Brooke Bryant

April 20, 2016

Gretchen Matuszak

Medical Nutrition Therapy Nutrient

1. What is the nutrient?
Vitamin D is fat-soluble vitamin that is naturally present in some foods but is fortified in
others. Vitamin D can be obtained through sun exposure and supplements also.

2. What is the RDA/DRI for the nutrient?

Table 2: Recommended Dietary Allowances (RDAs) for Vitamin D [1]

Age

Male

Female

Pregnancy

Lactation

012 months*

400 IU
(10 mcg)

400 IU
(10 mcg)

113 years

600 IU
(15 mcg)

600 IU
(15 mcg)

1418 years

600 IU
(15 mcg)

600 IU
(15 mcg)

600 IU
(15 mcg)

600 IU
(15 mcg)

1950 years

600 IU
(15 mcg)

600 IU
(15 mcg)

600 IU
(15 mcg)

600 IU
(15 mcg)

5170 years

600 IU
(15 mcg)

600 IU
(15 mcg)

>70 years

800 IU
(20 mcg)

800 IU
(20 mcg)

* Adequate Intake (AI)

Table was found on: https://ods.od.nih.gov/factsheets/VitaminDHealthProfessional/

3. How is the nutrient metabolized?
Vitamin D can be metabolized through the skin where it is produced from sun exposure. Human
skin-derived vitamin D3 is produced from 7-dehydroxycholesterol upon exposure to ultraviolet
B radiation. As a fat-soluble vitamin, dietary vitamin D is incorporated into chylomicrons and
transported via lymphatics into the venous circulation. Some of the dietary vitamin D is extracted
by adipose tissue and muscle, but the remainder and most of the endogenously synthesized

Brooke Bryant
April 20, 2016
Gretchen Matuszak
vitamin D is transported to the liver. Here, it is metabolized by the cytochrome enzymes vitamin
D2 (NIH, 2012).

4. What are food sources of the nutrient?

Foods that contain vitamin D include the flesh of fatty fish such as (salmon, tuna, and mackerel)
and fish liver oils. Small amounts of vitamin D are found in beef liver, cheese, and egg yolks.
Mushrooms contain small amounts of vitamin D but help with absorbing ultra violet light that
help produce vitamin D within the body. In the 1930s it was made that milk had to be fortified
with vitamin D along with other foods like milk, cheese, yogurt, some fortified breakfast cereals,
and orange juices.

5. What disease states alter the nutrients metabolism?

People with inflammatory bowel disease may have problems absorbing vitamin D due to the
intestines being inflamed and for the constant excretion of nutrients not giving the body enough
time to absorb it. People who are obese that have had gastric bypass surgery can often times have
problems metabolizing vitamin D or do not take in enough vitamin D due to the surgery causing
them to eat less foods. People with cancer also may have problems with metabolizing vitamin D
due to their disease state and because they are not supposed to be out in the sun because of
certain types of medications they are on and because of the radiation treatment.

6. What are the tests or procedures to assess the nutrient level in the body?
25-hydroxy vitamin D test. The 25-hydroxy vitamin D test is the most accurate way
to measure how much vitamin D is in your body. In the kidney, 25-hydroxy vitamin D changes
into an active form of the vitamin. The active form of vitamin D helps control calcium and
phosphate levels in the body (Medline Plus, 2015).

7. What is the drug nutrient interactions?

There are several drugs that interact with vitamin D and they include steroids like
Corticosteroid medications such as prednisone, often prescribed to reduce
inflammation, can reduce calcium absorption and impair vitamin D metabolism.
These effects can further contribute to the loss of bone and the development of
osteoporosis associated with their long-term use. Some other drugs that interact
with vitamin D include the weight-loss drug orlistat and the cholesterol-lowering drug

cholestyramine can reduce the absorption of vitamin D and other fat-soluble vitamins. Both

Brooke Bryant
April 20, 2016
Gretchen Matuszak
phenobarbital and phenytoin, used to prevent and control epileptic seizures, increase the hepatic
metabolism of vitamin D to inactive compounds and reduce calcium absorption (NIH, 2012).

8. How is the nutrient measured?

Vitamin D is measured in IUs but on the charts that I have listed above it is shown in IUs and
also in (mcg).

9. What is the Upper Tolerable Limits?

Table 4: Tolerable Upper Intake Levels (ULs) for Vitamin D [1]

Age

Male

Female

Pregnancy

06 months

1,000 IU
(25 mcg)

1,000 IU
(25 mcg)

712 months

1,500 IU
(38 mcg)

1,500 IU
(38 mcg)

13 years

2,500 IU
(63 mcg)

2,500 IU
(63 mcg)

48 years

3,000 IU
(75 mcg)

3,000 IU
(75 mcg)

9 years

4,000 IU
(100 mcg)

4,000 IU
(100 mcg)

4,000 IU
(100 mcg)

Lactation

4,000 IU
(100 mcg)

Table was found on: https://ods.od.nih.gov/factsheets/VitaminDHealthProfessional/

10. What are the physical signs of deficiency?

Symptoms of bone pain and muscle weakness are some signs of vitamin D deficiency.
Rickets and osteomalacia are the classical vitamin D deficiency diseases. In children, vitamin
D deficiency causes rickets, a disease characterized by a failure of bone tissue to properly
mineralize, resulting in soft bones and skeletal deformities

11. What are physical signs of toxicity?

Vitamin D toxicity can cause non-specific symptoms such as anorexia, weight loss, polyuria, and
heart arrhythmias. More seriously, it can also raise blood levels of calcium which leads to

Brooke Bryant
April 20, 2016
Gretchen Matuszak
vascular and tissue calcification, with subsequent damage to the heart, blood vessels, and
kidneys. Vitamin D toxicity cannot come from sun exposure because of the heat exposure to skin
(NIH, 2012).

References

25-hydroxy vitamin D test: MedlinePlus Medical Encyclopedia. (2015, April 5). Retrieved April
20, 2016, from https://www.nlm.nih.gov/medlineplus/ency/article/003569.htm
Office of Dietary Supplements - Vitamin D. (n.d.). Retrieved April 19, 2016, from
https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/