One reason is that sun exposure affects vitamin D status, so serum 25(OH)D levels are usually higher than would be predicted on the basis of vitamin D dietary intakes alone [1]. Although 25(OH)D functions as a biomarker of exposure, the extent to which 25(OH)D levels also serve as a biomarker of effect on the body (i.e., relating to health status or outcomes) is not clear [1,3]. The effect of vitamin D supplementation on glycemic control in type 2 diabetes patients: A systematic review and meta-analysis. Vitamin D (also referred to as "calciferol") is a fat-soluble vitamin that is naturally present in a few foods, added to others, and available as a dietary supplement. In addition to bone deformities and pain, severe rickets can cause failure to thrive, developmental delay, hypocalcemic seizures, tetanic spasms, cardiomyopathy, and dental abnormalities [45,46]. Email. [. J Am Coll Cardiol 2017;70:89-100. A person can also boost . Levels of 50 nmol/L (20 ng/mL) or more are sufficient for most people. Bone is constantly being remodeled. In the most recent meta-analysis, 10 randomized clinical trials (including the VITAL trial described below) that included 6,537 cancer cases provided 10 to 50 mcg (400 to 2,000 IU) vitamin D3 daily (six trials) or 500 mcg (20,000 IU)/week to 12,500 mcg (500,000 IU)/year boluses of vitamin D3 (four trials) [91]. Ann Intern Med 1996;125:961-8. Ann Intern Med 1990;112:352-64. Those who are older or at risk for . Corticosteroid medications, such as prednisone (Deltasone, Rayos, and Sterapred), are often prescribed to reduce inflammation. Cancer Res 2006;66:10213-9. Home; ABOUT; LEARN ABOUT C . The groups showed no significant differences in measures of muscle strength or performance [85]. Very limited evidence suggests no substantial differences in the bioavailability of vitamin D from various foods [19]. [, Logan VF, Gray AR, Peddie MC, Harper MJ, Houghton LA. Pediatrics 2020;145:e20193574. Vitamin D3 is produced by sunlight on the skin. J Clin Endocrinol Metab 2012;97:1146-52. Prolonged exclusive breastfeeding without vitamin D supplementation can cause rickets in infants, and, in the United States, rickets is most common among breastfed Black infants and children [47]. [, Laurent MR, Gielen E, Pauwels S, Vanderschueren D, Bouillon R. Hypervitaminosis D associated with tanning bed use: A case report. 25-hydroxyvitamin D response to graded vitamin D3 supplementation among obese adults. J Clin Endocrinol Metab 2014;99:1132-41. Effect of vitamin D supplementation on blood pressure: A systematic review and meta-analysis incorporating individual patient data. Type B UV (UVB) radiation with a wavelength of approximately 290320 nanometers penetrates uncovered skin and converts cutaneous 7-dehydrocholesterol to previtamin D3, which in turn becomes vitamin D3. Increasing incidence of nutritional rickets: A population-based study in Olmsted County, Minnesota. [. Observational studies suggest that adequate vitamin D levels might reduce the risk of contracting MS and, once MS is present, decrease the risk of relapse and slow the disease's progression [138]. The vitamin D3 and calcium supplements did not reduce breast cancer incidence, and 25(OH)D levels at the start of the study were not associated with breast cancer risk [99]. Studies show that 25(OH)D appears to be approximately five times more potent than the parent vitamin for raising serum 25(OH)D concentrations [17,20,21]. Nutrients 2018 Apr 16;10(4). However, a meta-analysis of 12 vitamin D supplementation trials (including 5 in which body composition measurements were primary outcomes) found that vitamin D supplements without calorie restriction did not affect body weight or fat mass when the results were compared with those of placebo [154]. Office of Dietary Supplements, National Institutes of Health. Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. The second hydroxylation occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D [1,25(OH)2D], also known as "calcitriol" [1]. [, Brown LL, Cohen B, Tabor D, Zappala G, Maruvada P, Coates PM. [, Shea MK, Fielding RA, Dawson-Hughes B. JAMA 2018;319:1630. In addition, 26% of participants aged 25 years and 14% of those aged 611 years took supplements; rates increased with age from 10% of those aged 1219 years to 49% of men and 59% of women aged 60 and older. Overall, clinical trials show that vitamin D supplementation does not reduce CVD risk, even for people with low 25(OH)D status (below 20 nmol/L [12 ng/mL]) at baseline [93,124]. The fifty bottles of 1000 IU vitamin D pills mentioned above would weigh in the ballpark of 2500 g. A typical vitamin D tablet weighs 150 mg and is >99.9% filling. Dietary supplements can contain vitamins D2 or D3. Elsevier, 2018. [, Jiang X, Dimou NL, Al-Dabhani K, Lewis SJ, Martin RM, Haycock PC, et al. Some observational studies show associations between low serum levels of 25(OH)D and increased risks of cancer incidence and death. JAMA 2018;319:1705-16. In a cohort of 4,733 men, of which 1,731 had prostate cancer, those with 25(OH)D levels of 4570 nmol/L (1828 ng/mL) had a significantly lower risk of the disease than men with either lower or higher values [109]. Adv Nutr 2012;3:353-61. Vitamin D and its metabolites are carried in the blood bound to vitamin D binding protein (DBP) and albumin--for most tissues it is the free (i.e., unbound) metabolite that enters the cell; however, DBP bound metabolites can enter some cells such as the kidney and parathyroid gland through a megalin/cubilin mechanism. The 'sunshine vitamin': benefits beyond bone? [, Dibaba DT. Another meta-analysis of genetic studies in 146,581 participants (primarily adults) found that a low vitamin D status increased blood pressure and hypertension risk in people with genetic variants associated with low endogenous production of 25(OH)D [129]. Surg Obes Relat Dis 2016;12:693-702. Join the ODS Email List. Thiazide diuretics (e.g., Hygroton, Lozol, and Microzide) decrease urinary calcium excretion. One trial included 206 adults (mean age 52 years) who were randomized to take a bolus dose of 2,500 mcg (100,000 IU) vitamin D3 followed by 500 mcg (20,000 IU)/week or a placebo for 4 months [132]. Clinical trials to date provide little evidence that vitamin D supplementation helps maintain glucose homeostasis, reduces the risk of progression from prediabetes to type 2 diabetes, or helps manage the disease, particularly in vitamin D-replete individuals. More recently, a 2022 ancillary study of the Vitamin D and Omega-3 Trial (VITAL; described in the Cancer section below) investigated whether supplemental vitamin D3 (50 mcg [2,000 IU]/day) would lower the risk of fractures in 25,871 generally healthy men aged 50 years and older and women aged 55 years and older over a median follow-up of 5.3 years [82]. An analysis of NHANES 20092016 data found that only 20.5% of breastfed infants and 31.1% of infants who were not breastfed ingested these recommended amounts of supplements [60]. Weight loss
Vitamin D is essential for bone strength and may support the immune system and other functions. Breast cancer
[, Perez-Castrillon JL, Vega G, Abad L, Sanz A, Chaves J, Hernandez G, Duenas A. Jin, J. Vitamin D and calcium supplements for preventing fractures. Daily supplementation with 15 g vitamin D2 compared with vitamin D3 to increase wintertime 25-hydroxyvitamin D status in healthy South Asian and white European women: A 12-wk randomized, placebo-controlled food-fortification trial. However, a post hoc analysis showed a 62% lower incidence of diabetes among participants with low baseline serum 25(OH)D levels (less than 30 nmol/L [12 ng/mL]) who took the vitamin D supplement than among those who took the placebo [145,150]. Sun exposure
Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. [, Graeff-Armas LA, Bendik I, Kunz I, Schoop R, Hull S, Beck M. Supplemental 25-hydroxycholecalciferol is more effective than cholecalciferol in raising serum 25-hydroxyvitamin D concentrations in older adults. Preventing multiple sclerosis: To (take) vitamin D or not to (take) vitamin D? It may help prevent depression, inflammatory disease, and heart disorders. Kirkland Signature Vitamin D3, 1000 IU, 2-packs. Relative effectiveness of oral 25-hydroxyvitamin D3 and vitamin D3 in raising wintertime serum 25-hydroxyvitamin D in older adults. 290-2007-10055-I. [, Rockwell M, Kraak V, Hulver M, Epling J. Plasma vitamin D and prostate cancer risk: Results from the Selenium and Vitamin E Cancer Prevention Trial. [, Han J, Guo X, Yu X, Liu S, Cui X, Zhang B, Liang H. 25-hydroxyvitamin D and total cancer incidence and mortality: A meta-analysis of prospective cohort studies. [, Jagannath VA, Filippini G, Di Pietrantonj C, Asokan GV, Robak EW, Whamond L, Robinson SA. JAMA 2018;319:1696-1704. Vitamin D supplements and muscle function
A one-year trial to assess the value of orlistat in the management of obesity. Orlistat
The vitamin D paradox in Black Americans: A systems-based approach to investigating clinical practice, research, and public healthexpert panel meeting report. Cancer Epidemiol Biomarkers Prev 2014;23:1484-93. However, because the extent and frequency of sunscreen use are unknown, the role that sunscreen may play in reducing vitamin D synthesis is unclear [1]. For example, a meta-analysis included 34 observational studies that followed 180,667 participants (mean age greater than 50 years) for 1.3 to more than 32 years. [, Weisberg P, Scanlon KS, Li R, Cogswell ME. Vitamin D testing can let you know if you need to increase your vitamin D levels. Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals. Cancer Epidemiol Biomarkers Prev 2014;23:1220-9. The weight-loss drug orlistat (Xenical and alli), together with a reduced-fat diet, can reduce the absorption of vitamin D from food and supplements, leading to lower 25(OH)D levels [164-167]. Observational studies and clinical trials provide mixed evidence on whether vitamin D intakes or serum levels affect cancer incidence, progression, or mortality risk. One meta-analysis of 20 clinical trials compared the effects of 0.5 mcg (20 IU)/day to 1,250 mcg (50,000 IU)/week vitamin D supplementation for 26 months with those of placebo on glycemic control in 2,703 adults from around the world who had diabetes [143]. Clinical trials, however, do not support these findings. Studies of the effects of vitamin D supplements on hypertension have also had mixed findings. A variety of foods and their vitamin D levels per serving are listed in Table 3. [, Yao S, Kwan ML, Ergas IJ, Roh JM, Cheng T-YD, Hong C-C, et al. The Endocrine Society, the National and International Osteoporosis Foundation, and the American Geriatric Society define vitamin D deficiency as the level of 25-hydroxyvitamin (25 OH D) of less than 30 ng/mL. Circulating 25-hydroxyvitamin D concentration and risk of breast, prostate, and colorectal cancers: The Melbourne Collaborative Cohort Study. Brooks SPJ, Sempos CT. Jean-Claude Guilland Tlcharger La vitamine D Livre PDF Franais Online . J Natl Cancer Inst 2007;100:1581-91. These participants were randomized to take 25 mcg (1,000 IU) vitamin D3, 1,200 mg calcium, both supplements, or a placebo daily for 35 years, followed by an additional 35 years of observation after participants stopped the treatment. Role of vitamin D in atherosclerosis. Serum concentrations of 25(OH)D are reported in both nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL). It concluded that the current evidence was insufficient to evaluate the benefits and harms of supplementation to prevent fractures. [, Lukert BP, Raisz LG. [, Taylor CL, Thomas PR, Aloia JF, Millard PS. J Natl Cancer Inst 2007;99:1563-5. Vitamin D has other roles in the body, including reduction of inflammation as well as modulation of such processes as cell growth, neuromuscular and immune function, and glucose metabolism [1-3]. For a reader-friendly overview of Vitamin D, see our consumer fact sheet on Vitamin D. For information on vitamin D and COVID-19, see Dietary Supplements in the Time of COVID-19. Despite increasing serum 25(OH)D levels to an average of more than 80 nmol/L (32 ng/ml), vitamin D supplementation did not affect lower-extremity power, strength, or lean mass. It may even help prevent cancer and protect against. No. alert icon. Type 2 diabetes
Vitamin D is important for bone and muscle strength and immune function. A reverse J-shaped association between serum 25-hydroxyvitamin D and cardiovascular disease mortality: The CopD study. Proportions at risk of deficiency were lowest among children aged 15 years (0.5%), peaked at 7.6% in adults aged 2039 years, and fell to 2.9% among adults aged 60 years and older; patterns were similar for risks of inadequacy. Read More. The results showed that baseline serum 25(OH)D levels were inversely associated with total number of CVD events (including myocardial infarction, ischemic heart disease, heart failure, and stroke) and mortality risk [120]. [, Jorde R, Sollid ST, Svartberg J, Schirmer H, Joakimsen RM, Njolstad I, et al. 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