2. What is Vitamin D?
• Fat Soluble Vitamin
• Found in food
• Absorbed through sunlight exposure
• Converted to hormone form through liver and
kidney
3. Two Major Forms of Vitamin D
• Vitamin D2, ergocalciferol
• Vitamin D3, cholecalciferol
4. Other Forms of Vitamin D
• Vitamin D1: molecular compound of
ergocalciferol with lumisterol, 1:1
• Vitamin D4: 22-dihydroergocalciferol
• Vitamin D5: sitocalciferol (made from 7-
dehydrosisterol)
5.
6.
7.
8.
9. What are the sources?
• Cod Liver Oil, 1 Tbs: 1,360 IU
• Salmon, cooked, 3 1/2 oz: 360 IU
• Mackerel, cooked, 3 1/2 oz: 345 IU
• Sardines, canned in oil, drained, 3 1/2 oz: 270 IU
• Milk, nonfat, reduced fat, and whole, vitamin D fortified, 1 c: 98
IU
• Margarine, fortified, 1 Tbs: 60 IU
• Pudding, 1/2 c prepared from mix and made with vitamin D
fortified milk: 50 IU
• Dry cereal, Vitamin D fortified w/10% of the recommended
daily value, 3/4 c: 40-50 IU (other cereals may be fortified with
more or less vitamin D)
• Liver, beef, cooked, 3 1/2 oz: 30 IU
• Egg, 1 whole (vitamin D is present in the yolk): 25 IU
11. What does Vitamin D do?
• Maintain normal blood levels of Calcium and
Phosphorus
• Aids in absorption of calcium
• Promotes bone mineralization
• Prevents rickets in children and Osteomalacia in
adults
12. Role in immunomodulation
• Binds to nuclear Vitamin D receptors (VDR)
• Immune enhancing and immunosuppressive
effects
• Increase activity of NKCs
• Increased production of cathelicidin
• Therepeutic Clinical Applications
13. How much Vitamin D do we need?
• Ages 19-50: 200 International Units (IU)
• Ages 51-69: 400 IU
• Age 70 and older: 600 IU
14.
15. When can vitamin D deficiency occur?
• Rickets
• Osteomalacia
17. Who may need extra vitamin D to
prevent a deficiency?
• Older Americans (greater than age 50)
• individuals with limited sun exposure
• occupations that prevent exposure to sunlight
• reduced ability to absorb dietary fat
• exclusively breast-fed infants
18. What is the health risk of too much
vitamin D?
• nausea
• vomiting
• poor appetite
• constipation
• weakness
• weight loss
19. When is it ordered?
• 25 OH Vitamin D test
• 1,25 di OH Vitamin D test
35. What does the test result mean?
• 25 OH Vitamin D test
Low blood levels = not getting enough exposure
to sunlight
problem with absorption from the intestines
High levels = supplementation from vitamin pills
or other nutritional supplements
• 1,25 di OH Vitamin D test
Low levels = kidney disease
one of the earliest changes to occur in persons
with early kidney failure.
High levels = excess parathryoid hormone
diseases such as sarcoidosis or some lymphomas, that can make
1,25 di OH Vitamin D outside of the kidneys
36. Spike in Vitamin D testing
• ABC NEWS - NEW YORK, NY, USA
“Sunshine Vitamin May Cut Death Risk”
• BBC NEWS - UNITED KINGDOM
“Pain Linked With Low Vitamin D”
• BLOOMBERG.COM
“Death May Be Nearer For People Who lack
Vitamin D”
• BRITTANIA RADIO
“Vitamin D Can Heal Tuberculosis?”
38. Role in cancer prevention and
recovery
• Calcitriol – Induces
death of cancer cells
• Regulates Cell growth,
Differentiation etc.
• Daily intake of 1,000IU/day
reduces risks
39. Vitamin D and Obesity
• Seasons
• Altitude
• Calcium
• Link between other
diseases
• Treatable
40. Vitamin D and Diabetes
• Low serum levels at greater risk
• Lack of Vitamin D interferes with insulin secretion
41. Vitamin D and depression
• SAD
• 130 patients
• 600 or 4,000 IU supplements
• Re-evaluated 1 year later
42. Conclusion
• Vitamin D – The wonder drug?
• LabCorp – Testing volume doubled every ear for
the past four years
• Quest Diagnostics – Testing volume tripled
between May 2006 and May 2008
Thanks to these studies and national headlines praising its apparent cancer-fighting properties it appears many people now consider vitamin d their wonder drug and are rushing to labs to have their levels tested.
The patients requesting these tests through their physicains represent an increasingly health conscious-public. These patients want greater control over managing their own health, they have greater access to information related to health promotion and illness prevention, and there are a growing number of media stores that address their demand for news and information about personal health issues. Spikes are often seen when these three drivers come together – as in the case of vitamin d
There is no count on how many people get their vitamin d checked. But at testing giant LabCorp, the volume of vitamin D tests doctors order has, on average, doubled every year for the past four. So far this year, test orders are up another 90%. At competitor Quest Diagnostics, the volume of D tests approximately tripled between may 2006 and last may.
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http://abcnews.go.com/video/playerIndex?id=5563319 Vitamin D video