Tags

Type your tag names separated by a space and hit enter

Use of vitamin D in clinical practice.

Abstract

The recent discovery--from a meta-analysis of 18 randomized controlled trials--that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization. Vitamin D's final metabolic product is a potent, pleiotropic, repair and maintenance, seco-steroid hormone that targets more than 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. One of the most important genes vitamin D up-regulates is for cathelicidin, a naturally occurring broad-spectrum antibiotic. Natural vitamin D levels, those found in humans living in a sun-rich environment, are between 40-70 ng per ml, levels obtained by few modern humans. Assessing serum 25-hydroxy-vitamin D (25(OH)D) is the only way to make the diagnosis and to assure treatment is adequate and safe. Three treatment modalities exist for vitamin D deficiency: sunlight, artificial ultraviolet B (UVB) radiation, and vitamin D3 supplementation. Treatment of vitamin D deficiency in otherwise healthy patients with 2,000-7,000 IU vitamin D per day should be sufficient to maintain year-round 25(OH)D levels between 40-70 ng per mL. In those with serious illnesses associated with vitamin D deficiency, such as cancer, heart disease, multiple sclerosis, diabetes, autism, and a host of other illnesses, doses should be sufficient to maintain year-round 25(OH)D levels between 55 -70 ng per mL. Vitamin D-deficient patients with serious illness should not only be supplemented more aggressively than the well, they should have more frequent monitoring of serum 25(OH)D and serum calcium. Vitamin D should always be adjuvant treatment in patients with serious illnesses and never replace standard treatment. Theoretically, pharmacological doses of vitamin D (2,000 IU per kg per day for three days) may produce enough of the naturally occurring antibiotic cathelicidin to cure common viral respiratory infections, such as influenza and the common cold, but such a theory awaits further science.

Links

  • FREE Publisher Full Text
  • Authors

    ,

    Source

    MeSH

    Calcifediol
    Cholecalciferol
    Humans
    Mortality
    Sunlight
    Vitamin D
    Vitamin D Deficiency
    Vitamins

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    18377099

    Citation

    Cannell, John J., and Bruce W. Hollis. "Use of Vitamin D in Clinical Practice." Alternative Medicine Review : a Journal of Clinical Therapeutic, vol. 13, no. 1, 2008, pp. 6-20.
    Cannell JJ, Hollis BW. Use of vitamin D in clinical practice. Altern Med Rev. 2008;13(1):6-20.
    Cannell, J. J., & Hollis, B. W. (2008). Use of vitamin D in clinical practice. Alternative Medicine Review : a Journal of Clinical Therapeutic, 13(1), pp. 6-20.
    Cannell JJ, Hollis BW. Use of Vitamin D in Clinical Practice. Altern Med Rev. 2008;13(1):6-20. PubMed PMID: 18377099.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Use of vitamin D in clinical practice. AU - Cannell,John J, AU - Hollis,Bruce W, PY - 2008/4/2/pubmed PY - 2009/3/6/medline PY - 2008/4/2/entrez SP - 6 EP - 20 JF - Alternative medicine review : a journal of clinical therapeutic JO - Altern Med Rev VL - 13 IS - 1 N2 - The recent discovery--from a meta-analysis of 18 randomized controlled trials--that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization. Vitamin D's final metabolic product is a potent, pleiotropic, repair and maintenance, seco-steroid hormone that targets more than 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. One of the most important genes vitamin D up-regulates is for cathelicidin, a naturally occurring broad-spectrum antibiotic. Natural vitamin D levels, those found in humans living in a sun-rich environment, are between 40-70 ng per ml, levels obtained by few modern humans. Assessing serum 25-hydroxy-vitamin D (25(OH)D) is the only way to make the diagnosis and to assure treatment is adequate and safe. Three treatment modalities exist for vitamin D deficiency: sunlight, artificial ultraviolet B (UVB) radiation, and vitamin D3 supplementation. Treatment of vitamin D deficiency in otherwise healthy patients with 2,000-7,000 IU vitamin D per day should be sufficient to maintain year-round 25(OH)D levels between 40-70 ng per mL. In those with serious illnesses associated with vitamin D deficiency, such as cancer, heart disease, multiple sclerosis, diabetes, autism, and a host of other illnesses, doses should be sufficient to maintain year-round 25(OH)D levels between 55 -70 ng per mL. Vitamin D-deficient patients with serious illness should not only be supplemented more aggressively than the well, they should have more frequent monitoring of serum 25(OH)D and serum calcium. Vitamin D should always be adjuvant treatment in patients with serious illnesses and never replace standard treatment. Theoretically, pharmacological doses of vitamin D (2,000 IU per kg per day for three days) may produce enough of the naturally occurring antibiotic cathelicidin to cure common viral respiratory infections, such as influenza and the common cold, but such a theory awaits further science. SN - 1089-5159 UR - https://www.unboundmedicine.com/medline/citation/18377099/abstract/Use_of_vitamin_D_in_clinical_practice_ L2 - http://archive.foundationalmedicinereview.com/publications/13/1/6.pdf DB - PRIME DP - Unbound Medicine ER -