Compounding Corner

Vitamin D



Vitamin D is not a vitamin, it is a hormone. Vitamin D has an effect on numerous disease
states and disorders including:

-Chronic muscle pain (1,2,3)         
-Diabetes (types I and II) (4,5,6,7)
-Multiple Sclerosis (8,9,43)
-Cardiovascular disease (5,10-16)
-Decrease risk of osteoporosis (5)
-Migraine Headache (17)
-Osteoarthritis (5,18,19)
-Polycystic ovary syndrome (PCOS) (20)
-Hypertension (21-23)
-Depression (5,24,25)
-Epilepsy (26,27)
-Wheezing illnesses (44)
-Autoimmune disorders: (28-32) 
     · Graves Disease (33)
     · Ankylosing spondylitis (A chronic inflammatory disease that primarily causes pain and inflammation of the joints
       between the vertebrae of the spine and the joints between the spine and pelvis) (34) 
     · Systemic Lupus Erythematosus (SLE) (35)
     · Rheumatoid arthritis (32)
     · Fibromyalgia (28)
     · Psoriasis (44)
-Cancers of the breast, colon, prostate, bladder, esophagus, kidney, lung, pancreas, rectum, stomach, uterus, and non-Hodgkin lymphoma (5,36)
-Decrease relative risk of mortality from any cause. (37)

Population at Risk

Many researchers feel there is a worldwide vitamin D deficiency in various populations including:
-Postmenopausal women (38)
-Men and women in nursing homes (38)
-Children (38)
-Infants (38)
-Pregnant and lactating women (38)
-Obesity (38)
-Elderly (38)
-Dark skin pigmentation (41)
-Celiac disease (38)
-Crohn's disease (39,40)
-Gastric bypass patients (38)
-Cystic fibrosis (38)
-People who avoid the sun/use sunscreen (41,38) -People living in northern latitudes (N.D.) (41)

Deficiency Symptoms
-Rickets (44) -Muscle weakness (44,45)
-Soft bones and teeth (44) -Bone pain (44)
-Phosphorous retention in kidneys (44) -Growth retardation (38)
-Inadequate absorption of calcium and phosphorous (44)

Sources of Vitamin D (38,42)
-Sun, 3000-10,000IU D3
-Salmon fresh, wild 600-1000IU D3
-Salmon fresh, farmed (3.5 oz) 100-250 IU D3
-Salmon canned (3.5 oz) 300-600 IU D3
-Mackerel, canned (3.5 oz) 200-450 IU D3
-Tuna, canned (3.6 oz) 200-360 IU D3
-Cod liver oil (1 tsp / 0.17 oz) 400-1400 IU D3
-Herring, pickled (3.5 oz) 680 IU D3
-Sardines, canned (3.5 oz) 200-360 IU D3
-Egg yolk, fresh 20-148 IU D3
-Fortified milk 60-100 IU/8 oz, usually D3
-Fortified butter 50 IU/3.5 oz, usually D3

Dose
-Vitamin D2 (ergocalciferol) is inactive and must be converted in the body to the active
D3 (cholecalciferol). D2 should be avoided. (45)
-Healthy adults, 4000 to 5000IU of vitamin D3 (active form) per day. (45,48,49)
-Infants, 1000IU D3 daily. (4,45,50)
-Children, 2000 IU D3 daily. (45)
-Pregnant women, 4000 IU D3 daily. (50,)
-Doses higher than 5000IU should be at the recommendation of the health practitioner
after serum testing.
-Deficiency-50,000IU D3 taken once weekly for 8 weeks. (38)
-Vitamin D levels don't plateau until after 3-4 months of supplementation. (48)
-Maximum benefit is seen within 5-9 months of supplementation. (45)
-Skin color, chronic disease, time of the year, and the latitude one lives at will influence
the dose of vitamin D. (38,45)

Normal Levels
-30 to 40ng/ml is the minimum level to experience health benefits. (44,45)
-Optimum levels vary in the medical literature but range from 40ng/ml to 100ng/ml.
(9,46,44,47)

Toxicity
-Infants, vitamin D toxicity is seen when 40,000IU are ingested daily for 1-4 months. (45)
-Adults, several months of 100,000IU daily ingestion are needed to see toxicity. (45)
-Toxicity must be accompanied by high levels of calcium in the blood (hypercalcemia). A
high vitamin D level alone is not diagnostic of toxic levels. (45)

Monitoring
-Serum 25(OH)D and serum calcium should be used to monitor optimum levels and
toxicity. (45)

Reference list - see link below.



view PDF - Vitamin D.pdf