Vitamin D Monograph
Alternative Medicine Review 2008 (Jun); 13 (2): 153–164 ~ FULL TEXT
Vitamin D is a secosteroid molecule which, in its active 1,25 di-hydroxylated form, has hormone activities in humans. Most cells and tissues in the body have vitamin D receptors (VDRs) that stimulate the nuclear transcription of various genes to alter cellular function or provide a rapid response in cellular membranes. Vitamin D appears to have an effect on numerous disease states and disorders, including chronic musculoskeletal pain, diabetes (types 1 and 2), multiple sclerosis, cardiovascular disease, osteoporosis, and cancers of the breast, prostate, and colon. According to many researchers there is currently a worldwide vitamin D deficiency in various populations, including infants, pregnant and lactating women, the elderly, individuals living in latitudes far from the equator, persons who avoid the sun or ultraviolet radiation in the blue spectrum (UVB), and populations with dark skin pigmentation. Vitamin D in the food supply is limited and most often inadequate to prevent deficiencies. Supplemental vitamin D is likely necessary to avoid deficiency in winter months; however, all forms of vitamin D supplementation may not be equal in efficacy for maintaining optimal blood levels.
Calcium and Vitamin D Supplementation Decreases Incidence of Stress Fractures in Female Navy Recruits
J Bone Miner Res 2008 (May); 23 (5): 741–749
Stress fractures (SFx) are one of the most common and debilitating overuse injuries seen in military recruits, and they are also problematic for nonmilitary athletic populations. The goal of this randomized double-blind, placebo-controlled study was to determine whether a calcium and vitamin D intervention could reduce the incidence of SFx in female recruits during basic training. We recruited 5201 female Navy recruit volunteers and randomized them to 2000 mg calcium and 800 IU vitamin D/d or placebo. SFx were ascertained when recruits reported to the Great Lakes clinic with symptoms. All SFx were confirmed with radiography or technetium scan according to the usual Navy protocol. Using intention-to-treat analysis by including all enrolled subjects, we found that the calcium and vitamin D group had a 20% lower incidence of SFx than the control group (5.3% versus 6.6%, respectively, p = 0.0026 for Fisher's exact test).
Use of Vitamin D in Clinical Practice
Alternative Medicine Review 2008 (Mar); 13 (1): 6–20 ~ FULL TEXT
The recent discovery--from a meta-analysis of 18 randomized controlled trials--that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization.
Vitamin D and Fracture Reduction:
An Evaluation of the Existing Research
Alternative Medicine Review 2008 (Mar); 13 (1): 21–33 ~ FULL TEXT
The analysis outlined in this article leads to a series of striking conclusions. First, most of the available clinical trials and meta-analyses of vitamin D and fracture underestimate the true fracture reduction potential of vitamin D. Second, achievement of vitamin D serum sufficiency levels (now set in the United States, Europe, and many other places at a minimum of 32 ng per mL) could provide for a 50- to 60-percent fracture reduction. And third, providing for vitamin D sufficiency is the simplest, most life-supporting, and most cost effective means of significantly reducing the incidence of osteoporotic fractures worldwide. Given the urgent need, the Osteoporosis Education Project (OEP) has initiated a call for universal vitamin D repletion as the primary basis for osteoporotic fracture prevention worldwide.
Benefits and Requirements of Vitamin D for Optimal Health: A Review
Alternative Medicine Review 2005; 10 (2): 94–111 ~ FULL TEXT
Vitamin D sufficiency is required for optimal health. The conditions with strong evidence for a protective effect of vitamin D include several bone
diseases, muscle weakness, more than a dozen types of internal cancers, multiple sclerosis, and type 1 diabetes mellitus. There is also weaker evidence for several other diseases and conditions. There are good reasons that vitamin D sufficiency be maintained during all stages of life, from fetal development to old age. Adequate calcium intake is also recommended. The current vitamin D requirements in the United States are based on protection against bone diseases.
These guidelines are being revised upward in light of new findings, especially for soft-tissue health. The consensus of scientific understanding appears to be that vitamin D deficiency is reached for serum 25-hydroxyvitamin D (25(OH)D) levels less than 20 ng/mL (50 nmol/L), insufficiency in the range from 20-32 ng/mL, and sufficiency in the range from 33-80 ng/mL, with normal in sunny countries 54-90 ng/mL, and excess greater than 100 ng/mL.
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