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Vitamin D
Natural Standard Flashcard. Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This flashcard is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Summary

  • Vitamin D is found in many foods, including fish, eggs, fortified milk, and cod liver oil. Spending time in the sun also helps the body make vitamin D.
  • Two forms of vitamin D are important in humans: vitamin D2, which is made by plants, and vitamin D3, which is made by human skin when exposed to sunlight. Foods may be fortified with vitamin D2 or D3.
  • The major role of vitamin D is to maintain normal levels of calcium and phosphorus in the body. Vitamin D helps the body absorb calcium, which forms and maintains strong bones. It is used alone or together with calcium to improve bone health and decrease fractures. Vitamin D may also protect against osteoporosis, high blood pressure, cancer, and other diseases.
  • Not getting enough vitamin D may cause health problems. Children may develop rickets, which is a softening or weakening of the bones. Adults may develop osteomalacia, which causes weak bones and muscles. Elderly and obese people may be at a high risk for vitamin D deficiency, along with people who have cystic fibrosis (mucus build-up in the lungs) or inflammatory bowel disease. Those who have limited sun exposure and babies who are only breastfed may also be at risk.

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

GRADING SYSTEM LINK

Deficiency (phosphate)

A

Kidney disease (causing low phosphate levels)

A

Osteomalacia (bone softening in adults)

A

Psoriasis (disorder causing skin redness and irritation)

A

Rickets (bone weakening in children)

A

Thyroid conditions (causing low calcium levels)

A

Thyroid conditions (due to low vitamin D levels)

A

Vitamin D deficiency

A

Dental cavities

B

Fall prevention

B

Muscle weakness/pain

B

Osteoporosis (general)

B

Renal osteodystrophy (bone problems due to chronic kidney failure)

B

Asthma

C

Autoimmune diseases

C

Bone density (children)

C

Bone diseases (kidney disease or kidney transplant)

C

Cancer prevention (breast, colorectal, prostate, other)

C

Cognition

C

Fertility

C

Fibromyalgia (long-term, body-wide pain)

C

Fractures (prevention)

C

Fractures (treatment)

C

Hepatic osteodystrophy (bone disease in people with liver disease)

C

High blood pressure

C

HIV

C

Immune function

C

Increasing lifespan

C

Inflammatory bowel disease

C

Kidney disease (chronic)

C

Loose teeth

C

Mood disorders

C

Multiple sclerosis (MS)

C

Muscle strength

C

Muscle wasting/weakness

C

Myelodysplastic syndrome (disease of blood cell production)

C

Osteoarthritis

C

Osteogenesis imperfecta (disorder in which bones break easily)

C

Osteomalacia (bone softening caused by anti-seizure drugs)

C

Osteoporosis (due to corticosteroids)

C

Osteoporosis (due to drugs)

C

Osteoporosis (in people with cystic fibrosis)

C

Pregnancy

C

Prevention of respiratory tract infections

C

Rickets (that does not respond to treatment)

C

Seasonal affective disorder (SAD)

C

Senile warts

C

Sexual dysfunction

C

Skin conditions

C

Skin pigment disorders

C

Stroke

C

Tuberculosis

C

Type 1 diabetes

C

Type 2 diabetes

C

Vitamin D deficiency (infants and breast feeding mothers)

C

Vitiligo (irregular white patches on the skin)

C

Weight gain (in women with menopause)

C

Atopic eczema (skin condition causing itchy, scaly rashes)

D

Cancer treatment (prostate)

D

Heart disease

D

High cholesterol

D

Safety

  • Vitamin D is likely safe when taken by mouth in doses of 100 micrograms daily (4,000 IU) and when applied to the skin alone or in combination with corticosteroids for up to three months.
  • Vitamin D is possibly safe when taken by mouth or injected into the muscle in doses of 300,000 IU three times a year for vitamin D deficiency.
  • Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar.
  • Caution is advised in people with blood pressure disorders or those taking drugs or herbs and supplements that affect blood pressure.
  • Use caution in people with headaches, heart disease, immune disorders (including lymph cancer and tuberculosis), kidney disease, liver disease, lung disorders, musculoskeletal disorders, skin disorders, stomach disorders, and thyroid disorders.
  • Use caution in pregnant women at risk of high blood pressure associated with pregnancy.
  • Use caution in breastfeeding women.
  • Avoid if allergic or sensitive to vitamin D, any similar compounds, or any part of the formula.
  • Avoid in people with abnormal amounts of calcium in the urine or abnormal calcium levels.

Possible side effects

  • Allergic skin reactions (inflammation, irritation, rash, and thinning), build-up of calcium in the arteries, changes in blood pressure, changes in blood sugar levels, changes in cholesterol levels, changes in the liver's processing of drugs, daytime sleepiness, excessive vitamin D levels, hardening of the arteries, headaches, increased calcium excretion or levels, increased risk of falls and fractures, increased risk of heart attack and stroke, increased risk of high blood pressure during pregnancy, increased risk of urinary tract infection, kidney or urinary stones, muscle pain, respiratory tract infection, stomach problems (constipation, cramps, diarrhea, upset stomach, and vomiting).

Possible interactions

  • Acitretin, agents processed by the liver, agents that affect blood pressure, agents that affect blood sugar, agents that affect the immune system, agents that bind bile, agents that decrease calcium, agents that prevent seizures, agents that promote urination, agents that treat heart disorders, agents that treat retrovirus infections (HIV), aluminum, antacids, antiandrogens, anti-asthma agents, antibacterials, antibiotics, anticancer agents, anti-inflammatories, athletic performance enhancers, birth control, bisphosphonates, calcipotriene, calcium and calcium salts, cardiac glycosides, cholesterol-lowering agents (such as HMG-CoA reductase inhibitors), cimetidine, cinacalcet, corticosteroids, cyclosporine, dental agents, diltiazem, exemestane, fat-soluble agents, fertility agents, heparins, hormonal agents, hormone replacement therapy, insulin, interferon, ketoconazole, laxatives, lung agents, magnesium, micronutrients, mineral oil, nervous system agents, opioids, orlistat, osteoporosis agents, pain relievers, rifampin, sevelamer, silicon, skin agents, stomach agents, sunscreen, tar-based shampoo, thyroid hormone antagonists, vaccines, vitamins (including vitamin A and vitamin K), vitamin D receptor agonists, and other herbs or supplements with similar effects.

Dosing

Adults (18 years and older)

  • Vitamin D can be found in most multivitamins. It can also be found as softgels, capsules, tablets, and liquids. The recommended daily allowance (RDA) is 600 IU for those 1-70 years of age and pregnant or breastfeeding women, and 800 IU for those over 71 years of age.
  • Vitamin D has been taken by mouth in the form of vitamin D2 (ergocalciferol), vitamin D3 (cholecalciferol), alfacalcidol (1-alfa-OH D3), doxercalciferol, calcitriol (DN-101), paricalcitol, Vi-delta Liquid emulsion®, Ostelin®, elocalcitol, alpha-hydroxyvitamin D, dihydrotachysterol, cod liver oil, and Viganoil®.
  • Vitamin D has been taken by mouth as a mixture in milk. Vitamin D has been taken by mouth with calcium, calcium carbonate, calcium lactate, or all-rac-alpha-tocopherol.
  • Vitamin D has been injected into the muscle or vein.
  • Vitamin D has been applied to the skin as ointments containing calcipotriene (Dovonex®), analogs (substances similar to vitamin D), calcipotriol, tacalcitol, calcitriol, and betamethasone dipropionate. Vitamin D has been applied to the skin with light therapy or steroids.

Children (younger than 18 years)

  • The recommended daily allowance (RDA) is 600 IU daily for those 1-70 years of age and 1,000 IU daily for infants aged 0-12 months.
  • Vitamin D has been taken by mouth in the form of vitamin D2 (ergocalciferol), vitamin D3, cholecalciferol, calcitriol, and alfacalcidol. Vitamin D has been taken by mouth with calcium, all-rac-alpha-tocopherol,
  • Vitamin D has been injected into the muscle or vein.
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.