altered immunity and other autoimmune diseases.

Young children that don’t get enough vitamin D can develop rickets, which causes bowed legs and knock knees.

Adults that don’t get enough vitamin D can develop bone weakness and increased risk of fracture.

People who are at increased risk of low vitamin D include:

People with naturally very dark skin – the pigment in skin (melanin) acts as a filter to UVB (ultraviolet B) radiation and reduces the amount of vitamin D that the body makes in the skin.

People with little or no sun exposure – Some groups of people are at particular risk of receiving little or no sun exposure. They include:

Older adults – especially people who are frail, in medium-to-long-term residential or aged care, and housebound people

People who wear covering clothing for religious and cultural reasons

People who deliberately avoid sun exposure for cosmetic or health reasons

People at high risk of skin cancers and who therefore avoid exposure to the sun

People hospitalised or institutionalised for long periods

People with a disability or chronic disease

People in occupations with little sun exposure, such as office workers, taxi drivers, factory workers or night-shift workers.

Breastfed babies with other risk factors for low vitamin D – breastfed babies who fall into the risk categories above or have mothers with low vitamin D. Babies get their initial store of vitamin D from their mothers. While infant formula is fortified with vitamin D, breastmilk contains very little. Therefore, breastfed infants rely more heavily on their mothers’ initial stores. If the mother of a breastfed baby has low vitamin D (or had low vitamin D during pregnancy) then her baby is also at risk of low vitamin D.

People with medical conditions or medications affecting vitamin D metabolism, including:

Obesity

End-stage liver disease

Kidney disease

Conditions that cause fat malabsorption (such as cystic fibrosis, coeliac disease and inflammatory bowel disease)

Use of some drugs that increase the breakdown of vitamin D (such as rifampicin and some anticonvulsants).

People who are at increased risk of low vitamin D include:

People with naturally very dark skin – the pigment in skin (melanin) acts as a filter to UVB (ultraviolet B) radiation and reduces the amount of vitamin D that the body makes in the skin.

People with little or no sun exposure – Some groups of people are at particular risk of receiving little or no sun exposure. They include:

Older adults – especially people who are frail, in medium-to-long-term residential or aged care, and housebound people

People who wear covering clothing for religious and cultural reasons

People who deliberately avoid sun exposure for cosmetic or health reasons

People at high risk of skin cancers and who therefore avoid exposure to the sun

People hospitalised or institutionalised for long periods

People with a disability or chronic disease

People in occupations with little sun exposure, such as office workers, taxi drivers, factory workers or night-shift workers.

Breastfed babies with other risk factors for low vitamin D – breastfed babies who fall into the risk categories above or have mothers with low vitamin D. Babies get their initial store of vitamin D from their mothers. While infant formula is fortified with vitamin D, breastmilk contains very little. Therefore, breastfed infants rely more heavily on their mothers’ initial stores. If the mother of a breastfed baby has low vitamin D (or had low vitamin D during pregnancy) then her baby is also at risk of low vitamin D.

People with medical conditions or medications affecting vitamin D metabolism, including:

Obesity

End-stage liver disease

Kidney disease

Conditions that cause fat malabsorption (such as cystic fibrosis, coeliac disease and inflammatory bowel disease)

Use of some drugs that increase the breakdown of vitamin D (such as rifampicin and some anticonvulsants).


Cautions:

Vitamin D is LIKELY SAFE when taken by mouth or given as a shot into the muscle in recommended amounts. Most people do not commonly experience side effects with vitamin D, unless too much is taken. Some side effects of taking too much vitamin D include weakness, fatigue, sleepiness, headache, loss of appetite, dry mouth, metallic taste, nausea, vomiting, and others.

Taking vitamin D for long periods of time in doses higher than 4000 units daily is POSSIBLY UNSAFE and may cause excessively high levels of calcium in the blood. However, much higher doses are often needed for the short-term treatment of vitamin D deficiency. This type of treatment should be done under the supervision of a healthcare provider.


Special Precautions & Warnings:

Pregnancy and breast-feeding: Vitamin D is LIKELY SAFEduring pregnancy and breast-feeding when used in daily amounts below 4000 units. Do not use higher doses. Vitamin D is POSSIBLY UNSAFE when used in higher amounts during pregnancy or while breast-feeding. Using higher doses might cause serious harm to the infant.

Kidney disease: Vitamin D may increase calcium levels and increase the risk of “hardening of the arteries” in people with serious kidney disease. This must be balanced with the need to prevent renal osteodystrophy, a bone disease that occurs when the kidneys fail to maintain the proper levels of calcium and phosphorus in the blood. Calcium levels should be monitored carefully in people with kidney disease.

High levels of calcium in the blood: Taking vitamin D could make this condition worse.

“Hardening of the arteries” (atherosclerosis): Taking vitamin D could make this condition worse, especially in people with kidney disease.

Sarcoidosis: Vitamin D may increase calcium levels in people with sarcoidosis. This could lead to kidney stones and other problems. Use vitamin D cautiously.

Histoplasmosis: Vitamin D may increase calcium levels in people with histoplasmosis. This could lead to kidney stones and other problems. Use vitamin D cautiously.

Over-active parathyroid gland (hyperparathyroidism): Vitamin D may increase calcium levels in people with hyperparathyroidism. Use vitamin D cautiously.

Lymphoma: Vitamin D may increase calcium levels in people with lymphoma. This could lead to kidney stones and other problems. Use vitamin D cautiously.

Tuberculosis: Vitamin D might increase calcium levels in people with tuberculosis. This might result in complications such as kidney stones.