Vitamin D supplementation @ יואל קסלר

Summary

At Vitamin D supplementation @ יואל קסלר we are presenting a concise review article recently published in the Cleveland Clinic Journal of Medicine on Vitamin D supplementation.

ABSTRACT

Vitamin D supplementation is common in the United States, with about one-fifth of the adult population taking a daily supplement in one form or another. Although the detrimental effects of insufficient sun exposure in childhood was established centuries ago, the beneficial effects of vitamin D sufficiency have only recently been established, given the myriad investigations associating vitamin D deficiency with numerous chronic diseases. But it is far less clear precisely how to replete low 25-hydroxyvitamin D (25[OH]D) levels, how long treatment should be continued, if there are potential hazards in doing so, and how to assess and counsel patients regarding the use of vitamin D. This article provides a brief historical review, examines how to assess and counsel patients on the use of vitamin D, presents scenarios that clinicians are likely to encounter, and reviews the literature on recommendations for vitamin D supplementation.

KEY POINTS

Typical vitamin D replacement requires at least 2,000 IU/ day, with some authors recommending 5,000 IU/day.
The richest food sources of vitamin D, consumed in manageable portions, provide only a small percentage of the recommended daily intake of 800 IU.
Several mechanisms contribute to the ability of vitamin D₃ to attain and maintain goal serum concentrations of 25(OH)D more efficiently than vitamin D₂, including that vitamin D₂has a lower affinity for D binding protein and D 25-hydroxylase converts D to 25(OH)D₃substantially faster.