Guidelines for Preventing and Treating Vitamin D Deficiency and Insufficiency Revisited

Boston University Medical Center, School of Medicine, 715 Albany Street, M 1013, Boston, Massachusetts 2118, USA.
The Journal of Clinical Endocrinology and Metabolism (Impact Factor: 6.21). 03/2012; 97(4):1153-8. DOI: 10.1210/jc.2011-2601
Source: PubMed


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Available from: David A Hanley, Apr 07, 2015
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    • "It was shown that only 25% of women ingesting 1200 IU/d for 6 months achieved 25(OH) D levels higher than 30 ng/ml, the lowest value of optimal range according to some authors [1], [7], [16], but not IOM experts (25(OH)D >20 ng/ml) [12]. In consequence, fundamental questions of: a) how much vitamin D is enough to reach and maintain optimal 25(OH)D level, and b) what is the optimal range for 25(OH)D levels, remain an issue of debate [32], [33]. "
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    ABSTRACT: The optimal vitamin D intake for nursing women is controversial. Deterioration, at least in bone mass, is reported during lactation. This study evaluated whether vitamin D supplementation during lactation enhances the maternal and infant's vitamin D status, bone mass and body composition.
    PLoS ONE 09/2014; 9(9):e107708. DOI:10.1371/journal.pone.0107708 · 3.23 Impact Factor
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    • "The Endocrine Society definition [15]: "
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    ABSTRACT: Introduction: Inflammation is believed to be a contributing factor to many chronic diseases. The influence of vitamin D deficiency on inflammation is being explored but studies have not demonstrated a causative effect. Methods: Low serum 25(OH)D is also found in healthy persons exposed to adequate sunlight. Despite increased vitamin D supplementation inflammatory diseases are increasing. The current method of determining vitamin D status may be at fault. The level of 25(OH)D does not always reflect the level of 1,25(OH)2D. Assessment of both metabolites often reveals elevated 1,25(OH)2D, indicating abnormal vitamin D endocrine function. Findings: This article reviews vitamin D's influence on the immune system, examines the myths regarding vitamin D photosynthesis, discusses ways to accurately assess vitamin D status, describes the risks of supplementation, explains the effect of persistent infection on vitamin D metabolism and presents a novel immunotherapy which provides evidence of an infection connection to inflammation. Conclusion: Some authorities now believe that low 25(OH)D is a consequence of chronic inflammation rather than the cause. Research points to a bacterial etiology pathogenesis for an inflammatory disease process which results in high 1,25(OH)2D and low 25(OH)D. Immunotherapy, directed at eradicating persistent intracellular pathogens, corrects dysregulated vitamin D metabolism and resolves inflammatory symptoms.
    Inflammation Research 07/2014; 63(10). DOI:10.1007/s00011-014-0755-z · 2.35 Impact Factor
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    • "Vitamin D deficiency is also associated with an increased risk of falls and fractures in the elderly [5] [6] and with potential " nonskeletal " effects, notably on the cardiovascular [7] [8] [9] and immune [10] systems as well as in cancers [11] [12]. Dietary sources of VTD are very limited and usual daily intakes are generally not higher than 200–400 IU in western countries [13] [14] [15]. The major source of VTD comes from UVB light-driven skin photosynthesis "
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    ABSTRACT: In this double blind, unicentre, randomized, placebo controlled study, we evaluated the changes in 25-hydroxyvitamin D (25(OH)D) serum levels in 150 young Belgian adults (18-30 years), monthly supplemented with 50,000 IU of vitamin D (VTD) or placebo for 6 months, from November 2010 to May 2011. At T0, 30% of the population presented 25(OH)D serum levels below 20 ng/mL. In the VTD-treated group, mean serum levels increased from 21.2 ± 8.2 to 30.6 ± 8.8 ng/mL (P < 0.001) at T3mo and to 36.0 ± 9.2 ng/mL (P < 0.001) at T6mo. Despite documented VTD intake, no changes in serum levels were, however, observed in 10% of the treated group. In the placebo group, mean 25(OH)D serum levels decreased from 22.8 ± 8.5 to 14.0 ± 6.9 ng/mL at T3mo (P < 0.001) but returned to values not significantly different from those observed at T0 (23.5 ± 8.6 ng/mL) at T6mo. No difference between serum calcium levels was observed between the groups throughout the study. In conclusion, monthly supplementation with 50,000 UI of VTD in winter can warrant serum 25(OH)D levels above 20 ng/mL in 96.2% of those healthy young adults without inducing unacceptably high 25(OH)D concentration. This supplementation is safe and may be proposed without 25(OH)D testing.
    International Journal of Endocrinology 11/2013; 2013(1):652648. DOI:10.1155/2013/652648 · 1.95 Impact Factor
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