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Vitamin D
Recommended Dietary Allowance (RDA) for Vitamin D:
400 IU/day
To prevent rickets in children and osteomalacia in adults
Vitamin D Deficiency
Rickets, Osteomalacia
Influenza, Tuberculosis
MS, RA, SLE, Type I diabetes
Hypertension, CAD, PVD, CHF
Syndrome X, Type 2 Diabetes
Chronic Fatigue, SAD,
Depression
Cataracts, Infertility
Osteoporosis
Cancer
Vitamin D
25(OH)D
1,25(OH)D
26
+ cells throughout
the body
7-dehydrocholesterol
UVB
photons
Nuclear Receptors
System and Tissue Distribution of Nuclear
Vitamin D Receptors (VDR)
System
Tissue
Immune
Thymus, bone marrow, macrophages, B cells, T cells
Gastrointestinal
Esophagus, stomach, small intestine, colon, rectum
Cardiovascular
Endothelial cells, smooth muscle cells, myocytes
Respiratory
Lung alveolar cells
Hepatic
Liver parenchyma cells
Renal
Proximal and distal tubules, collecting duct
Endocrine
Parathyroid, thyroid, pancreatic beta cells
Exocrine
Parotid gland, sebaceous gland
CNS
Brain neurons, astrocytes, microglia
Epidermis/appendage Skin, breast, hair follicles
Musculoskeletal
Osteoblasts, osteocytes, chondrocytes, striated muscle
Connective Tissue
Fibroblasts, stroma
Reproductive
Testis, ovary, placenta, uterus, endometrium, yolk sac
Nutrigenomics
Vitamin D
Confirmatory PCR for 1,25-dihydroxyvitamin D-regulated genes found
by Affymetrix GeneChip transcriptional profiling
Wood RJ, Tchack L, Angelo G, etal. DNA Microarray Analysis of Vitamin Dinduced Gene Expression in a Human Colon Carcinoma Cell Line.
Physiological Genomics 2004;17:122-129.
Human Migration Out of Africa
35° N
35° S
Lamson Rl, etal. SLC24A5, a putative cation exchanger, affects pigmentation in
zebrafish and humans. Science 2005;310:1782-1786.
Indigenous Human Skin Color by
Latitude
35° N
35° S
Jablonski NG, Chaplin G. The evolution of human skin coloration. J Hum Evol 2000;39:57-106
Seasonal Variation in 25-hydroxyvitamin D
Levels in People at Latitude 48° N
Cannell JJ, etal. Epidemic influenza and vitamin D. Epidemiol Infect 2006;134:1129-1140.
Cannell JJ, etal. Epidemic influenza and vitamin D. Epidemiol Infect 2006;134:1129-1140
Noncalcemic Functions of
1,25-dihydroxyvitamin D
Cytokines
Adaptive
Innate
Immune modulation
Tuberculosis Treated with Sunshine
Immunomodulatory Effects of
1,25-dihydroxyvitamin D
Multiple Sclerosis in World War II Veterans
by Latitude and State of Residence
Multiple Sclerosis Prevalence for U.S. WWII, KC Veterans
at Time of Entery into the Armed Forces vs. Latitude
220
MS Prevalence (relative units)
200
180
160
140
120
100
80
60
40
20
25
30
35
40
45
50
Latitude (degrees N)
Wallin MT, etal. Multiple sclerosis in US veterans… Ann Neurol 2004;55:65-71
Breast Cancer Mortality Rates and Contours
of Annual Mean Daily Solar Irradiance
Lappe JM, etal. Vitamin D and calcium supplementation reduces cancer risk: Results
of a randomized trial. Am J Clin Nutr 2007;85:1586-1591.
25-hydroxyvitamin D3 Blood Levels
Calcium Absorption
Severely deficient < 8 ng/ml
Deficient
8-19 ng/ml
Insufficient
20-29 ng/ml
Sufficient
30-49 ng/ml
Optimal
50-99 ng/ml
Excessive
Toxic
100-150 ng/ml
>150 ng/ml
(1 ng/ml = 2.5 nmol/L, 1 nmol/L = O.4 ng/ml)
32 ng/ml
PTH Levels
Preop Vitamin D3 levels
in 73 Veterans Undergoing Heart
Surgery at the Seattle VA Hospital
No. of
Patients
History of
Cancer
25-hydroxyvitamin D3
Level (ng/ml)
7 (9.6 %)
1 (colon)
41 (56.2%)
6*
9 (12.3%)
0
20-29.9 (insufficient)
13 (17.8%)
0
30-49.9 (sufficient)
3 (4.1%)
0
50-100 (optimal)
< 8 (severely deficient)
8-19.9 (deficient)
* Prostrate cancer – 3; Colon cancer – 1; Tonsillar cancer – 1; Melanoma -- 1
Surgery performed December 2006 – July 2007
Sources of Vitamin D
Cholecalciferol (D3) and Ergocalciferol (D2)
Dietary
Natural
Salmon (wild, 3.5 oz)
Salmon (farmed, 3.5 oz)
Cod liver oil (1 tsp)
Tuna (canned, 3.6 oz)
Egg yolk
800 IU D3
150 IU D2 or D3
400-1100 IU D3
230 IU D3
20 IU D 2 or D3
Fortified Foods
Milk (8 oz)
100 IU D3
Orange juice (8 oz)
100 IU D3
Infant formula (8 oz)
100 IU D3
Butter (3.5 oz)
50 IU D3
Breakfast cereals/serving 100 IU D3
Skin synthesizes 20,000 IU D3 in 20 minutes
when exposed to sunlight
Supplements
Prescription
Ergocalciferol (D2)
50,000 IU/capsule
Over the Counter
Multivitamins
Cholecalciferol (D3)
400 IU D2 or D 3
400, 800, 1000,
2000, 5000 and
50,000 IU/tablet
5,000 IU D3 50,000 IU D3
OTC at vitalady.com, lifespannutrition.com
Serum 25-hydroxyvitamin D3 Levels on 0,
1000, 5000, and 10,000 IU of Vitamin D3 a Day
(80
80 ng/ml)
ng/ml
60
(60ng/ml
ng/ml)
30(30
ng/ml
ng/ml)
10,000 IU qd
5000 IU qd
1000 IU qd
0
Heany RP, etal. Human serum 25-hydroxycholecalciferol response to extended
oral dosing with cholecalciferol. Am J Clin Nutr 2003;77:204-210.
Benefits of Vitamin D
• Skeletal-muscular
– Strong muscles and bones
• Infections
– Prevent influenza, treat tuberculosis
• Cancer
– Prevent breast, colon, and prostate cancer
– ? Suppress metastasizes
• Autoimmune Diseases
– Prevent multiple sclerosis and type 1 diabetes
• Cardiovascular Disease
– Slow progression of atherosclerosis
– Treat hypertension and congestive heart failure
• Neuropsychiatric Disorders
– Prevent schizophrenia and relieve depression