Again, the pattern was similar for the risk of inadequacy. A study of cohorts that included 5,313 participants who developed lung cancer and 5,313 matched controls found no association between serum 25(OH)D levels and risk of subsequent lung cancer, even when the investigators analyzed the data by sex, age, race and ethnicity, and smoking status [104]. Heat intolerance may cause: Feeling uncomfortably hot in moderately warm temperatures Fatigue and exhaustion during warm weather Mood changes whenever you're Cancer Epidemiol Biomarkers Prev 2014;23:1220-9. [, Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, et al. In Canada, milk must be fortified with 0.881.0 mcg/100 mL (3540 IU), and the required amount for margarine is at least 13.25 mcg/100 g (530 IU). Cholecalciferol or 25-hydroxycholecalciferol supplementation does not affect muscle strength and physical performance in prefrail and frail older adults. For men 19 to 51-plus years it's 400-420 mg; for women it's 310-320 mg. An animal-free version of vitamin D3 sourced from lichen is also available [32]. Bone health also depends on support from the surrounding muscles to assist with balance and postural sway and thereby reduce the risk of falling. 
Calcium plus vitamin D supplementation and the risk of breast cancer. While the study was small, it was concise and included a group of men who underwent a thorough acclimatization process in a heat chamber while they walked on a treadmill for 10 days. The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers. A few studies have examined the effect of vitamin D supplementation on specific cancers. Nutr Metab Cardiovasc Dis 2016;26:663-73. The federal government's 2020-2025 Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. Three trials conducted since that meta-analysis also found no effect of vitamin D supplementation on depressive symptoms. Another study that compared 200 male smokers in Finland with pancreatic cancer to 400 matched controls found that participants in the highest quintile of 25(OH)D levels (more than 65.5 nmol/L [26.2 ng/mL]) had a threefold greater risk of developing pancreatic cancer over 16.7 years than those in the lowest quintile (less than 32 nmol/L [12.8 ng/mL]) [106]. (July 7, 2022) https://bmjopen.bmj.com/content/9/2/e023809, King, Dana E. "Dietary Magnesium and C-reactive Protein Levels." PMID: 31504098 [, Okereke OI, Reynolds III CF, Mischoulon D, Chang G, Vyas CM, Cook NR, et al. The groups showed no significant differences in measures of muscle strength or performance [85]. Screening for vitamin D deficiency: Systematic review for the U.S. Preventive Services Task Force recommendation. They then hypothesized that folic acid and its metabolite, 5-methyltetrahydrofolate (5-MTHF), could improve the elderly group's vessel function. People with limited sun exposure
Curr Opin Endocrinol Diabetes 2002;9:87-98. Neither aging nor obesity alters vitamin D absorption from the gut [4]. Effects of vitamin D supplementation on musculoskeletal health: A systematic review, meta-analysis, and trial sequential analysis. Vitamin D alone did not significantly affect the development of new serrated polyps, but the combination of vitamin D with calcium increased the risk almost fourfold. In addition, although 25(OH)D levels rise in response to increased vitamin D intake, the relationship is nonlinear [1]. The first hydroxylation, which occurs in the liver, converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as "calcidiol." Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: Dose-response meta-analysis of prospective studies. Nutritional rickets among children in the United States: Review of cases reported between 1986 and 2003. [, Brondum-Jacobsen P, Benn M, Jensen GB, Nordestgaard BG. In the Women's Health Initiative clinical trial (described above), vitamin D3 and calcium supplements had no effect on rates of colorectal cancer. Adv Nutr 2012;3:353-61. Environ Health Perspect 2017;125(7):077004. [, Pittas A, Dawson-Hughes B, Sheehan P, Ware JH, Knowler WC, Aroda VR, et al. The U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to assess the benefits and harms of screening for vitamin D deficiency in asymptomatic adults [6]. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. [, Pappa HM, Bern E, Kamin D, Grand RJ. US Preventive Services Task Force recommendation statement. The second trial included 155 adults aged 6080 years who had clinically relevant depressive symptoms, no major depressive disorder, and serum 25(OH)D levels less than 50 to 70 nmol/L (20 to 28 ng/mL) depending on the season; in addition, they were not taking antidepressants [133,134]. Am J Clin Nutr 2012;95:1350-6. Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. Symptoms of heat exhaustion include: confusion; loss of consciousness; vomiting; muscle Intake recommendations for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by expert committees of NASEM [1]. In this procedure, part of the upper small intestine, where vitamin D is absorbed, is bypassed, and vitamin D that is mobilized into the bloodstream from fat stores might not raise 25(OH)D to adequate levels over time [66,67]. It concluded "with moderate certainty" that vitamin D supplementation does not reduce the numbers of falls or injuries, such as fractures, resulting from falls [77,78]. [, Cauley JA, Chlebowski RT, Wactawski-Wende J, Robbins JA, Rodabough RJ, Chen Z, et al. Thiazide diuretics
"The effect of oral capsule of curcumin and vitamin E on the hot flashes and anxiety in postmenopausal women: A triple blind randomised controlled trial." [, Aloia JF, Talwar SA, Pollack S, Yeh J. Vitamin D plays a role in glucose metabolism. Vitamin D is also needed for the normal development and growth of muscle fibers. After reviewing data on vitamin D needs, an expert committee of the Food and Nutrition Board (FNB) at the National Academies of Sciences, Engineering, and Medicine (NASEM) concluded that people are at risk of vitamin D deficiency at serum 25(OH)D concentrations less than 30 nmol/L (12 ng/mL; see Table 1 for definitions of "deficiency" and "inadequacy") [1]. Effect of long-term vitamin D3 supplementation vs placebo on risk of depression or clinically relevant depressive symptoms and on change in mood scores: A randomized clinical trial. Signs and symptoms of osteomalacia are similar to those of rickets and include bone deformities and pain, hypocalcemic seizures, tetanic spasms, and dental abnormalities [45]. Clin Gastroeterol Hepatol 2020; published online ahead of print. Pediatrics 2008;122:1142-52. J Womens Health 2013:22,915-29. January 2020. In this triple-blind, randomized controlled clinical trial, 93 postmenopausal women were assigned into three groups (two intervention groups and one control group). [, Vogiatzi MG, Jacobson-Dickman E, DeBoer MD. The effect of vitamin D supplementation on lower-extremity power and function in older adults: a randomized controlled trial. The largest trial to date of vitamin D supplements for diabetes prevention randomized 2,423 men and women aged 25 years and older (mean age 60 years) with prediabetes and overweight or obesity (mean BMI of 32.1) to 100 mcg (4,000 IU)/day vitamin D3 or placebo for a median of 2.5 years [145]. The emerging issue of 25-hydroxyvitamin D in foods. Moderate use of commercial tanning beds that emit 2% to 6% UVB radiation is also effective [13,29]. J Am Coll Cardiol 2017;70:89-100. However, the supplementation had no significant effects on fasting blood glucose, hemoglobin A1c, or fasting insulin levels. Nutrition 2015;31:421-9. Although 25(OH)D functions as a biomarker of exposure, the extent to which 25(OH)D levels also serve as a biomarker of effect on the body (i.e., relating to health status or outcomes) is not clear [1,3]. The vitamin D supplements were associated with serum 25(OH)D levels of 54 to 135 nmol/L (21.6 to 54 ng/mL). Even though sunlight is a major source of vitamin D for some people, the FNB based the vitamin D RDAs on the assumption that people receive minimal sun exposure [1]. Conclusions about vitamin D supplements and bone health
Am J Clin Nutr 2016;104:1151-9. WebSince Vitamin D is fat soluble, toxicity can occur at high levels of oral intake of supplements. Vitamin D supplementation to reduce depression in adults: Meta-analysis of randomized controlled trials. Greater amounts of the pigment melanin in the epidermal layer of the skin result in darker skin and reduce the skins ability to produce vitamin D from sunlight [1]. Int J Obes (Lond) 2012;36:387-96. It can often cause heavy sweating. Vitamin D helps regulate the renin-angiotensin-aldosterone system (and thereby blood pressure), vascular cell growth, and inflammatory and fibrotic pathways [118]. The importance of 25-hydroxyvitamin D assay standardization and the Vitamin D Standardization Program. Int J Obes Relat Metab Disord 2001;25:1154-60. Post-treatment levels of plasma 25- and 1,25-dihydroxy vitamin D and mortality in men with aggressive prostate cancer. [, Kristal AR, Till C, Song X, Tangen CM, Goodman PJ, Neuhauser ML, et al. Am J Clin Nutr 2019;110:1043-4. (July 7, 2022) https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250, Moran, Daniel S. "How Significant is Magnesium in Thermoregulation?" Among the women with two or more serum 25(OH)D samples taken before diagnosis (which reduced random measurement variation), a 50 nmol/L increase in 25(OH)D was associated with a 41% reduced risk of MS, and 25(OH)D levels less than 30 nmol/L were associated with an MS risk that was twice as high as levels of 50 nmol/L or higher. Use of vitamin D drops leading to kidney failure in a 54-year-old man. About 2.3 million osteoporotic fractures occurred in the United States in 2015 [73]. Am J Clin Nutr 2017;105:1372-81. Many epidemiological and genetic studies have shown an association between MS and low 25(OH)D levels before and after the disease begins [137]. Vitamin D supplements may interact with several types of medications. The vitamin D3 and calcium supplements did not reduce breast cancer incidence, and 25(OH)D levels at the start of the study were not associated with breast cancer risk [99]. Nutr Clin Pract 2013;28:194-208. These values, which vary by age and sex, include: An FNB committee established RDAs for vitamin D to indicate daily intakes sufficient to maintain bone health and normal calcium metabolism in healthy people. In a meta-analysis of 16 prospective cohort studies in a total of 137,567 participants who had 8,345 diagnoses of cancer, 5,755 participants died from cancer [88]. Some studies have used dietary supplements containing the 25(OH)D3 form of vitamin D. Per equivalent microgram dose, 25(OH)D3 is three to five times as potent as vitamin D3 [37,38]. "5 Supplements for Heat Intolerance" [, Perez-Castrillon JL, Vega G, Abad L, Sanz A, Chaves J, Hernandez G, Duenas A. Because endogenous vitamin D is derived from cholesterol, statins may also reduce vitamin D synthesis [167]. For example, a meta-analysis of 21 studies that included 11,941 men with prostate cancer and 13,870 controls found a 17% higher risk of prostate cancer for participants with higher levels of 25(OH)D [108]. [, Robien K, Oppeneer SJ, Kelly JA, Hamilton-Reeves JM. Am J Clin Nutr 2017;105:810-9. This includes foods such as frozen salmon or mackerel. An analysis of NHANES 20112014 data on serum 25(OH)D levels found that most people in the United States aged 1 year and older had sufficient vitamin D intakes according to the FNB thresholds [43]. [, Laurent MR, Gielen E, Pauwels S, Vanderschueren D, Bouillon R. Hypervitaminosis D associated with tanning bed use: A case report. Vitamin D obtained from sun exposure, foods, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. Int J Obes Relat Metab Disord 1997;21:S24-30. In addition, the Food and Drug Administration (FDA) has approved UV-treated mushroom powder as a food additive for use as a source of vitamin D2 in food products [18]. JAMA 2018;319:1705-16. JAMA Cardiol 2017;2:608-16. Rickets occurred mainly in Black children who were breastfed longer, were born with low birthweight, weighed less, and were shorter than other children. [, Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol 2017;13:466-79. One trial included 65 adult men and women (mean age 32 years) with overweight or obesity who were otherwise healthy, did not have diabetes, and had low serum vitamin D levels (at or below 50 nmol/L [20 ng/mL]) [147]. One reason is that sun exposure affects vitamin D status, so serum 25(OH)D levels are usually higher than would be predicted on the basis of vitamin D dietary intakes alone [1]. (July 7, 2022) https://www.climate.gov/news-features/understanding-climate/climate-change-global-temperature, Mayo Clinic. Animal-based foods typically provide some vitamin D in the form of 25(OH)D in addition to vitamin D3. 10 April 2012. stay hydrated and drink plenty of cold fluids, Ataei-Almanghadim, Khatereh. Studies examining the effects of supplemental vitamin D on muscle strength and on rate of decline in muscle function have had inconsistent results [55]. (May 10, 2012) http://www.ncbi.nlm.nih.gov/pubmed/17664882, Special Offer on Antivirus Software From HowStuffWorks and TotalAV Security, published in the Clinical Physiology and Pharmacology. The mean age of all participants was 67.1 years; 50.6% were women and 20.2% were Black. Positive association between circulating 25-hydroxyvitamin D levels and prostate cancer risk: New findings from an updated meta-analysis. Am J Clin Nutr 2004;80:1710S-6S. MS is an autoimmune disease of the central nervous system that damages the myelin sheath surrounding and protecting nerve cells in the brain and spinal cord. Vitamin D is essential for bone strength and may support the immune system and other functions. One study found that when the 25(OH)D content of beef, pork, chicken, turkey, and eggs is taken into account, the total amount of vitamin D in the food is 2 to 18 times higher than the amount in the parent vitamin alone, depending on the food [20]. Am J Clin Nutr 2008;88:558S-64S. However, a meta-analysis of 7 cohort studies that included 7,808 men with prostate cancer found higher 25(OH)D levels to be significantly associated with lower mortality rates from prostate cancer or any other cause [115]. Most of the studies described in this section measured serum 25(OH)D levels using various methods that were not standardized by comparing them to the best methods. People with dark skin
"Climate Change: Global Temperature." N Engl J Med 2007;357:266-81. So what is the Recommended Dietary Allowance (RDA) for magnesium? WebSymptoms of vitamin D deficiency you cannot ignore. For example, an analysis was conducted of 19 prospective studies that provided data on prediagnostic levels of 25(OH)D for 13,462 men who developed prostate cancer and 20,261 control participants [113]. [, Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. Serum concentration of 25(OH)D is currently the main indicator of vitamin D status. [, de Sevaux RGL, Hoitsma AJ, Corstens FHM, Wetzels JFM. However, higher serum 25(OH)D levels (at a cut point of 75 nmol/L [30 ng/mL]) were linked to a modestly higher risk of slow-growth prostate cancer and a more substantial lower risk of aggressive disease. Have a question? In the NHANES 20012006 survey, 25(OH)D deficiency (less than 25 nmol/L [10 ng/mL]) was more than twice as common among children and adults who reported oral steroid use (11%) than in nonusers (5%) [174]. Vitamin D and cardiovascular disease: Controversy unresolved. Vitamin D, Volume 2: Health, Disease and Therapeutics, Fourth Edition. N Engl J Med 2019;381:520-30. pii: E493. [, Aloia JF, Li-Ng M, Pollack S. Statins and vitamin D. Am J Cardiol 2007;100:1329. It rises fast and your sweating mechanism fails so tour body can't cool down. Agency for Healthcare Research and Quality. Observational studies have linked lower serum 25(OH)D levels to an increased risk of diabetes, but their results might have been confounded by the fact that many participants were overweight or had obesity and were therefore more predisposed to developing diabetes and having lower 25(OH)D levels [1]. J Midwifery Womens Health 2019;64:276-88. Vitamin D content stays high even when J Clin Endocrinol Metab 2014;99:3551-60. Vitamin D supplementation and prevention of type 2 diabetes. A randomized, double-blind, placebo-controlled trial. doi: 10.1001/jamanetworkopen.2019.17789. Serum 25-hydroxyvitamin D concentrations and risk of prostate cancer: Results from the Prostate Cancer Prevention Trial. The effect of vitamin D supplementation on prostate cancer: A systematic review and meta-analysis of clinical trials. This made the older study participants more at risk for many things, including heat stroke. Few people near the equator develop the disease, whereas the prevalence is higher further north and south. N Engl J Med 2006;354:669-82. Proportions at risk of deficiency were lowest among children aged 15 years (0.5%), peaked at 7.6% in adults aged 2039 years, and fell to 2.9% among adults aged 60 years and older; patterns were similar for risks of inadequacy. People with obesity might need greater intakes of vitamin D to achieve 25(OH)D levels similar to those of people with normal weight [1,64,65]. No association between vitamin D supplementation and risk of colorectal adenomas or serrated polyps in a randomized trial. Ann Intern Med 2014;160:558-64. 25-hydroxyvitamin D deficiency and risk of MS among women in the Finnish Maternity Cohort. Bones Ache Bone pain and muscle weakness are the common symptoms of vitamin D deficiency. Ann Oncol 2018;29:1468-75. Pages 41-78 in Feldman D, Pike JW, Bouillon R, Giovannucci E, Goltzman D, Hewison M, eds. [, Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O'Sullivan MJ, et al. Some vitamin D3 is also converted to nonactive forms [1]. A meta-analysis of prospective studies that evaluated the association between serum 25(OH)D levels and cancer incidence (8 studies) or cancer mortality (16 studies) found that cancer risk decreased by 7% and cancer mortality rates decreased by 2% with each 20 nmol/L (8 ng/mL) increase in serum 25(OH)D levels [89]. (July 7, 2022) https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html, de Baaij, Jeroen H F. "Magnesium in man: implications for health and disease." Maternal vitamin D status: Effect on milk vitamin D content and vitamin D status of breastfeeding infants. The human body produces vitamin D as a response to sun exposure. Vitamin D deficiency is associated with vascular dysfunction, arterial stiffening, left ventricular hypertrophy, and hyperlipidemia [119]. A 50 nmol/L (20 ng/mL) increase in 25(OH)D levels was associated with an 11% reduction in total cancer incidence rates and, in women but not men, a 24% reduction in cancer mortality rates. For example, almost all of the U.S. milk supply is voluntarily fortified with about 3 mcg/cup (120 IU), usually in the form of vitamin D3 [23]. [, Tripkovic L, Wilson LR, Hart K, Johnsen S, de Lusignan S, Smith CP, et al. [, Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. In one Minnesota county, the incidence rate of rickets in children younger than 3 years in the decade beginning in 2000 was 24.1 per 100,000 [48]. [, Moyer VA. Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: U.S. Preventive Services Task Force recommendation statement. 290-2007-10055-I. (July 7, 2022) https://portlandpress.com/clinsci/article-abstract/129/2/159/71306/Folic-acid-supplementation-improves-microvascular, Walling, Elizabeth. However, FoodData Central does not include the amounts of 25(OH)D in foods. 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Ataei-Almanghadim, Khatereh vitamin D3 similar for the U.S. Preventive Services Task Force....
Calcium plus vitamin D supplementation and the risk of breast cancer. While the study was small, it was concise and included a group of men who underwent a thorough acclimatization process in a heat chamber while they walked on a treadmill for 10 days. The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers. A few studies have examined the effect of vitamin D supplementation on specific cancers. Nutr Metab Cardiovasc Dis 2016;26:663-73. The federal government's 2020-2025 Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. Three trials conducted since that meta-analysis also found no effect of vitamin D supplementation on depressive symptoms. Another study that compared 200 male smokers in Finland with pancreatic cancer to 400 matched controls found that participants in the highest quintile of 25(OH)D levels (more than 65.5 nmol/L [26.2 ng/mL]) had a threefold greater risk of developing pancreatic cancer over 16.7 years than those in the lowest quintile (less than 32 nmol/L [12.8 ng/mL]) [106]. (July 7, 2022) https://bmjopen.bmj.com/content/9/2/e023809, King, Dana E. "Dietary Magnesium and C-reactive Protein Levels." PMID: 31504098 [, Okereke OI, Reynolds III CF, Mischoulon D, Chang G, Vyas CM, Cook NR, et al. The groups showed no significant differences in measures of muscle strength or performance [85]. Screening for vitamin D deficiency: Systematic review for the U.S. Preventive Services Task Force recommendation. They then hypothesized that folic acid and its metabolite, 5-methyltetrahydrofolate (5-MTHF), could improve the elderly group's vessel function. People with limited sun exposure
Curr Opin Endocrinol Diabetes 2002;9:87-98. Neither aging nor obesity alters vitamin D absorption from the gut [4]. Effects of vitamin D supplementation on musculoskeletal health: A systematic review, meta-analysis, and trial sequential analysis. Vitamin D alone did not significantly affect the development of new serrated polyps, but the combination of vitamin D with calcium increased the risk almost fourfold. In addition, although 25(OH)D levels rise in response to increased vitamin D intake, the relationship is nonlinear [1]. The first hydroxylation, which occurs in the liver, converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as "calcidiol." Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: Dose-response meta-analysis of prospective studies. Nutritional rickets among children in the United States: Review of cases reported between 1986 and 2003. [, Brondum-Jacobsen P, Benn M, Jensen GB, Nordestgaard BG. In the Women's Health Initiative clinical trial (described above), vitamin D3 and calcium supplements had no effect on rates of colorectal cancer. Adv Nutr 2012;3:353-61. Environ Health Perspect 2017;125(7):077004. [, Pittas A, Dawson-Hughes B, Sheehan P, Ware JH, Knowler WC, Aroda VR, et al. The U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to assess the benefits and harms of screening for vitamin D deficiency in asymptomatic adults [6]. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. [, Pappa HM, Bern E, Kamin D, Grand RJ. US Preventive Services Task Force recommendation statement. The second trial included 155 adults aged 6080 years who had clinically relevant depressive symptoms, no major depressive disorder, and serum 25(OH)D levels less than 50 to 70 nmol/L (20 to 28 ng/mL) depending on the season; in addition, they were not taking antidepressants [133,134]. Am J Clin Nutr 2012;95:1350-6. Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. Symptoms of heat exhaustion include: confusion; loss of consciousness; vomiting; muscle Intake recommendations for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by expert committees of NASEM [1]. In this procedure, part of the upper small intestine, where vitamin D is absorbed, is bypassed, and vitamin D that is mobilized into the bloodstream from fat stores might not raise 25(OH)D to adequate levels over time [66,67]. It concluded "with moderate certainty" that vitamin D supplementation does not reduce the numbers of falls or injuries, such as fractures, resulting from falls [77,78]. [, Cauley JA, Chlebowski RT, Wactawski-Wende J, Robbins JA, Rodabough RJ, Chen Z, et al. Thiazide diuretics
"The effect of oral capsule of curcumin and vitamin E on the hot flashes and anxiety in postmenopausal women: A triple blind randomised controlled trial." [, Aloia JF, Talwar SA, Pollack S, Yeh J. Vitamin D plays a role in glucose metabolism. Vitamin D is also needed for the normal development and growth of muscle fibers. After reviewing data on vitamin D needs, an expert committee of the Food and Nutrition Board (FNB) at the National Academies of Sciences, Engineering, and Medicine (NASEM) concluded that people are at risk of vitamin D deficiency at serum 25(OH)D concentrations less than 30 nmol/L (12 ng/mL; see Table 1 for definitions of "deficiency" and "inadequacy") [1]. Effect of long-term vitamin D3 supplementation vs placebo on risk of depression or clinically relevant depressive symptoms and on change in mood scores: A randomized clinical trial. Signs and symptoms of osteomalacia are similar to those of rickets and include bone deformities and pain, hypocalcemic seizures, tetanic spasms, and dental abnormalities [45]. Clin Gastroeterol Hepatol 2020; published online ahead of print. Pediatrics 2008;122:1142-52. J Womens Health 2013:22,915-29. January 2020. In this triple-blind, randomized controlled clinical trial, 93 postmenopausal women were assigned into three groups (two intervention groups and one control group). [, Vogiatzi MG, Jacobson-Dickman E, DeBoer MD. The effect of vitamin D supplementation on lower-extremity power and function in older adults: a randomized controlled trial. The largest trial to date of vitamin D supplements for diabetes prevention randomized 2,423 men and women aged 25 years and older (mean age 60 years) with prediabetes and overweight or obesity (mean BMI of 32.1) to 100 mcg (4,000 IU)/day vitamin D3 or placebo for a median of 2.5 years [145]. The emerging issue of 25-hydroxyvitamin D in foods. Moderate use of commercial tanning beds that emit 2% to 6% UVB radiation is also effective [13,29]. J Am Coll Cardiol 2017;70:89-100. However, the supplementation had no significant effects on fasting blood glucose, hemoglobin A1c, or fasting insulin levels. Nutrition 2015;31:421-9. Although 25(OH)D functions as a biomarker of exposure, the extent to which 25(OH)D levels also serve as a biomarker of effect on the body (i.e., relating to health status or outcomes) is not clear [1,3]. The vitamin D supplements were associated with serum 25(OH)D levels of 54 to 135 nmol/L (21.6 to 54 ng/mL). Even though sunlight is a major source of vitamin D for some people, the FNB based the vitamin D RDAs on the assumption that people receive minimal sun exposure [1]. Conclusions about vitamin D supplements and bone health
Am J Clin Nutr 2016;104:1151-9. WebSince Vitamin D is fat soluble, toxicity can occur at high levels of oral intake of supplements. Vitamin D supplementation to reduce depression in adults: Meta-analysis of randomized controlled trials. Greater amounts of the pigment melanin in the epidermal layer of the skin result in darker skin and reduce the skins ability to produce vitamin D from sunlight [1]. Int J Obes (Lond) 2012;36:387-96. It can often cause heavy sweating. Vitamin D helps regulate the renin-angiotensin-aldosterone system (and thereby blood pressure), vascular cell growth, and inflammatory and fibrotic pathways [118]. The importance of 25-hydroxyvitamin D assay standardization and the Vitamin D Standardization Program. Int J Obes Relat Metab Disord 2001;25:1154-60. Post-treatment levels of plasma 25- and 1,25-dihydroxy vitamin D and mortality in men with aggressive prostate cancer. [, Kristal AR, Till C, Song X, Tangen CM, Goodman PJ, Neuhauser ML, et al. Am J Clin Nutr 2019;110:1043-4. (July 7, 2022) https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/symptoms-causes/syc-20373250, Moran, Daniel S. "How Significant is Magnesium in Thermoregulation?" Among the women with two or more serum 25(OH)D samples taken before diagnosis (which reduced random measurement variation), a 50 nmol/L increase in 25(OH)D was associated with a 41% reduced risk of MS, and 25(OH)D levels less than 30 nmol/L were associated with an MS risk that was twice as high as levels of 50 nmol/L or higher. Use of vitamin D drops leading to kidney failure in a 54-year-old man. About 2.3 million osteoporotic fractures occurred in the United States in 2015 [73]. Am J Clin Nutr 2017;105:1372-81. Many epidemiological and genetic studies have shown an association between MS and low 25(OH)D levels before and after the disease begins [137]. Vitamin D supplements may interact with several types of medications. The vitamin D3 and calcium supplements did not reduce breast cancer incidence, and 25(OH)D levels at the start of the study were not associated with breast cancer risk [99]. Nutr Clin Pract 2013;28:194-208. These values, which vary by age and sex, include: An FNB committee established RDAs for vitamin D to indicate daily intakes sufficient to maintain bone health and normal calcium metabolism in healthy people. In a meta-analysis of 16 prospective cohort studies in a total of 137,567 participants who had 8,345 diagnoses of cancer, 5,755 participants died from cancer [88]. Some studies have used dietary supplements containing the 25(OH)D3 form of vitamin D. Per equivalent microgram dose, 25(OH)D3 is three to five times as potent as vitamin D3 [37,38]. "5 Supplements for Heat Intolerance" [, Perez-Castrillon JL, Vega G, Abad L, Sanz A, Chaves J, Hernandez G, Duenas A. Because endogenous vitamin D is derived from cholesterol, statins may also reduce vitamin D synthesis [167]. For example, a meta-analysis of 21 studies that included 11,941 men with prostate cancer and 13,870 controls found a 17% higher risk of prostate cancer for participants with higher levels of 25(OH)D [108]. [, Robien K, Oppeneer SJ, Kelly JA, Hamilton-Reeves JM. Am J Clin Nutr 2017;105:810-9. This includes foods such as frozen salmon or mackerel. An analysis of NHANES 20112014 data on serum 25(OH)D levels found that most people in the United States aged 1 year and older had sufficient vitamin D intakes according to the FNB thresholds [43]. [, Laurent MR, Gielen E, Pauwels S, Vanderschueren D, Bouillon R. Hypervitaminosis D associated with tanning bed use: A case report. Vitamin D obtained from sun exposure, foods, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. Int J Obes Relat Metab Disord 1997;21:S24-30. In addition, the Food and Drug Administration (FDA) has approved UV-treated mushroom powder as a food additive for use as a source of vitamin D2 in food products [18]. JAMA 2018;319:1705-16. JAMA Cardiol 2017;2:608-16. Rickets occurred mainly in Black children who were breastfed longer, were born with low birthweight, weighed less, and were shorter than other children. [, Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol 2017;13:466-79. One trial included 65 adult men and women (mean age 32 years) with overweight or obesity who were otherwise healthy, did not have diabetes, and had low serum vitamin D levels (at or below 50 nmol/L [20 ng/mL]) [147]. One reason is that sun exposure affects vitamin D status, so serum 25(OH)D levels are usually higher than would be predicted on the basis of vitamin D dietary intakes alone [1]. (July 7, 2022) https://www.climate.gov/news-features/understanding-climate/climate-change-global-temperature, Mayo Clinic. Animal-based foods typically provide some vitamin D in the form of 25(OH)D in addition to vitamin D3. 10 April 2012. stay hydrated and drink plenty of cold fluids, Ataei-Almanghadim, Khatereh. Studies examining the effects of supplemental vitamin D on muscle strength and on rate of decline in muscle function have had inconsistent results [55]. (May 10, 2012) http://www.ncbi.nlm.nih.gov/pubmed/17664882, Special Offer on Antivirus Software From HowStuffWorks and TotalAV Security, published in the Clinical Physiology and Pharmacology. The mean age of all participants was 67.1 years; 50.6% were women and 20.2% were Black. Positive association between circulating 25-hydroxyvitamin D levels and prostate cancer risk: New findings from an updated meta-analysis. Am J Clin Nutr 2004;80:1710S-6S. MS is an autoimmune disease of the central nervous system that damages the myelin sheath surrounding and protecting nerve cells in the brain and spinal cord. Vitamin D is essential for bone strength and may support the immune system and other functions. One study found that when the 25(OH)D content of beef, pork, chicken, turkey, and eggs is taken into account, the total amount of vitamin D in the food is 2 to 18 times higher than the amount in the parent vitamin alone, depending on the food [20]. Am J Clin Nutr 2008;88:558S-64S. However, a meta-analysis of 7 cohort studies that included 7,808 men with prostate cancer found higher 25(OH)D levels to be significantly associated with lower mortality rates from prostate cancer or any other cause [115]. Most of the studies described in this section measured serum 25(OH)D levels using various methods that were not standardized by comparing them to the best methods. People with dark skin
"Climate Change: Global Temperature." N Engl J Med 2007;357:266-81. So what is the Recommended Dietary Allowance (RDA) for magnesium? WebSymptoms of vitamin D deficiency you cannot ignore. For example, an analysis was conducted of 19 prospective studies that provided data on prediagnostic levels of 25(OH)D for 13,462 men who developed prostate cancer and 20,261 control participants [113]. [, Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. Serum concentration of 25(OH)D is currently the main indicator of vitamin D status. [, de Sevaux RGL, Hoitsma AJ, Corstens FHM, Wetzels JFM. However, higher serum 25(OH)D levels (at a cut point of 75 nmol/L [30 ng/mL]) were linked to a modestly higher risk of slow-growth prostate cancer and a more substantial lower risk of aggressive disease. Have a question? In the NHANES 20012006 survey, 25(OH)D deficiency (less than 25 nmol/L [10 ng/mL]) was more than twice as common among children and adults who reported oral steroid use (11%) than in nonusers (5%) [174]. Vitamin D and cardiovascular disease: Controversy unresolved. Vitamin D, Volume 2: Health, Disease and Therapeutics, Fourth Edition. N Engl J Med 2019;381:520-30. pii: E493. [, Aloia JF, Li-Ng M, Pollack S. Statins and vitamin D. Am J Cardiol 2007;100:1329. It rises fast and your sweating mechanism fails so tour body can't cool down. Agency for Healthcare Research and Quality. Observational studies have linked lower serum 25(OH)D levels to an increased risk of diabetes, but their results might have been confounded by the fact that many participants were overweight or had obesity and were therefore more predisposed to developing diabetes and having lower 25(OH)D levels [1]. J Midwifery Womens Health 2019;64:276-88. Vitamin D content stays high even when J Clin Endocrinol Metab 2014;99:3551-60. Vitamin D supplementation and prevention of type 2 diabetes. A randomized, double-blind, placebo-controlled trial. doi: 10.1001/jamanetworkopen.2019.17789. Serum 25-hydroxyvitamin D concentrations and risk of prostate cancer: Results from the Prostate Cancer Prevention Trial. The effect of vitamin D supplementation on prostate cancer: A systematic review and meta-analysis of clinical trials. This made the older study participants more at risk for many things, including heat stroke. Few people near the equator develop the disease, whereas the prevalence is higher further north and south. N Engl J Med 2006;354:669-82. Proportions at risk of deficiency were lowest among children aged 15 years (0.5%), peaked at 7.6% in adults aged 2039 years, and fell to 2.9% among adults aged 60 years and older; patterns were similar for risks of inadequacy. People with obesity might need greater intakes of vitamin D to achieve 25(OH)D levels similar to those of people with normal weight [1,64,65]. No association between vitamin D supplementation and risk of colorectal adenomas or serrated polyps in a randomized trial. Ann Intern Med 2014;160:558-64. 25-hydroxyvitamin D deficiency and risk of MS among women in the Finnish Maternity Cohort. Bones Ache Bone pain and muscle weakness are the common symptoms of vitamin D deficiency. Ann Oncol 2018;29:1468-75. Pages 41-78 in Feldman D, Pike JW, Bouillon R, Giovannucci E, Goltzman D, Hewison M, eds. [, Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O'Sullivan MJ, et al. Some vitamin D3 is also converted to nonactive forms [1]. A meta-analysis of prospective studies that evaluated the association between serum 25(OH)D levels and cancer incidence (8 studies) or cancer mortality (16 studies) found that cancer risk decreased by 7% and cancer mortality rates decreased by 2% with each 20 nmol/L (8 ng/mL) increase in serum 25(OH)D levels [89]. (July 7, 2022) https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html, de Baaij, Jeroen H F. "Magnesium in man: implications for health and disease." Maternal vitamin D status: Effect on milk vitamin D content and vitamin D status of breastfeeding infants. The human body produces vitamin D as a response to sun exposure. Vitamin D deficiency is associated with vascular dysfunction, arterial stiffening, left ventricular hypertrophy, and hyperlipidemia [119]. A 50 nmol/L (20 ng/mL) increase in 25(OH)D levels was associated with an 11% reduction in total cancer incidence rates and, in women but not men, a 24% reduction in cancer mortality rates. For example, almost all of the U.S. milk supply is voluntarily fortified with about 3 mcg/cup (120 IU), usually in the form of vitamin D3 [23]. [, Tripkovic L, Wilson LR, Hart K, Johnsen S, de Lusignan S, Smith CP, et al. [, Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. In one Minnesota county, the incidence rate of rickets in children younger than 3 years in the decade beginning in 2000 was 24.1 per 100,000 [48]. [, Moyer VA. Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: U.S. Preventive Services Task Force recommendation statement. 290-2007-10055-I. (July 7, 2022) https://portlandpress.com/clinsci/article-abstract/129/2/159/71306/Folic-acid-supplementation-improves-microvascular, Walling, Elizabeth. However, FoodData Central does not include the amounts of 25(OH)D in foods. 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Ataei-Almanghadim, Khatereh vitamin D3 similar for the U.S. Preventive Services Task Force....