More than 80% of healthy Indians are vitamin D deficient: Diabetes Foundation of IndiaPratibha Masand MUMBAI: We might live in a country full of sunshine but Indians are still deprived of the sunshine vitamin. Vitamin D which is wrongly called so is a pro-hormone that influences the expression of more than 200 genes in the human body. Nearly every tissue in the human body has receptors of vitamin D, be it the brain, heart, skin, kidney, pancreas etc. Any deficiency of vitamin D in the human body is bound to affect normal functioning of all organs having Vitamin D receptors. Vitamin D deficiency is fast becoming a global and national health concern. It is estimated that around 80% of the Indian population has Vitamin D levels less than normal. However, the bigger concern is that the population at large is not even aware of Vitamin D deficiency and its consequences. One of India's leading diabetologists, Dr Banshi Saboo, founder of Diabetes Foundation of India, said, "Earlier, vitamin D was thought to be responsible for maintaining calcium homeostasis to prevent osteoporosis and maintain bone health.
But, in the past decade, research has established the strong association of vitamin D deficiency in diabetes, immunity, asthma, TB, high blood pressure, neuro-muscular function, etc. Dr Saboo further added, "Low level of vitamin D is associated with higher incidence of type 2 diabetes and correcting Vitamin D deficiency improves insulin sensitivity and helps in better management of hyperglycaemia. Also vitamin D deficiency has been associated with high incidence of type 1 diabetes." As the mother is the sole source of vitamin D substrate for her developing foetus, vitamin D status is very important during pregnancy. Maternal deficiency of vitamin D is linked with abnormal foetal growth and gestational diabetes. Sunscreen lotions, staying indoors, clothing habits, pollution and minimal exposure to direct sunlight (during the period of 10am to 3pm) are the major reasons of such widespread deficiency in the Indian population. An eminent endocrinologist from Mumbai, Dr Manoj Chadha said that vitamin D deficiency has no defined signs or symptoms.
"People who complain of back pains, unexplained muscle pains, general fatigue are the most likely to be vitamin D deficient. Vitamin D deficiency can be easily corrected by Vitamin D supplementation or some lifestyle changes. In a vitamin D deficient person, oral 60,000 IU per week for 8 weeks followed by maintenance dose of 60,000 IU per month is a reasonably safe method to correct the deficiency." Although there are few major studies carried out in India to determine the optimum (sufficient) levels of serum vitamin D 25(OH) D to be maintained to prevent chronic ailments, globally there is a consensus that vitamin D deficiency is defined as serum 25(OH) D levels less than 20 ng/ml and insufficiency as serum 25(OH) D less than 30 ng/ml. Whereas, serum 25(OH) D levels above 30 ng/ml is found to be sufficient. Given the fact that vitamin D receptors are present in various organs and tissues of the human body, maintaining vitamin D levels in blood above 30 ng/ml may ensure normal functioning of the body organs and protect many from suffering from chronic ailments.
From Around the WebMore From The Times of IndiaVitamin D is a fat-soluble vitamin. Very few foods naturally contain vitamin D (fatty fish livers are the exception), so dermal synthesis is the major natural source of the vitamin. Vitamin D from the diet or dermal synthesis is biologically inactive and requires enzymatic conversion to active metabolites.Vitamin D is converted enzymatically in the liver to 25-hydroxyvitamin D (25[OH]D), the major circulating form of vitamin D, and then in the kidney to 1,25-dihydroxyvitamin D, the active form of vitamin D.for all drugs one need to see the frequency and they are prescribed accordingly. I can understand your anxiety on monthly dose.well note that Half-life elimination of Vitamin D (Calcifediol): Healthy adults: ~11 days; Stage 3 and 4 CKD: ~25 days.hence good to go. Thanks for asking and for patent read and concern for your mother.It’s vitamin D (one of its 5 forms).It may be stored in body fat, for future use - that’s why a monthly intake is enough!
Well… you can google it to see better the storing/using mechanism, the dosage factors (like sun, being more or less fat) but I hope this is enough! :)It gets stored in liver and fat. Vitamin d helps in calcium absorption from intestines and prevent losses from kidneys. Cholecalciferol, also known as vitamin D3 and colecalciferol, is a type of vitamin D found in food and used as a dietary supplement.[1] As a supplement it is used to treat and prevent vitamin D deficiency including rickets.[3] It is also used for familial hypophosphatemia, hypoparathyroidism that is causing low blood calcium, and Fanconi syndrome.[4] It is taken by mouth. Excessive doses can result in vomiting, constipation, weakness, and confusion.[5] Other risks include kidney stones.[6] Normal doses are safe in pregnancy.[5] It may not be effective in people with severe kidney disease.[6] After being converted into 1,25-dihydroxyvitamin D, it works by increasing the uptake of calcium by the intestines.[5] Food in which it is found include some fish, cheese, and eggs.
Cholecalciferol was first described in 1936.[8] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[9] Cholecalciferol is available as a generic medication and over the counter.[4] The wholesale cost in the developing world is about 2.14 USD per 30 ml bottle.[10] In the United States treatment costs less than 25 USD per month.[4] Certain foods such as milk have cholecalciferol added to them in some countries. One gram is 40,000,000 (40x106) IU, equivalently 1 IU is 0.025 µg. Recommendations vary depending on the country: Many question whether the current recommended intake is sufficient to meet physiological needs. Individuals without regular sun exposure, the obese, and darker skinned individuals all have lower blood levels and require more supplementation. The Institute of Medicine in 2010 recommended a maximum uptake of 4,000 IU/day, finding that the dose for lowest observed adverse effect level is 40,000 IU daily for at least 12 weeks,[12] and that there was a single case of toxicity above 10,000 IU after more than 7 years of daily intake;
this case of toxicity occurred in circumstances that have led other researchers to dispute it as a credible case to consider when making vitamin D intake recommendations.[12] Patients with severe vitamin D deficiency will require treatment with a loading dose; its magnitude can be calculated based on the actual serum 25-hydroxy-vitamin D level and body weight. Also, there is a therapy for rickets utilizing a single dose, called stoss therapy in Europe, taking from 300,000 IU (7,500 µg) to 500,000 IU (12,500 µg = 12.5 mg), in a single dose, or in two to four divided doses. There are conflicting reports concerning the absorption of cholecalciferol (D3) versus ergocalciferol (D2), with some studies suggesting less efficacy of D2,[15] and others showing no difference.[16] At present, D2 and D3 doses are frequently considered interchangeable, but more research is needed to clarify this. A meta-analysis of 2007 concluded that daily intake of 1000 to 2000 IU per day of vitamin D3 could reduce the incidence of colorectal cancer with minimal risk.
[17] Also a 2008 study published in Cancer Research has shown the addition of vitamin D3 (along with calcium) to the diet of some mice fed a regimen similar in nutritional content to a new Western diet with 1000 IU cholecalciferol per day prevented colon cancer development.[18] In humans, with 400 IU daily, there was no effect of cholecalciferol supplements on the risk of colorectal cancer. Supplements are not recommended for prevention of cancer as any effects of cholecalciferol are very small.[20] Although significant correlations exist between low levels of blood serum cholecalciferol and higher rates of various cancers, multiple sclerosis, tuberculosis, heart disease, and diabetes,[21] the consensus is that supplementing levels is not beneficial. It is a secosteroid, that is, a steroid molecule with one ring open. Cholecalciferol is inactive: it is converted to its active form by two hydroxylations: the first in the liver, the second in the kidney, to form calcitriol, whose action is mediated by the vitamin D receptor, a nuclear receptor which regulates the synthesis of hundreds of enzymes and is present in virtually every cell in the body.
It is one of the five forms of vitamin D.[23][24] 7-Dehydrocholesterol is the precursor of cholecalciferol. Within the epidermal layer of skin,[25] 7-Dehydrocholesterol undergoes an electrocyclic reaction as a result of UVB radiation, resulting in the opening of the vitamin precursor B-ring through a conrotatory pathway. Following this, the pre-cholecalciferol undergoes a [1,7] antarafacial sigmatropic rearrangement [26] and therein finally isomerizes to form vitamin D3. It can be discussed whether cholecalciferol and all forms of vitamin D are by definition "vitamins", since the definition of vitamins includes that the substance cannot be synthesized by the body and must be ingested; cholecalciferol is synthesized by the body during UVB radiation exposure. Cholecalciferol is then hydroxylated in the liver to become calcifediol (25-hydroxyvitamin D3). Calcifediol is then hydroxylated in the kidney, and becomes calcitriol (1,25-dihydroxyvitamin D3) or active vitamin D3. The three steps in the synthesis of vitamin D3 are regulated as follows:
Click on icon in lower right corner to open. Click on genes, proteins and metabolites below to link to respective articles. {{{bSize}}}px|alt=Vitamin D Synthesis Pathway (view / edit)]] Vitamin D Synthesis Pathway (view / edit) Cholecalciferol is produced industrially for use in vitamin supplements and to fortify foods. As a pharmaceutical drug it is called cholecalciferol (USAN) or colecalciferol (INN, BAN). It is produced by the ultraviolet irradiation of 7-dehydrocholesterol extracted from lanolin found in sheep's wool.[27] Cholesterol is extracted from wool grease and wool wax alcohols obtained from the cleaning of wool after shearing. The cholesterol undergoes a four-step process to make 7-dehydrocholesterol, the same compound that is produced in the skin of animals. The 7-dehydrocholesterol is then irradiated with ultraviolet light. Some unwanted isomers are formed during irradiation: these are removed by various techniques, leaving a resin which melts at about room temperature and usually has a potency of 25,000,000 to 30,000,000 International Units per gram.
Cholecalciferol is also produced industrially for use in vitamin supplements from lichens, which is suitable for vegans. Rodents are somewhat more susceptible to high doses than other species, and cholecalciferol has been used in poison bait for the control of these pests. It has been claimed that the compound is less toxic to non-target species. However, in practice it has been found that use of cholecalciferol in rodenticides represents a significant hazard to other animals, such as dogs and cats. "Cholecalciferol produces hypercalcemia, which results in systemic calcification of soft tissue, leading to renal failure, cardiac abnormalities, hypertension, CNS depression, and GI upset. Signs generally develop within 18-36 hr of ingestion and can include depression, anorexia, polyuria, and polydipsia." In New Zealand, possums have become a significant pest animal, and cholecalciferol has been used as the active ingredient in lethal gel baits and cereal pellet baits "DECAL" for possum control.