Vitamin D supplementation: what is right?

Alvarez-Hernández, Daniel and Gómez-Alonso, Carlos and Cannata-Andía, Jorge B. (2006) Vitamin D supplementation: what is right? Clinical cases in mineral and bone metabolism, 3 (1). pp. 71-75. ISSN 1724-8914

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Abstract

The vitamin D system comprises a group of metabolites, of which calcitriol or 1,25(OH)2 D is the most active form, although its substrate calcidiol or 25(OH)D is also able to activate the vitamin D receptor. In order to have a correct vitamin D supplementation policy, it is mandatory to understand the regulation and functionality of the vitamin D system, the definition of “normality” and the objectives to achieve. Although 25(OH)D activity is lower than 1,25(OH)2 D by a factor of 100, its serum concentration is 1000-times higher, so 25(OH)D is believed to substantially contribute to the overall vitamin D effect on target organs. For several years we have been using a wrong threshold for 25(OH)D “sufficiency” mainly in people older than 50 years. Nowadays, however, several studies indicate that the most adequate or sufficient 25(OH)D levels in patients under risk of metabolic bone diseases should be 30-40 ng/mL. Thus, considering the factors involved in vitamin D metabolism, the population at risk of vitamin D deficiency is extraordinarily high and should be considered as a public health priority. In most European countries, fortification of dairy products is forbidden and in the USA the FDA (Foods and Drugs Administration) limited fortification exclusively to milk and cereals. Although food fortification has demonstrated being useful in the normalization of vitamin D levels, the issue on the adequate dose is still pending. To summarize, the best attitude regarding vitamin D supplementation is to admit that most patients under risk of metabolic bone disease would need 25(OH)D supplementation. A dose of 800- 1600 UI/day (with an adequate calcium intake), administered either daily or periodically would allow to achieve adequate levels in most patients

Item Type:	Article
Uncontrolled Keywords:	Calcidiol, calcitriol, vitamin D status, food fortification, vitamin D supplementation
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 612 Fisiologia umana > 612.7 Sistema muscoloscheletrico, tegumento
Depositing User:	Danilo Dezzi
Date Deposited:	23 Jan 2014 16:21
Last Modified:	23 Jan 2014 16:21
URI:	http://eprints.bice.rm.cnr.it/id/eprint/4713

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