Optimal serum 25-hydroxyvitamin D levels for multiple health outcomes

Deptartment of Rheumatology, Institute of Physical Medicine, University Hospital Zurich, Zurich, Switzerland.
Advances in Experimental Medicine and Biology (Impact Factor: 1.96). 02/2008; 624:55-71. DOI: 10.1007/978-0-387-77574-6_5
Source: PubMed


Recent evidence suggests that higher vitamin D intakes beyond current recommendations may be associated with better health outcomes. In this chapter, evidence is summarized from different studies that evaluate threshold levels for serum 25(OH)D levels in relation to bone mineral density (BMD), lower extremity function, dental health, risk of falls, admission to nursing home, fractures, cancer prevention and incident hypertension. For all endpoints, the most advantageous serum levels for 25(OH)D appeared to be at least 75 nmol/l (30 ng/ml) and for cancer prevention, desirable 25(OH)D levels are between 90-120 nmol/l (36-48 ng/ml). An intake of no less than 1000 IU (25 mcg) of vitamin D3 (cholecalciferol) per day for all adults may bring at least 50% of the population up to 75 nmol/l. Thus, higher doses of vitamin D are needed to bring most individuals into the desired range. While estimates suggest that 2000 IU vitamin D3 per day may successfully and safely achieve this goal, the implications of 2000 IU or higher doses for the total adult population need to be addressed in future studies.

118 Reads
  • Source
    • "Nevertheless, the measures here are those used in routine clinical practice in the UK. There are also some conflicting definitions of optimal vitamin D levels (Looker et al., 2002; Hypponen and Power, 2007), with some recommendations setting the threshold for vitamin D insufficiency at a level less than 75 nmol/L (Bischoff-Ferrari et al., 2006; Bischoff-Ferrari, 2008), while others that a cut off at less than 50 nmol/L defines insufficiency (World Health Organisation, 2003). Further work is needed to answer the question of causality; however , in the meantime it is important that primary and secondary health care professionals are aware of the high rates of vitamin D deficiency in psychosis. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Vitamin D deficiency is seen in a high proportion of people with established psychotic disorders, but it is not known if this is present at onset of the illness. We set out to examine vitamin D levels in people with their first episode of psychosis (FEP). We conducted a matched case-control study to examine vitamin D levels and rates of vitamin D deficiency in sixty nine patients presenting with their FEP and sixty nine controls matched for age, sex and ethnicity. Differences between groups were tested using student's-t tests, paired t-tests and odds ratios for further analysis. Vitamin D levels were significantly lower in cases than in controls (p<0.001). The odds ratio of being vitamin D deficient was 2.99 in the FEP group relative to the control group. There was no correlation between vitamin D levels and length of hospitalisation in the patient group (r=-0.027, p=0.827). We found higher rates of vitamin D deficiency in people with FEP compared to matched controls. Given that vitamin D is neuroprotective; that developmental vitamin D deficiency may be a risk factor for psychosis, and that incipient psychosis may affect lifestyle factors and diet, future studies are required to examine this association further. In the meantime, there is a need for more widespread testing of vitamin D levels in FEP and for the development of appropriate management strategies.
    Schizophrenia Research 09/2013; 150(2-3). DOI:10.1016/j.schres.2013.08.036 · 3.92 Impact Factor
  • Source
    • "Potential markers of vitamin D status have been reviewed [3]. Plasma PTH has been proposed as a functional marker, because an elevated concentration is a recognised risk factor for bone loss and fractures in older people [6-9,13,46-48], which can potentially be modified by vitamin D supplementation [49,50]. The circulating concentration of 25OHD below which PTH increases outside the normal range may be used to establish a threshold value for vitamin D insufficiency [1]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The randomised, double blind intervention trial 'Optimising Vitamin D Status in Older People' (VDOP) will test the effect of three oral dosages of vitamin D given for one year on bone mineral density (BMD) and biochemical markers of vitamin D metabolism, bone turnover and safety in older people. VDOP is funded by Arthritis Research UK, supported through Newcastle University and MRC Human Nutrition Research and sponsored by the Newcastle upon Tyne Hospitals NHS Foundation Trust#. Vitamin D insufficiency is common in older people and may lead to secondary hyperparathyroidism, bone loss, impairment of muscle function and increased risk of falls and fractures. Vitamin D supplementation trials have yielded conflicting results with regard to decreasing rates of bone loss, falls and fractures and the optimal plasma concentration of 25 hydroxy vitamin D (25OHD) for skeletal health remains unclear.Method/designOlder (>=70 years) community dwelling men and women are recruited through General Practices in Northern England and 375 participants are randomised to take 12,000 international units (IU), 24,000 IU or 48,000 IU of vitamin D3 orally each month for one year starting in the winter or early spring. Hip BMD and anthropometry are measured at baseline and 12 months. Fasting blood samples are collected at baseline and three-month intervals for the measurement of plasma 25OHD, parathyroid hormone (PTH), biochemical markers of bone turnover and biochemistry to assess the dose--response and safety of supplementation. Questionnaire data include falls, fractures, quality of life, adverse events and outcomes, compliance, dietary calcium intake and sunshine exposure. This is the first integrated vitamin D supplementation trial in older men and women using a range of doses given at monthly intervals to assess BMD, plasma 25OHD, PTH and biochemical markers of bone turnover and safety, quality of life and physical performance. We aim to investigate the vitamin D supplementation and plasma 25OHD concentration required to maintain bone health and to develop a set of biochemical markers that reflects the effect of vitamin D on bone. This will aid future studies investigating the effect of vitamin D supplementation on fracture risk.ISRCTN 35648481 (assigned 16 August 2012), EudraCT 2011-004890-10.
    Trials 09/2013; 14(1):299. DOI:10.1186/1745-6215-14-299 · 1.73 Impact Factor
  • Source
    • "Compliance and effectiveness of vitamin D treatment can be evaluated by measuring 25(OH)D levels, but this should not be done earlier than three months after starting vitamin D supplementation, because reaching a steady state in 25(OH)D levels takes some time11. Whereas it is considered as the minimum goal to achieve 25(OH)D levels of at least 20 ng/ml (50 nmol/l), there is accumulating evidence that the optimal 25(OH)D levels may range from approximately 30 to 40 ng/ml (75 to 100 nmol/l)2223. When choosing the vitamin D dose for a patient it should also be considered that the expected increase in 25(OH)D levels is inversely associated with body mass index (BMI)8788. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Vitamin D is mainly derived from endogenous ultraviolet-B induced vitamin D synthesis in the skin, and the current high prevalence of vitamin D deficiency can, therefore, largely be attributed to lifestyle related low sunlight exposure. Regulation of bone and mineral metabolism is a classic vitamin D effect, but the identification of the vitamin D receptor (VDR) in almost all human cells suggests a role for vitamin D also in extra-skeletal diseases. Experimental studies demonstrated several antihypertensive and vascular protective effects of vitamin D, such as suppression of the renin angiotensin aldosterone system, beneficial modulation of classic cardiovascular risk factors, and anti-atherosclerotic properties including improvements of endothelial function. Additional neuroprotective actions of vitamin D have also been reported. In line with this, epidemiological studies have largely shown that vitamin D deficiency is an independent risk factor for arterial hypertension and strokes. Data from randomized controlled trials (RCTs) are, however, limited and less promising, with currently no confirmation that vitamin D reduces stroke incidence. Whereas some RCTs suggest that vitamin D supplementation might modestly reduce blood pressure, this has not been consistently observed in all studies. It is, therefore, premature to recommend vitamin D supplementation for the prevention and treatment of arterial hypertension and stroke. Nevertheless, the fact that patients with arterial hypertension and cerebrovascular disease are at a relatively high risk of vitamin D deficiency, and therewith associated musculoskeletal diseases can serve as a rationale for the evaluation, prevention and treatment of vitamin D deficiency in these patients.
    The Indian Journal of Medical Research 04/2013; 137(4):669-679. · 1.40 Impact Factor
Show more


118 Reads
Available from