Insufficient Vitamin D imposes increased risk factor of chronic diseases like osteoporosis, cancer, ischemic heart attack, diabetes, autoimmune and infectious diseases and not to mention rickets. The widespread cases of Vitamin D deficiency had augmented the general populations’ awareness on the benefit of sunlight exposure (UVB) as a source of Vitamin D. However, many dermatologists are apprehensive with the anticipated increased number of melanoma from sun exposure.
In order to ensure adequate Vitamin D intake, Vitamin D supplements as well as food fortification had been used (Calvo et al, 2005). Occasional exposure of the face and hands to sunlight is adequate for Vitamin D nutrition. Sun exposure of total-body provides the equivalent of 10000IU Vitamin D, which is its physiologic limit. Supplementation of Vitamin D should be used in part of the world where adequate sun exposure is impossible. Vitamin D supplementation is beneficial to avoid severe osteomalacia. osteoporosis and secondary hyperparathyroidism in addition to chronic diseases mentioned above.
Recommended dietary allowance of Vitamin D is 200IU, however to ensure that serum 25(OH)D concentrations exceed 100nmol/L, a total vitamin D supply of 4000IU/d is required. Intake of greater than 1000IU/d has been avoided because of the reason that Vitamin D is potentially toxic (Vieth, 1999). Clinical and laboratory safety studies have been made in conjunction with Vitamin D supplement + Calcium in ambulatory women above 65 years of age who were experiencing Vitamin D insufficiency in the course of 1 year.
Calcium was administered together with Vitamin D, as these two are essential to bone health. The study revealed adverse results like hypercalcemia and gastrointestinal as consequences to the supplement administration. Other than this, increased in uric acid had also been noted although renal function was not altered (Brazier, et al, 2005). Supplementation of Vitamin D and Calcium were well tolerated by the elderly women. Another study linked intake/ supplementation of Vitamin D and Calcium with the preservation of physical function in women.
Aging is linked with a lot physiological and functional alterations that attributes to increased disability, falls and fractures. The Women’s Health Initiative (WHI) showed that Vitamin D and Calcium supplementation resulted in considerably less hipbone loss in postmenopausal women. However, since the study was limited on using the baseline dose of Vitamin D and Calcium, the results concluded that the supplementation of both minerals did not improve physical functioning measures (Brunner, et al, 2008).
Vitamin D and Calcium supplementation in women posed no significant reduction in disease or fracture risk but with possible kidney stone development making physicians alter their prescribing practices. Women fearing long-term health risks of this supplementation have also sought alternative treatments. Thus, women who needed the treatment may be denied of the appropriate medical action (Weisman & Schwartz, 2007). Vitamin D Supplementation 3
References:
Brazier, M. , Grados, F. , Kamel, S. , Mathieu, M. , Morel, A. , Maamer, M. , Sebert, J-L. , Fardellone, P.(2005). Clinical and Laboratory Safety of One Year’s Use of a Combination Calcium + Vitamin D Tablet in Ambulatory Elderly Women with Vitamin D Insufficiency: Results of a Multicenter, Randomized, Double-Blind, Placebo-Controlled Study. Clinical Therapeutics, Vol 27, 1885-1893. Brunner, R. L. , Cochrane, B. , Jackson, R. D. , Larson, J. , Lewis, C. , Limacher, M. , Rosal, M. , Shumaker, S. &Wallace, R. (2008). Calcium, Vitamin D Supplementation, and Physical Function in the Women’s Health Initiative. Journal of the American Dietetic Association, 108, 1472-1479.
Calvo, M. S. , Whiting, S. J. & Barton, C, N. (2005). Symposium: Vitamin D Insufficiency: A significant risk factor in chronic diseases and potential disease-specific biomarkers of Vitamin D insufficiency. Journal of Nutrition, 135, 310-316. Weisman, S. M. & Schwartz, D. ( 2007, Jan 31). Law, Ethics and Gender – Studying Women in Clinical Trials: Scientific and Legal Implications. Gender Medicine, 4, 3-7. Vieth, R. (1999). Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. The American Journal of Clinical Nutrition. 69, 842-856.