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Vitamin D


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Vitamin D

  1. 1. Vitamin D Its More Important then you Think By Adam Rinde, ND
  2. 2. Vitamin D <ul><li>What is It? </li></ul><ul><li>What happens if I have a deficiency? </li></ul><ul><li>What types of conditions are treated with vitamin D? </li></ul><ul><li>How can I find out if I am defficient? </li></ul><ul><li>How much do I need to take? </li></ul>
  3. 3. Vitamin D <ul><li>Acts as a hormone and nutrient </li></ul><ul><li>Calciferol (D2) is the storage form </li></ul><ul><li>Cholecalciferol (D3) is the active form </li></ul>
  4. 4. Vitamin D <ul><li>Vitamin D fits the definition of a hormone because it can be produced by the body, has specific tissue targets, and does not have to be supplied by the diet </li></ul><ul><li>It is categorized as a Fat Soluble Vitamin </li></ul>
  5. 5. Vitamin D <ul><li>More then 50 genes are known to be transcribed by Vitamin D </li></ul><ul><li>Involved in Calcium and Phosphate Metabolism And Absorption </li></ul><ul><li>Enhances Bone Development </li></ul><ul><li>differentioation, proliferation, and tissue growth in many tissues including (skin, muscles, pancreas, nerves, the parathyroid gland, and the immune system) </li></ul>
  6. 6. Vitamin D Metabolism
  7. 7. Sources of Vitamin D <ul><li>Salmon (3.5 oz): Fresh, wild (600-1000 IU of Vitamin D3) </li></ul><ul><li>Fresh Farmed Salmon (3.5 oz): about 100-250 IU of D3 or D2 </li></ul><ul><li>Canned salmon (3.5 oz): 300-600 IU of Vitamin D3 </li></ul><ul><li>Sardines, canned (3.5 oz):about 300 IU of Vitamin D3 </li></ul><ul><li>[1] Holick,Michael. 2007. Vitamin D Deficiency. N Engl J Med 2007;357:266-81ral Sources </li></ul>
  8. 8. Sources of Vitamin D <ul><li>Mackerel, canned (3.5 oz):250 IU of D3 </li></ul><ul><li>Tuna, canned (3.6 oz): 230 IU of D3 </li></ul><ul><li>Shitake Mushrooms (Fresh): 3.5 oz about 100 IU of D2 </li></ul><ul><li>Shitake Mushroom (sun-dried): 3.5 oz about 1600 IU of D2 </li></ul><ul><li>Exposure to sunlight (UVB) radiation .5 minimal erythemal dose about 3000 IU of Vitamin D3 [1] </li></ul>
  9. 9. Absorption of Dietary Vitamin D <ul><li>Bile Salts form Micelle </li></ul><ul><li>Vitamin D is passively diffused across the intestine </li></ul><ul><li>Absorbed in Small Intestine </li></ul>
  10. 10. Regulation of Vitamin d
  11. 11. Rate Limiting Factors of Vitamin D3 activation <ul><li>Calcitriol formation in the kidney dependent on another rNADPH dependent enzyme, 25, OH- Ds, 1-hydroxylase (1-monooxygenase) a mitochondrial mixed-function oxidase. An enzyme also present in macrophages and some cnacer cells </li></ul><ul><li>It is influenced by PTH, and low plasma calcium concentrations, and eh concentration of 1,25 (OH)2 D3 Calcitriol. </li></ul><ul><li>Dietary Phophorous intake will aslo imprair activity </li></ul>
  12. 12. Functions and Mechanisms of Aciton <ul><li>Vitamin D acts on the following tissues </li></ul><ul><ul><li>intestine, bone, kidney, and now believed to also act on cardiac, muscle, brain, skin, hematopoietic, and immune clls amongh others </li></ul></ul><ul><ul><li>Related to the function of cell nifferentioation. </li></ul></ul><ul><ul><li>Nuclear recptors fin over 30 organs have been found for Vitamin D </li></ul></ul><ul><ul><li>stimulates calcium reabsorption and absorption </li></ul></ul><ul><ul><li>stimulates phosphorus absorption. </li></ul></ul>
  13. 13. Vitamin D and the cell receptor
  14. 14. Interactions with other Nutrients <ul><li>Calcium </li></ul><ul><li>Phosphorous </li></ul><ul><li>Vitamin K </li></ul>
  15. 15. Defficiencies <ul><li>Rickets </li></ul><ul><li>Osteopmalacia </li></ul>
  16. 16. Risk Factors for Defficiency <ul><li>Elderly Populations </li></ul><ul><li>Northern Latitutudes </li></ul><ul><li>People of Color </li></ul><ul><li>Intestinal Bowel Disorders </li></ul><ul><li>Disorders of Parathyroid, Liver, or Kidney </li></ul><ul><li>Anticonvulsant Drug Therapy </li></ul>
  17. 17. Signs and Symptoms of Defficiency <ul><li>Bone Pain </li></ul><ul><li>Osteopenia </li></ul><ul><li>Osteoporosis </li></ul>
  18. 18. Side Effects and Interactions <ul><li>one published report of toxicity at 40,000 IU’s of Vitamin D3 daily. </li></ul><ul><li>may raise blood cholesterol </li></ul><ul><li>Side effects reported: dizziness, naseau, headaches, weight loss, </li></ul><ul><li>Rare: excessive Vitamin D may lead to increased thirst, blindness, deafness, hearing loss, increase urination, diarhhea,and irritability </li></ul>
  19. 19. contraindications <ul><li>Sarcoidosis when elevated calcium levels are present </li></ul>
  20. 20. Assessment of Nututriture <ul><li>Plasma Concentration of 25-OH Vitamin D3 (Calcidiol) </li></ul><ul><li>However some cholecalciferol is stored in fat and muscles. </li></ul>
  21. 21. Therapeutic Use of Prescription Dose Vitamin D <ul><li>Psorasis (Dovonex), Topical </li></ul><ul><li>Vitiligo (Dovonex/Calipotriol) </li></ul><ul><li>Osteoporosis (1000 IU/day) </li></ul><ul><li>Osteopmalacia </li></ul><ul><li>Rickets </li></ul><ul><li>Polycystic Ovarian Syndrome </li></ul><ul><li>Chronic Pain </li></ul><ul><li>Multiple Sclerosis (???) </li></ul><ul><li>Prostate Cancer </li></ul><ul><li>Renal Failure </li></ul><ul><li>Hypoparathyroidsm </li></ul><ul><li>Seasonal Affect Disorder </li></ul>
  22. 22. Therapeutic Use <ul><li>Depression </li></ul><ul><li>Type I Diabetes </li></ul><ul><li>Type II Diabetes </li></ul>
  23. 23. Therapeutic Use to prevent or replace defficieny <ul><li>Chron’s Disease </li></ul><ul><li>Celiac Disease </li></ul><ul><li>Cystic Fibrosis </li></ul>
  24. 24. Vitamin D as Complementary Medicine <ul><li>Chron’s Disease to prevent osteopmalaxia </li></ul>
  25. 25. Vitamin D for Prevention <ul><li>Breast Cancer </li></ul><ul><li>Colon Cancer </li></ul>