Vitamin D Metabolism

What May Vitamin D Improve?

-Improved bone health
-Increased absorption of calcium
-Reduced risk of falls and bone fractures
-Reduced coronary artery disease
-Improved muscular function
-Lowering of high blood pressure
-Improved blood sugar tolerance
-Improved nerve function
-Improved kidney function
-Reduced risk of 17 cancers
-Reduced influenza, cold infections, tuberculosis

Vitamin D Deficiency

Low Vitamin D Risks

Increased blood pressure - 2.4 times

High blood sugar - 2.5 times
Metabolic syndrome 4.0 times

Vitamin D and Bones

Vitamin D is important for people with osteoporosis. Studies show that calcium and vitamin D
together can increase bone density in postmenopausal women. Vitamin D also helps with other
disorders associated with weak bones, like rickets.

Vitamin D and the Heart

Low levels of vitamin D associated with increased risk of
cardiovascular disease and mortality.
One study: Low vitamin D risk increase of
Coronary Artery Disease - 45%
Stroke - 78%
Heart attack - 50%
Death 77-100%
25-57% USA adults may be deficient

Vitamin D and Critical Illness

For critically ill patients in the hospital, low vitamin D levels
have been found to be related to
1.Organ malfunction
2.Length of stay
3.Infection rates

Vitamin D and MS
Several studies have suggested that maintaining adequate
levels of vitamin D may have a protective effect and lower
the risk of developing multiple sclerosis (MS). Other studies
suggest that for people who already have MS, vitamin D
may lessen the frequency and severity of their symptoms.
More research is needed to assess these findings.

Is there any proof that vitamin D supplements

can prevent MS or keep symptoms of MS from
worsening?
When a person has MS, his or her immune system attacks
the coating that protects the nerve cells. Research suggests
that a connection between vitamin D and MS could be tied
to the positive effects vitamin D has on the immune system.
The link between vitamin D and MS is strengthened by the
association between sunlight and the risk of MS. The farther
away from the equator a person lives, the higher the risk of
MS. Sunlight is the body's most efficient source for vitamin D
suggesting that exposure to sunlight may offer protection
from MS.

Vitamin D and Cancer Cure

1.

2.
3.
4.
5.
6.

Inverse correlation between incidence, mortality and or survival rates

for many cancers including breast, colorectal, ovarian, and prostate
cancers.
Emerging evidence that more than 17 cancers are likely to be vitamin D
sensitive.
1000 IU/day could reduce cancers 7% for men, 9% for women in US.
25(OH)D level of 52 ng/ml reduced breast cancer by 50%
60-80 ng/ml may be optimal for most individuals
25(OH)D level increase from 29 to 39 reduced cancer risk by 60% after
4 years.

Vitamin D and the Lungs

Asthma: Early studies indicate may reduce severe exacerbations,

exercise induced bronchoconstriction
Lower respiratory tract infections are more frequent in those with low
25(OH)D levels.
2000 IU Vitamin D abolished the seasonality of influenza and
dramatically reduced the self-reported incidence.
Vitamin D reduces inflammation and viral pathogens.

Vitamin D and Depression

Vitamin D may be primarily associated with cognitive domains

other than memory , such as executive cognitive functions,

depression, bipolar disorders, and schizophrenia.
Low 25(OH)D may be a risk factor for cognitive impairment (41-

60%).
Receptors for Vitamin D are present in brain cells.

Increased Vitamin D may improve cognitive function in

patients with Alzheimer's

Pros and Cons

Vitamin D From the SUN
5-6 times more deaths from internal cancers related to low
vitamin D levels than skin cancers
Regular moderate outdoor UV exposure increases survival of
melanoma patients

Current Vitamin D
Recommendations
Institute of Medicine recommendations:
400 IU: infants 0 to 12 months
600 IU: age 1 70 years
800 IU: age above 70
4000 IU upper limit
Endocrine Society's Clinical guidelines
400 IU - 1000 IU: infants 0 to 12 months
600 IU 1000 IU: age 1 18 years
600 IU 2000 IU: 19 - 70 years
800 IU 2000 IU: above 70
1000 IU to 6 mo, 4000 IU over 8 yrs upper limit

Vitamin D Sources
The Sunshine Vitamin
Fortified foods:
Typically supply 150 IU per day, but highly variable
(100 - 400 IU per day).
Supplements:-Over-the-counter usually vitamin D3
Vitamin D3 is more than three times

powerful than D2.

Vitamin D Sources

Why Euopeans Need Vitamin D

70 percent of Europeans suffer from low vitamin D
levels---Spanish Foundation for Science and
Technology
In recent years, there have been reports
suggesting a high prevalence of low vitamin D
intakes and vitamin D deficiency or inadequate
vitamin D status in Europe.
European latitude and Climate resulting in
inadequate sun exposure.

Why Euopeans Need Vitamin D

Lifestyle factors such as longer working hours
indoors and less outdoor playtime for children may
impact on achieving sufficient sun exposure
The importance of time spent outdoors was shown
in a Swiss population study, where it was a
significant predictor of low vitamin D levels in
patients aged over 65 years

Vitamin D and sun exposure

in Europe

Sunlight is not strong enough to trigger synthesis of

vitamin D in the skin from October to March.
Therefore, European population rely on dietary
vitamin D and body stores to maintain a healthy
vitamin D status, particularly during the winter
season

How Much Vitamin D

is Needed?
The only way to know how much is needed is to test 25(OH)D.
Everyone should be tested!
Goal: 25(OH)D between 60-80 ng/ml after a consistent intake level
over 2 months.
100 IU of vitamin D raises 25(OH)D about 1 ng/ml.

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