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.
    Full-text · Article · Sep 2014 · PLoS ONE
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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.
    Full-text · Article · Jul 2014 · Inflammation Research
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    • "Furthermore, several biological and epidemiological evidence strongly suggests that brain development and critical brain functions can be effected by vitamin D inadequacy related to cognitive or behavioral endpoints (Holick 2012). Although there is some limited evidence for a relationship between vitamin D inadequacy and depression, or possibly schizophrenia, studies are relatively few in number and results are mixed (Bener et al., 2012; 2013b; Timini, 2004; McGrath et al., 2010; Vinh Quoc Luong et al., 2012; Polívka et al., 2012; Umhau et al., 2013). "
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    ABSTRACT: Attention deficit hyperactivity disorder (ADHD) is the most common behavioral disorders in children and recent studies reported a relationship between low levels of Vitamin D and incidence of ADHD. The aim of this study was to investigate the association between vitamin D deficiency and attention deficit hyperactivity disorder (ADHD). Also, to study the impact and role of vitamin D on the development of ADH in children. This is a case-control study which was conducted in children below 18 years of age from June 2011 to May 2013 at the School Health and Primary Health care Clinics, Qatar. The study was based on 1,331 cases and 1,331 controls. The data collection instrument included socio-demographic & clinical data, physician diagnosis family history, BMI, and serum 25(OH) vitamin D, calcium, albumin, billirubin, magnesium, calcium, cholesterol, urea, triglyceride and phosphorus. Descriptive and univariate statistical analysis were performed. Of the total number of 3470 children surveyed, 1331 of ADHD and 1,331 of healthy children gave their consent to participate in this study. The mean age (± SD, in years) for ADHD versus control children was 10.63±3.4 vs. 10.77±3.4. Overweight (7.7% vs 9.4%) and obesity (4.6% vs 7.7%) were significantly lower in ADHD children compared to their counterparts (P=0.001). Vitamin D deficiency was considerably higher in ADHD children compared to healthy children. The mean value of vitamin D in ADHD children was much lower than the normal value and there was a significant difference found in the mean values of vitamin D between ADHD (16.6±7.8 with median 16) and control children (23.5±9.9) (p<0.0001) and with median 23 (p = 0.006). Mean values of Calcium and phosphorous were significantly higher in control compared to ADHD children (p<0.001). 1331 of all ADHD children had 19.1% had severe vitamin D deficiency (< 10 ng/ml), 44.9% has moderate insufficient levels (between 10-20 ng/ml), 27.3% has mild insufficient levels (between 20-30 ng/ml) and only 8.1% of ADHD had sufficient serum vitamin D levels (>30 ng/ml). Multivariate logistic regression analysis revealed that household income, poor relationship between parents, mothers' occupation, consanguinity, BMI in percentiles, low duration of time under sun light, physical activity, low serum calcium level and low vitamin D level were considered as the main risk factors associated with the ADHD after adjusting for age, gender and other variables. The study showed that vitamin D deficiency was higher in ADHD children compared to healthy children. Supplementing infants with vitamin D might be a safe and effective strategy for reducing the risk of ADHD, but, further genomic and some other test and relevant studies need to be done.
    Full-text · Article · Feb 2014 · Global journal of health science
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