The document discusses vitamin D, including its synthesis from sun exposure, its role in various bodily processes, and its potential health benefits. Key points include:
- Vitamin D is synthesized in the skin upon exposure to sunlight and can also be obtained through food and supplements. It plays an important role in bone and immune health.
- Vitamin D receptors are found throughout the body and vitamin D has been shown to regulate gene expression, turning genes on and off. This may explain its wide-ranging effects.
- Studies suggest vitamin D may help reduce the risk of various cancers, heart disease, diabetes, respiratory infections, autoimmune diseases, and mental health conditions like depression. Optimal vitamin D levels are important
All About Vitamin D
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All About Vitamin D
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Need of Vitamin D3 supplement | Buy Vitamin D3 in EuropeRufus Greenbaum
Eat vitamin rich food; try as much as u can in contact with sun and start taking Vitamin D3 Supplement http://greenvits.eu/ . Many Researches proved that Vitamin D3 Supplement have numerous good effects on our health and it fight against various serious chronic illness like depression, cancer and many more.
Buying vitamin D in Europe is also important Decision as many over the counter supplements contains 180 % more vitamin d then stated in there level.
vitamin d is one of the fat soluble vitamin on which there is great emphasis in the present scenario. it is present in breast milk in very minute amount so it is recommended that it must be supplemented right after birth to prevent it deficiency which in children can result in rickets. if not diagnosed and treated in time it may result in number of bony deformities . in adults besides oesteomalacia it is associated with n umber of non communicable diseases.
Hello
This ppt were on the basic information for synthesis of vitamin D and vitamin K in our body.
Along with their RDA , Source , biochemical function and disease state.
Thank you
Need of Vitamin D3 supplement | Buy Vitamin D3 in EuropeRufus Greenbaum
Eat vitamin rich food; try as much as u can in contact with sun and start taking Vitamin D3 Supplement http://greenvits.eu/ . Many Researches proved that Vitamin D3 Supplement have numerous good effects on our health and it fight against various serious chronic illness like depression, cancer and many more.
Buying vitamin D in Europe is also important Decision as many over the counter supplements contains 180 % more vitamin d then stated in there level.
vitamin d is one of the fat soluble vitamin on which there is great emphasis in the present scenario. it is present in breast milk in very minute amount so it is recommended that it must be supplemented right after birth to prevent it deficiency which in children can result in rickets. if not diagnosed and treated in time it may result in number of bony deformities . in adults besides oesteomalacia it is associated with n umber of non communicable diseases.
Hello
This ppt were on the basic information for synthesis of vitamin D and vitamin K in our body.
Along with their RDA , Source , biochemical function and disease state.
Thank you
Raising D Level; Spreading the knowledge of the benefits, and necessity of vitamin D to our health and
well-being.
While raising the awareness of the dangers of its deficiency, the subtleness of its symptoms, and the danger of them becoming chronic and irreversible
10 healthy foods to fight vitamin d deficiencyMediFee
Ten healthy foods to fight vitamin d deficiency like Milk, Tuma, sunlight, Orange Juice, eggs, Mushrooms, cod liver oli, Cheese, Oysters, Soy milk and soy products.
This presentation given to the International Society for Enzymology in Corfu details the extent of vitamin D deficiency in the largest state of Australia, NSW. It highlights the over=testing phenomenon that has occurred and how to correct the problem.
LYMPH NODES OF HEAD AND NECK AND DIFFERENTIAL DIAGNOSIS OF CERVICAL LYMPHA...Dr. Monali Prajapati
1. Introduction
a. Anatomy
b. Structure
c. Function
2. Lymph nodes of head and neck
3. Drainage
4. Lymph node levels and sublevels
5. Clinical examination of nodes
6. Diagnosis
7. Causes of cervical lymphadenopathy
8. Differential diagnosis of cervical lymphadenopathy
9. References
Vitamin D Part 3-Vitamin D in Diseases and Dose RecommendationsHANISH BABU
Vitamin D in Diseases and Dose Recommendations is part 3 of 3 of the Webinar series on Vitamin D in Health and Disease by Dr Hanish Babu, MD.
2 Major Text Books, more than 250 Journal references and reference from dozens of Videos on Vitamin D from experts world over and 4 months of intensive research has gone into the preparation of these talks.
As a service to the public health, these presentations are free to use for educational purposes, with proper acknowledgements.
Dr Hanish Babu, MD, 2020
Vitamin D Part 1- Covid19 and Vitamin DHANISH BABU
Covid19 and Vitamin D is part 1 of 3 of the Webinar series on Vitamin D in Health and Disease by Dr Hanish Babu. 2 Major Text Books, more than 250 Journal references and reference from dozens of Videos on Vitamin D from experts world over and 4 months of intensive research has gone into the preparation of these talks.
As a service to the public health, these presentations are free to use for educational purposes, with proper acknowledgements.
Dr Hanish Babu, MD, 2020
The problem is that we have a health industry that is not concerned with food…
…and a food industry that is not concerned with health.
For further information on how to invest please contact:
Andrew Haythorpe
Founder, Managing Director
Mobile: +61407 737 973
Email: a@bettercells.com
Skype: andrewhaythorpe
A brief review about the role of vitamin D in health and disease. Most of the content in these slides were taken from another author with some editing to custom it for the purpose of general physician workshop scientific material. Some figures were our own data in our hospital
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
2. Sun (UVB) on skin turns
cholesterol into vitamin D
We can also get Vitamin D
from food & supplements
Synthesis
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
2
4. Protein
Ribosome
Messenger RNA makes
a copy of DNA
Goes out of nucleus
to ‘production’
factory (ribosomes)
mRNA runs through
ribosome like a tape,
giving instructions on
protein to make
DNA is blue
print
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Transcription
5. Genes don’t want to be making proteins
continuously – they need to be turned on & off
– Regulators
Vitamin D major regulator in humans
Over 230 VDRs in nucleus of most tissues
found
Vitamin D affects gene expression It turns genes on & off
What does Vitamin D do to make such
a difference in health?
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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6. 08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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VDR is present in:
Kidneys; Parathyroid glands;
Osteoclasts & osteoblasts
Intestines; Macrophages
Nuclei of islets of pancreas;
Brain Neurons, Substantia nigra,
Limbic system, Cortex, Cerebellum
May stimulate Neurotrophins
(regulate neuronal development)….
7. Adams & Hewison (2008). Nature Clinical Practice
Endocrinology & Metabolism, Volume 4, 80-90.
TLR = Toll-like receptor
allows immune system to
recognize microbes by
looking at molecular
patterns
CYP27B1: a gene
that encodes an
enzyme to convert
inactive vitamin D
to active vitamin D
Active vitamin D
VDR = Vitamin D Receptor
Active vitamin D binds to VDR
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Vitamin D Signaling Pathway
Pathogen invades cell
Toll-like receptor signaling activated
↑ Expression of VDR & CYP27B1 genes
Active vitamin D binds to VDR
Production of cAMP ↑ (fight microbes)
Vitamin D & VDR go to nucleus, binds
to vitamin D response element (VDRE)
Innate
Adaptive
VDRE
8. The literature on Vitamin D
has exploded in recent years
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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9. No Dodging Prostate Cancer With Vitamin D
Vitamin D May Help Curb Breast
Cancer, Study Finds
Vitamin D Deficiency Worsens Breast
Cancer?
Study backs Vitamin D in cancer fight
‘Sunshine vitamin’ may ward off
breast cancer
Vitamin D in preventive
medicine: are we ignoring
evidence?
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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10. What does vitamin D do?
This is one vitamin
we ALL need to
understand & take
from an early age!
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Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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11. Does sun exposure matter?
Further from equator Less UVB throughout year Higher incidence of various diseases
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Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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13. Recent publicity on melanoma - has reduced our sun
exposure – so we are getting less vitamin D
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Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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17. 18
Osteoporotic BoneNormal Bone
Osteoporosis disease
in which bones lose
minerals & bone density
Bones become thin, fragile
& easily broken
Source: The 2004 Surgeon General’s Report on Bone Health and Osteoporosis
http://www.surgeongeneral.gov/library/bonehealth
Myth Osteoporosis is only a
problem for older women
Osteoporosis can occur at any
age & in anyone
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Vitamin D inhibits parathyroid gene supresses proliferation of glands &
stimulates cellular differentiation of promyelocytes
Renal osteodystrophy (prevent hypertrophy of gland & inhibit secretion of PTH)
Calbindin
21. Osteopenia of Prematurity
Staging:
1. Hypodensity of bones
2. Abnormalities of metaphyses
Fraying and cupping
Dense line (healing)
3. Fractures
Courtesy of Steve Abrams MD
22. Vitamin D: Essential for our immune system
When ‘Foreign’ protein enters body
Helper T cells turn into Killer T cells
An army of specific killer cells attack & kill
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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23. Research from Copenhagen – May 2011
“Without vitamin D the white cells lie dormant!”
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Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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24. 08-07-2016
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MIMER Medical College Talegaon Dhabade
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Researchers at Queen Mary at University of London
decided to test out old treatment with modern day
antibiotics. What they discovered was that when
coupled together, antibiotics & high doses of vitamin
D - which is created in body when it is exposed sun -
helped people recover faster from tuberculosis."
"Before antibiotics were readily available, doctors
would to send their patients to receive heliotherapy -
basically prescribed sunbathing. Practice was
stopped since more effective antibiotics were
invented, but physicians have often wondered why
sunshine treatment seemed to somewhat work.”
'Sunshine Vitamin' Helps Treat Respiratory infections
“272 adults attending emergency department with
community-acquired pneumonia were examined for disease
severity & outcomes. Over half (53 %) of patients were
vitamin D deficient, of which 24 % had severe deficiency.
http://www.erscongress2012.org/
http://www.gponline.com/News/article/1148164/vitamin-d-testing-could-slash-
pneumonia-deaths/
It has long been thought that by inducing muscle
weakness (especially of diaphragm & intercostal
muscles), vitamin D deficiency gives rise to
difficulties in eliminating respiratory secretions,
facilitating development of infections
Several epidemiological studies have suggested that
vitamin D deficiency is associated with an increased
incidence of asthma & allergy symptoms.
25. 08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Vitamin D has been shown to influence microarray gene expression
in bronchial smooth muscle cells, with consequent effects on
remodeling, cell growth & survival
Functions of vitamin D also depend on individual VDR variability
Lower vitamin D levels are associated with ↑ airway
responsiveness, higher eosinophil counts & IgE levels, while higher
vitamin D levels associated with a lower likelihood of hospitalization
for asthma exacerbations
26. Whenever there is a risk of infection, make sure
Vitamin D levels are optimal
Is it a coincidence that flu & infections
are higher in winter months?
Vitamin D switches on production of over 200
antimicrobial peptides – Most important CATHELICIDIN
(naturally occurring broad-spectrum antibiotic)
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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27. A study demonstrated that vitamin D supplementation improved muscular power in
healthy overweight & obese individuals within 4 weeks.
Elevated vitamin D status was associated with greater losses in waist circumference, with
no additional benefits in lean mass accumulation, muscular strength, or glucose tolerance
during participation in a 12-week resistance exercise training program.
Another study, supports previous findings that indicate a relationship between vitamin D
status & waist circumference rather than fat mass.
Inverse relationship with waist circumference is particularly important as abdominal fat
has been implicated as an important factor in development of Type 2 diabetes.
Waist circumference is also an independent risk factor for cardiovascular disease.
Therefore, greater decrease in waist circumference associated with higher vitamin D
intake represents a potential reduction in risk for metabolic disease & cardiovascular risk.
http://www.clinicalnutritionjournal.com/article/S0261-5614(12)00181-1/abstract
Vitamin D and waist circumference
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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28. Diabetes in Children under 14 in Finland 1965 -2009
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Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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29. Vitamin D seems to do all the right things for the heart
VDR Present in artery walls, heart muscle
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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30. Vitamin D in cancer
Switches apoptosis back on – programmed cell death
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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31. Vitamin D tells cells when to divide,
stop dividing & also when to die
(apoptosis)
With low vitamin D levels:
Cells continue to divide out of
control!
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Major vitamin D catabolizing
enzyme, CYP24A1 (24-
hydroxylase), is often amplified &
over expressed in tumor cells
32. Slows down multiplication & spread of cancer cells
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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33. Reduces growth of new blood vessels to feed cancer cells & ↓ spread
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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34. "Vitamin D3 plays a key role in immune regulation & may protect against aging process.
Age-related changes In outer retina, there is high metabolic demand resulting in a
gradual ↑ in extracellular deposition, inflammation, & cell loss rise to visual decline.
Vitamin D3 administration for only 6 weeks in aged mice has a significant impact on this
aging process...
Recently, vitamin D3 has been linked epidemiologically to protect against age-related
macular degeneration."
In a study, supplemention with vitamin D3 helps rejuvenate aging eyes by
reducing inflammation & amyloid beta (risk factor for age-related macular
degeneration leading cause of blindness)
Vitamin D in Eye
http://www.neurobiologyofaging.org/article/S0197-4580(11)00519-7/abstract
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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35. “A cohort study included women over age of 75 years to study risk factors for
hip fractures over 4 years. Dietary factors & midday sun exposure habits were
examined. Presence of Alzheimer’s disease & other dementias was assessed
7 years after enrolment.”
Vitamin D and Alzheimer’s
http://www.ncbi.nlm.nih.gov/pubmed/22503994
http://blog.vitamindcouncil.org/2012/04/23/dietary-vitamin-d-intake-and-sun-
exposure-linked-to-lower-risk-of-alzheimers-in-france/
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Those in highest 5th of vitamin D intake had ¼ incidence rate of Alzheimer's
disease...
In addition, those in highest 5th of sun exposure had 50 % less incidence
of Alzheimer's..."
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Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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A link between lack of exposure to sunlight, consequent lack of
vitamin D production & development of MS
Whether low levels of vitamin D affect number of relapses &
disease course?
There is some evidence that lower levels of vitamin D are
associated with higher relapse rates & greater disability
One study also found that people with progressive forms of MS
had lower levels than those with relapsing remitting MS
Whether lack of vitamin D contributes to risk
of developing Multiple Sclerosis?
http://www.mstrust.org.uk/news/article.jsp?id=5503
37. 08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Vitamin D Improves Seizure Control in Epilepsy
Pilot study included 13 subjects between ages of 19 - 60, who had had epilepsy anywhere
between 10-42 years.
All subjects were given a one-time mega-dose of vitamin D3, ranging from 40,000 IU to 200,000
IU, followed by a daily dose of 2,000-2,600 IU for 3 months, in an effort to correct each
individual's vitamin D status & bring them up to at least 30 ng/ml.
At 90-day follow-up, median vitamin D level for group was 38 ng/ml (23.3 to 45 ng/ml).
They then tallied number of seizures experienced during 3-month long treatment period, compared to 3
months prior to treatment.
10 out of 13 had a decrease in number of seizures; 5 of which experienced more than 50 % reduction.
2 participants had more seizures, while 1 experienced no change at all. Overall, group had 40 % reduction
in number of seizures.
http://www.ncbi.nlm.nih.gov/pubmed?term=Correction%20of%20vitamin%20D%20deficiency%20improves%20seizure%20control%20in%20epilepsy%3A%20A%20pilot%20study
38. Vitamin D and Depression: Where is all the
Sunshine?
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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39. 08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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Role of Vitamin D in skin
VDR present on keratinocytes
Vitamin D induce differentiation of keratinocytes
& inhibit their proliferation
Effective in psoriasis vulgaris
(hyperproliferative disease), actinic keratitis
40. Role of vitamin D in hair growth
Researchers at Cairo University found - women with hair loss problems
also had lower levels of iron & vitamin D
Hair loss only got worse as levels dropped
“It might regulate expression of genes that promote normal hair follicle
growth”
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
41
Some studies have shown that vitamin D when applied topically to
scalp can ↓ chance of cancer patients developing hair loss after
being given certain types of chemotherapy
41. Arctic Circle EquatorGeographic Location
SeasideElevation Mountains
Sun-seeking Behaviors Always outsideNever outside
DeepSkin Pigmentation Light
Mostly uncoveredCultural Dress Mostly covered
Never Owned AnySunscreen Use Applies to any exposed skin
SUNLIGHT EXPOSURE FACTORS
Assessment of Vitamin D Stores
Diet No milk, No fish Vit D fortified Milk, Salmon 3 X a week
Present
Diseases assoc. with Vit D
Deficiency
Not present
Supplements No supplements 400 IU Vit D per day
DIETARY FACTORS
42. 43
Need more vitamin D with age
Age
Daily
vitamin D
(IU)
600 IU
200 IU
400 IU
0
100
200
300
400
500
600
up to 50 51-70 over 70
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
43. How much vitamin D should we take?
**Some cancers can raise blood calcium level, so in cancer patients ask for calcium
levels to be checked before starting & after being on high dose of vitamin D
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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44. UVA
UVB
Middle hours of day (between
10 am & 2 pm)
With low sun, good UVB rays are
filtered out & UVA gets through
47. Vitamin D2 (Ergocalciferol) or Vitamin D3 (Calcitriol)
Calcitriol analouges – Calcipotriol (topical), Doxercalciferol (1α hydroxy D2) & paricalcitol
Adults treated with vitamin D2 showed ↑ total blood levels of 25(OH)D & maintained total
blood levels of 1,25(OH)2D same as adults who received same dose of vitamin D3
Recent meta-analysis indicated that vitamin D3 is more efficacious at ↑ serum 25(OH)D
concentrations than vitamin D2
11-week course of treatment with 1000 IU vitamin D2, 1000 IU vitamin D3, or combination of
500 IU vitamin D2 & 500 IU of vitamin D3 daily equivalent ↑ in serum total 25(OH)D levels
Type of Vitamin D Supplementation
Mayo Clinic Proceedings Volume 88, Issue 7, Pages 720 - 755, July 2013
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50. Skepticism grows regarding widespread vitamin
D supplementation
• Serious questions about safety & efficacy of popular practices of high-dose vitamin D supplementation
across population
• One of these concerns is that not all of extra calcium absorption promoted by boosting vitamin D goes into
bone to prevent fractures
• Serum 25-hydroxyvitamin D levels were positively associated with increased calcified atherosclerotic
plaque in aorta & carotid arteries
• A large prospective randomized trial assessed effects of using calcium supplements on vascular event
rates:
NNT for 5 years of supplemental calcium in order to cause one additional MI than with placebo was 44.
NNT for one stroke was 56
NNT to cause one additional cardiovascular event was 29
In contrast, NNT to prevent one symptomatic fracture was 50
“The question we have to ask is: What does that low serum vitamin D level mean?
Is it the thing that predisposes, or is it somehow a byproduct of illness?”
(J.Clin.Endo.Metab. Jan. 8, 2010; Epub ahead of print PMID:20061416)
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MIMER Medical College Talegaon Dhabade
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51. Too much Vitamin D – Is it toxic?
Vitamin D intoxication hypercalcemia, hypercalciuria, &
hyperphosphatemia responsible for soft-tissue, vascular
calcifications & nephrolithiasis (long term use)
Serum 25(OH)D levels markedly elevated (>150 ng/mL)
Daily doses of vitamin D3 up to 10,000 IU (safe in healthy
males) with no evidence of hypercalcemia / hypercalciuria for
5 months
Tolerable upper level – 4000 IU (IOM guidelines)08-07-2016
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MIMER Medical College Talegaon Dhabade
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52. Drug interactions
1. Drugs that impair vitamin D absorption –
Obesity medication – Orlistat
Bile acid sequestrants – Cholestyramine & Colestipol
2. Drugs that may ↑ vitamin D catabolism –
Anticonvulsants, cimetidine, thiazides
3. Drugs that may ↓ vitamin D absorption –
Olestra (Fat substitutes)
Liquid paraffin
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MIMER Medical College Talegaon Dhabade
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53. 54
Putting it all together…
08-07-2016
Department of Pharmacology
MIMER Medical College Talegaon Dhabade
54. Low Vitamin D levels associated with:
Archives of Neurology, March 2011
American Heart Association's (AHA) Annual Scientific Sessions, Chicago, IL
November 15,
2010
Journal of Allergy and Clinical Immunology June 8, 2010
Diabetes Care. 2011 March08-07-2016
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MIMER Medical College Talegaon Dhabade
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55. Leg artery disease 80% more (NHANES2001-2004)
Heart attacks 62% more (Framingham study,Circulation Jan 2008)
High BP 300% more (In15 year study of women in Michigan School of
public health, AHA BP Conference 2009)
Diabetes 57% more (Australian Institute of medicine 2011)
Cancer 72% more colorectal cancer (NHANES 2010)*
Low Vitamin D levels
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Department of Pharmacology
MIMER Medical College Talegaon Dhabade
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56. In people taking Vitamin D supplements:
Pancreatic cancer 45% reduction in
120,000 in 2006
All cancers reduced by 77% in 1,200
Cancer Epidemiology Biomarkers & Prevention 15 (9): 1688–95. 2006
The American Journal of Clinical Nutrition 85 (6): 1586–91 2007
American Journal of Clinical Nutrition 91 (5): 1324–35. 2010
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MIMER Medical College Talegaon Dhabade
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57. Once the diseases have developed, Vitamin D levels still make a difference:
Doubles survival in people with colon cancer
Hospitalisation due to heart failure & mortality is reduced
Lowered heart deaths by 33% in women
Vitamin D supplements reduced cancer by up to 60% women
British Journal of Cancer September 15, 2009; 101(6):916-23
European Society of Cardiology (ESC) Congress 2010 August 28-September
1, 2010, Stockholm, Sweden
2nd annual conference on Cardiovascular Disease and Epidemiology
Prevention in Honolulu, Hawaii. April 23, 200208-07-2016
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MIMER Medical College Talegaon Dhabade
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58. Cancer Hypertension Heart disease
Autism Obesity Rheumatoid arthritis
Diabetes 1 and 2 Multiple Sclerosis Crohn"s disease
Flu Colds Tuberculosis
Septicemia Aging Psoriasis
Eczema Insomnia Hearing loss
Muscle pain Cavities Periodontal disease
Athletic performance Macular degeneration Myopia
Pre-eclampsia Seizures Fertility
Asthma Cystic fibrosis Migraines
Depression Alzheimer’s disease Schizophrenia
The list of illnesses benefitting from vitamin D grows by the day
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MIMER Medical College Talegaon Dhabade
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60. 1. Goodman Gillman
2. Martindale
3. KD Tripathi
4. KK Sharma
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MIMER Medical College Talegaon Dhabade
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References
61. 08-07-2016
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MIMER Medical College Talegaon Dhabade
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• Determine whether vitamin D inadequacy ↑ cancer risk
• Whether greater exposure to nutrient is protective
• Need to consider metabolism, catabolism, & VDR polymorphisms
• Address methodology to measure serum vitamin D level (biomarkers)
• Need surrogate markers of vitamin D activity
• Determine molecular targets for vitamin D
• Explore vitamin D/sun exposure dilemma
Further research is needed: