The 'sunshine vitamin': benefits beyond bone? Four percent had levels higher than 125 nmol/L (50 ng/mL). [, Skversky AL, Kumar J, Abramowitz MK, Kaskel FJ, Melamed ML. A mild deficiency may not produce any signs or symptoms. Serum vitamin D and risk of breast cancer within five years. Although your body can synthesize vitamin D when exposed to the sun, this method is no longer recommended due to the erratic nature of absorption and the risk of skin cancer on being exposed to sunlight. [, Salzer J, Hallmans G, Nystrom M, Stenlund H. Wadell G, Sundstrom P. Vitamin D as a protective factor in multiple sclerosis. For example, a 3-year trial in New Zealand randomized 5,110 adults (mean age 65.9 years) to a single dose of 5,000 mcg (200,000 IU) vitamin D3 followed by 2,500 mcg (100,000 IU) each month or a placebo for a median of 3.3 years [124]. J Clin Endocrinol Metab 2013;98:4845-51. However, women with vitamin D intakes higher than 15 mcg (600 IU)/day at the start of the trial and who received the supplements experienced a 28% increased risk of invasive (but not in situ) breast cancer. The results showed no association between 25(OH)D levels or vitamin D dose and the risk of falling in the 184 participants who completed the study. http://www.merckmanuals.com/professional/nutritional-disorders/vitamin-deficiency-dependency-and-toxicity/vitamin-d. Accessed May 20, 2015. Setting Australia from 2014 to 2020. Further research is needed to determine whether vitamin D inadequacy increases cancer risk, whether greater exposure to the nutrient can prevent cancer, and whether some individuals could have an increased risk of cancer because of their vitamin D status over time. Some studies have used dietary supplements containing the 25(OH)D3 form of vitamin D. Per equivalent microgram dose, 25(OH)D3 is three to five times as potent as vitamin D3 [37,38]. One research review found that almost 42% of U.S.. Vitamin D is also needed for the normal development and growth of muscle fibers. Living with Diabetes: How to Monitor Your Blood Sugar Levels, Kidney or liver failure, which prevents the body from adequately processing vitamin D, A family history of vitamin D deficiency or childhood rickets, People who have had sections of the small intestine removed (resection), A condition affecting the pancreas, such as exocrine pancreatic insufficiency, A tingly, pins-and-needles sensation in the hands or feet, Muscle weakness in body parts near the trunk of the body, such as the upper arms or thighs, Waddling while walking, due to muscle weakness in the hips or legs, Bowed legs (when the deficiency is severe), Vitamin D supplements (ergocalciferol), which are derived from a plant source; Drisdol, is a trade name for a vitamin D. Vitamin D supplements (cholecalciferol), which come from an animal source. Effects of vitamin D supplementation on musculoskeletal health: A systematic review, meta-analysis, and trial sequential analysis. [, Jorde R, Grimnes G. Vitamin D: No cure for depression. It reflects vitamin D produced endogenously and that obtained from foods and supplements [1]. Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: Results from a randomized controlled trial. Are you also experiencing joint pain, muscle pain, and bone fractures? 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]. Interventions to prevent falls in community-dwelling older adults. No substantial between-group differences in fracture incidence were found by race, ethnic group, BMI, age, baseline 25(OH)D levels, or whether participants took supplemental calcium, were at high fracture risk, or had a history of fragility fractures. These may indicate a serious problem: Vitamin D deficiency! Regardless of what level your physician decides constitutes vitamin D deficiency, therapy and prevention of vitamin D deficiency are straightforward, relatively inexpensive, and safe. Zbynek Pospisil/iStock. [, Herrick KA, Storandt RJ, Afful J, Pfeiffer CM, Schleicher RL, Gahche JJ, Potischman N. Vitamin D status in the United States, 2011-2014. Vitamin D fortification in the United States and Canada: Current status and data needs. N Engl J Med 2007;357:266-81. [, Muller DC, Hodge AM, Fanidi A, Albanes D, Mai XM, Shu XO, et al. MS is an autoimmune disease of the central nervous system that damages the myelin sheath surrounding and protecting nerve cells in the brain and spinal cord. Research suggests that vitamin D could play a role in the prevention . The results showed no significant differences in rates of progression to type 2 diabetes; in serum glucose, insulin, or hemoglobin A1c levels; or in measures of insulin resistance. Bone mineral density, bone mass, and fracture risk are correlated with serum 25(OH)D levels in White Americans and Mexican Americans, but not in Black Americans [14,83]. Some observational studies support an inverse association between 25(OH)D levels and breast cancer risk and mortality, but others do not [94-97]. Cancer Epidemiol Biomarkers Prev 2014;23:1494-504. The recommended daily allowance for vitamin D for children and adults is 600 IU (15 mcg) until age 70. Moderate use of commercial tanning beds that emit 2% to 6% UVB radiation is also effective [13,29]. Rates of deficiency varied by race and ethnicity: 17.5% of non-Hispanic Blacks were at risk of vitamin D deficiency, as were 7.6% of non-Hispanic Asians, 5.9% of Hispanics, and 2.1% of non-Hispanic White people. For example, a meta-analysis of 21 studies that included 11,941 men with prostate cancer and 13,870 controls found a 17% higher risk of prostate cancer for participants with higher levels of 25(OH)D [108]. Thiazide diuretics The significance of vitamin D status in breast cancer: A state of the science review. 4 This is because vitamin D helps regulate the nervous system, so people may become more . Total cancer incidence and mortality The United States mandates the fortification of infant formula with 12.5 mcg/100 kcal (40100 IU) vitamin D; 12 mcg/100 kcal (4080 IU) is the required amount in Canada [1]. The largest clinical trial, VITAL, to investigate the effects of vitamin D supplementation on the primary prevention of cancer in the general population gave 50 mcg (2,000 IU)/day vitamin D3 supplements with or without 1,000 mg/day marine omega-3 fatty acids or a placebo for a median of 5.3 years [93]. [, Li X, Liu Y, Zheng Y, Wang P, Zhang Y. However, normal-weight participants had greater reductions in cancer incidence and mortality rates than those with overweight or obesity. 14 Signs Of Vitamin D Deficiency - YouTube [, Bolland MJ, Grey A, Avenell A. A randomized controlled trial of vitamin D3 supplementation in African American women. Fourteen signs of vitamin D deficiency include: Although theres no single cause for deficiency, your overall risk may be higher as a result of certain underlying conditions or lifestyle factors. pii: E493. [, Skaaby T, Husemoen LLN, Thuesen BH, Pisinger C, Jorgensen T, Roswall N, et al. The first hydroxylation, which occurs in the liver, converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as "calcidiol." [, Sempos CT, Binkley N. 25-hydroxyvitamin D assay standardisation and vitamin D guidelines paralysis. The results of this analysis showed that 0.5 mcg (20 IU) to 214 mcg (8,570 IU)/day vitamin D supplementation (mean of 2,795 IU) for 6 weeks to 3 years reduced serum total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels, but not high-density lipoprotein cholesterol levels [126]. You may opt-out of email communications at any time by clicking on Vitamin D deficiency - Wikipedia [, Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. Learn about signs of vitamin D deficiency, the health benefits of vitamin D, and more in this research-based guide. In extreme cases, vitamin D toxicity causes renal failure, calcification of soft tissues throughout the body (including in coronary vessels and heart valves), cardiac arrhythmias, and even death. As a result, a finding can be falsely low or falsely high, depending on the assay used and the laboratory. include protected health information. Participants were randomized to take either 30 mcg (1,200 IU)/day vitamin D3 or a placebo for 1 year. But despite the importance of the sun for vitamin D synthesis, limiting skin exposure to sunlight and UV radiation from tanning beds is prudent [28]. Since 2014, however, several published studies and meta-analyses have found no relationship between 25(OH)D levels and prostate cancer risk [111,112]. Pharmacotherapy 2002;22:814-22. Other symptoms may include pale skin, a sore or swollen tongue, and nails . N Engl J Med 2019;381:520-30. The Endocrine Society states, for example, that to maintain serum 25(OH)D levels above 75 nmol/L (30 ng/mL), adults might need at least 37.5 to 50 mcg (1,5002,000 IU)/day of supplemental vitamin D, and children and adolescents might need at least 25 mcg (1,000 IU)/day [11]. Shortness of breath. doi: 10.1001/jamanetworkopen.2019.17789. (Photo: Getty . 1. Ann Intern Med 1996;125:961-8. [, Song Z-y, Yao Q, Zhuo Z, Ma Z, Chen G. Circulating vitamin D level and mortality in prostate cancer patients: A dose-response meta-analysis. One study included 1,119 men treated for prostate cancer whose plasma 25(OH)D levels were measured 4.9 to 8.6 years after their diagnosis. Overall, the risk of CVD events was 10% lower for each 25 nmol/L (10 ng/mL) increase in serum 25(OH)D. Another large observational study that followed 247,574 adults from Denmark for 07 years found that levels of 25(OH)D that were low (about 12.5 nmol/L [5 ng/mL]) and high (about 125 nmol/L [50 ng/mL]) were associated with a greater risk of mortality from CVD, stroke, and acute myocardial infarction [121]. One nmol/L is equal to 0.4 ng/mL, and 1 ng/mL is equal to 2.5 nmol/L. Effect of long-term vitamin D3 supplementation vs placebo on risk of depression or clinically relevant depressive symptoms and on change in mood scores: A randomized clinical trial. In one meta-analysis of 46 clinical trials that included 4,541 participants, vitamin D supplements (typically 40 mcg [1,600 IU]/day or less) for a minimum of 4 weeks had no significant effects on systolic or diastolic blood pressure [127]. International Journal of Epidemiology 2019;48:1416-24. A baby born to a mother with severe vitamin D deficiency can be born with signs of rickets or develop them within a few months after birth. In addition to having an increased risk of vitamin D deficiency, people with these conditions might not eat certain foods, such as dairy products (many of which are fortified with vitamin D), or eat only small amounts of these foods. Association of serum level of vitamin D at diagnosis with breast cancer survival: A case-cohort analysis in the Pathways Study. [, Rajakumar K. Vitamin D, cod-liver oil, sunlight, and rickets: A historical perspective. The USPSTF also reviewed the seven published studies on the effects of vitamin D supplementation (two of them also included calcium supplementation) on the risk of falls in community-dwelling adults aged 65 years or older who did not have osteoporosis or vitamin D deficiency. Vitamin D and calcium: A systematic review of health outcomes. Silva MC, Furlanetto TW. [, Nair-Shalliker V, Bang A, Egger S, Clements M, Gardiner RA, Kricker A, et al. Some observational studies show associations between low serum levels of 25(OH)D and increased risks of cancer incidence and death. 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]. Crit Rev Food Sci Nutr 2015;55:1193-205. 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]. Vitamin D might be involved in the pathophysiology of type 2 diabetes through its effects on glucose metabolism and insulin signaling as well as its ability to reduce inflammation and improve pancreatic beta-cell function [1443,145]. N Engl J Med 2019;381:1785-6. Federal agencies and national organizations advise taking photoprotective measures to reduce the risk of skin cancer, including using sunscreen with a sun protection factor (SPF) of 15 or higher, whenever people are exposed to the sun [28,30]. The vitamin D supplements were associated with serum 25(OH)D levels of 54 to 135 nmol/L (21.6 to 54 ng/mL). Excess amounts of vitamin D are toxic. 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]. Holick MF. However, comparing vitamin D intakes to serum 25(OH)D levels is problematic. Vitamin D Deficiency in Kids: Signs, Symptoms and More - Healthline Scientific Reports 2020;10:7736. There is a problem with 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]. Vitamin D deficiency and depression in adults: Systematic review and meta-analysis. The international Vitamin D Standardization Program has developed procedures for standardizing the laboratory measurement of 25(OH)D to improve clinical and public health practice [5,7-10]. [, Pappa HM, Bern E, Kamin D, Grand RJ. Journal of AOAC International 2017;100:1223-4. [, Ward LM, Gaboury I, Ladhani M, Zlotkin S. Vitamin D-deficiency rickets among children in Canada. Serum concentrations of 25(OH)D are reported in both nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL). Some prescription doses are given weekly, rather than daily. Interventions to prevent falls in older adults: Updated evidence report and systematic review for the US Preventive Services Task Force. [, Weisberg P, Scanlon KS, Li R, Cogswell ME. It is to reach and keep an adequate level of vitamin D in the body. [, Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. 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]. [, Lukert BP, Raisz LG. Although UVB exposure can produce vitamin D in infants, the American Academy of Pediatrics (AAP) advises parents to keep infants younger than 6 months out of direct sunlight, dress them in protective clothing and hats, and apply sunscreen on small areas of exposed skin when sun exposure is unavoidable [59]. [, Heath AK, Hodge AM, Ebeling PR, Eyles DW, Kvaskoff D, Buchanan DD, et al. 09-E015. Another study included 2,259 healthy individuals aged 45 to 75 years who had had one or more serrated polyps (precursor lesions to colorectal cancer) that had been removed [102]. Below are brief descriptions of studies of vitamin D and its association with, or effect on, breast, colorectal, lung, pancreatic, and prostate cancers. Vitamin D toxicity has been caused by consumption of dietary supplements that contained excessive vitamin D amounts because of manufacturing errors, that were taken inappropriately or in excessive amounts, or that were incorrectly prescribed by physicians, [155-157]. The U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to assess the benefits and harms of screening for vitamin D deficiency in asymptomatic adults [6]. To update its 2014 recommendation statement, the USPSTF commissioned a systematic review 26,27 of the evidence on screening for vitamin D deficiency, including the benefits and harms of screening and early treatment. Skin issues: A lack of vitamin A can cause dry, scaly and/or itchy skin. Vitamin D Deficiency: Signs and Symptoms - Health information submitted for this request. Losing hair: This can be a sign of vitamin D deficiency because this nutrient is essential for the follicular cycle in the hair. Vitamin D. Natural Medicines. A variety of foods and their vitamin D levels per serving are listed in Table 3. Vitamin D deficiency can also be caused by inadequate nutritional intake of vitamin D; disorders that limit vitamin D absorption; and disorders that impair the . What constituted a "higher" level varied by study but was typically at least 75 nmol/L (30 ng/mL). Have a question? What is Vitamin D Deficiency? Office of Dietary Supplements, National Institutes of Health. [, Kahwati LC, Weber RP, Pan H, Gourlay M, LeBlanc E, Coker-Schwimmer M, Viswanathan M. Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults: Evidence report and systematic review for the US Preventive Services Task Force. Adults 19-70 years: 600 IU. MedicineNet does not provide medical advice, diagnosis or treatment. Your healthcare professional can order a blood test to measure your levels of vitamin D. Two types of tests may be ordered that include: The most common test for vitamin D deficiency is the 25-hydroxy vitamin D test because 25-hydroxy, or calcidiol, has higher concentrations and stays in your blood longer, which makes it easier to detect. Teens 14-18 years: 600 IU. Older people and people with dark skin are less able to produce vitamin D from sunlight [1]. No improvement in depressive symptoms by vitamin D supplementation: Results from a randomised controlled trial. Vitamin D, Volume 2: Health, Disease and Therapeutics, Fourth Edition. Clin Pharmacol Ther 2009;85:198-203. When a person is very vitamin D deficient, they cannot absorb dietary calcium well; having adequate levels is important to absorb adequate amounts of calcium from your diet. The symptoms are subtle in most people and can include. other information we have about you. [, Dawodu A, Tsang RC. Breastfed babies dont get enough vitamin D from breast milk, so they need to take supplements. The groups showed no significant differences in measures of muscle strength or performance [85]. Osteoporosis is, in part, a long-term effect of calcium and/or vitamin D insufficiency, in contrast to rickets and osteomalacia, which result from vitamin D deficiency.
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