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    Vitamin D3:

    Vitamin D3 is essential for promoting calcium absorption in the gut and maintaining adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts. Without sufficient vitamin D3, bones can become thin, brittle, or misshapen. Vitamin D3 sufficiency prevents rickets in children and osteomalacia in adults. Together with calcium, vitamin D3 also helps protect older adults from osteoporosis. Vitamin D3 has other roles in human health, including modulation of neuromuscular and immune function and reduction of inflammation.

    Vitamin D3 THE VITAMIN THAT KEEPS CALCIUM IN YOUR BONES & YOUR ARTERIES CLEAN!

    Vitamin D3 is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement. It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D3 synthesis. Vitamin D3 obtained from sun exposure, food, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. The first occurs in the liver and converts vitamin D3 to 25-hydroxyvitamin D [25(OH) D], also known as calcidiol. The second occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D3 [1,25(OH)2D], also known as calcitriol.

    Vitamin D3 is essential for promoting calcium absorption in the gut and maintaining adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts. Without sufficient vitamin D3, bones can become thin, brittle, or misshapen. Vitamin D3 sufficiency prevents rickets in children and osteomalacia in adults. Together with calcium, vitamin D3 also helps protect older adults from osteoporosis.

    Vitamin D3 has other roles in human health, including modulation of neuromuscular and immune function and reduction of inflammation. Many genes encoding proteins that regulate cell proliferation, differentiation, and apoptosis are modulated in part by vitamin D3. Many laboratory-cultured human cells have vitamin D3 receptors and some convert 25(OH)D to 1,25(OH)2D. It remains to be determined whether cells with vitamin D3 receptors in the intact human carry out this conversion.

    Serum concentration of “25(OH) D” is the best indicator of vitamin D3 status. It reflects vitamin D3 produced cutaneously and that obtained from food and supplements and has a fairly long circulating half-life of 15 days. However, serum 25(OH) D levels do not indicate the amount of vitamin D3 stored in other body tissues. Circulating 1,25(OH)2D is generally not a good indicator of vitamin D3 status because it has a short half-life of 15 hours and serum concentrations are closely regulated by parathyroid hormone, calcium, and phosphate. Levels of 1,25(OH)2D do not typically decrease until vitamin D3 deficiency is severe. There is considerable discussion of the serum concentrations of 25(OH) D3 associated with deficiency (e.g., rickets), adequacy for bone health, and optimal overall health (Table 1). A concentration of <20 nanograms per milliliter (ng/mL) (or <50 nanomoles per liter [nmol/L]) is generally considered inadequate.

    Intake reference values for vitamin D3 and other nutrients are provided in the Dietary Reference Intakes (DRI) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of The National Academies (formerly National Academy of Sciences). DRI is the general term for a set of reference values used to plan and assess nutrient intakes of healthy people. These values, which vary by age and gender, include:

    1. Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient requirements of nearly all (97-98%) healthy people.
    2. Adequate Intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy.
    3. Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects.

    Most people meet their vitamin D3 needs through exposure to sunlight. Consequently, one could say that it is a hormone, since our bodies manufactures it in response to our skin’s exposure to sunlight! Ultraviolet (UV) B radiation with a wavelength of 290-315 nanometers penetrates uncovered skin and converts cutaneous 7-dehydrocholesterol to previtamin D3, which in turn becomes vitamin D3. Season, geographic latitude, time of day, cloud cover, smog, skin melanin content, and sunscreen are among the factors that affect UV radiation exposure and vitamin D3 synthesis. The UV energy above 42 degrees north latitude (a line approximately between the northern border of California and Boston) is insufficient for cutaneous vitamin D3 synthesis from November through February; in far northern latitudes, this reduced intensity lasts for up to 6 months. Latitudes below 34 degrees north (a line between Los Angeles and Columbia, South Carolina) allow for cutaneous production of vitamin D3 throughout the year.

    Dietary supplements

    In supplements and fortified foods, vitamin D3 is available in two forms, D2 (ergocalciferol) and D3 (cholecalciferol). Vitamin D2 is manufactured by the UV irradiation of ergosterol in yeast, and vitamin D3 is manufactured by the irradiation of 7-dehydrocholesterol from lanolin and the chemical conversion of cholesterol. The two forms have traditionally been regarded as equivalent based on their ability to cure rickets, but evidence has been offered that they are metabolized differently. Vitamin D3 could be more than three times as effective as vitamin D2 in raising serum 25(OH) D concentrations and maintaining those levels for a longer time, and its metabolites have superior affinity for vitamin D3-binding proteins in plasma. Because metabolite receptor affinity is not a functional assessment, as the earlier results for the healing of rickets were, further research is needed on the comparative physiological effects of both forms.

    Vitamin D3 has long provided significant support for healthy bone density. However, scientists have validated the critical role that vitamin D3 plays in regulating healthy cell division and differentiation, and has profound effects on the human immunity system. These findings link a deficiency of vitamin D3 to a host of common age-related problems. As a result of this research and startling evidence of a widespread vitamin D3 deficiency, prominent nutritional scientists are calling on Americans to increase their vitamin D3 intake to 1000 IU per day and higher while the current RDA is still only 400 IU by the FDA.

    Vitamin D3 is synthesized in the body from sunlight. But, due to the winter season, weather conditions, and sunscreen blockers, the body’s ability to produce optimal vitamin D3 levels may be inhibited. In fact, it has been proposed that annual fluctuations in vitamin D3 levels might explain the seasonality of influenza. All of these factors point to the value of taking a daily vitamin D3 supplement to ensure optimal vitamin D3 intake[Just one of our “effervescent Vitamin D3 tablet supplements” a day, supplies 1000 IU of vitamin D3 that is identical to that derived from sunlight on the skin].

    Caution. Individuals consuming more than 2,000 IU/day of vitamin D3 (from diet and supplements) should periodically obtain a serum 25-hydroxy vitamin D3 measurement. Toxicity is very unlikely in healthy individuals at a dose of less than 10,000 IU. Vitamin D3 supplementation is contraindicated in individuals with hypocalcaemia (high blood calcium levels). People with kidney disease, certain medical conditions (such as hyperparathyroidism, lymphoma, sarcoidosis), and those who use cardiac glycosides (digoxin) or thiazide diuretics should consult a physician before using supplemental vitamin D3.

    In General: The major biologic function of vitamin D3 is to maintain normal blood levels of calcium and phosphorus. Vitamin D3 aids in the absorption of calcium, helping to form and maintain strong bones. Recently, research also suggests vitamin D3 may provide protection from osteoporosis, hypertension (high blood pressure), cancer, and several autoimmune diseases. Vitamin D3 deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated, U.S. researchers indicate. Dr. James H. O'Keefe, cardiologist and director of Preventive Cardiology at the Mid America Heart Institute in Kansas City, Mo., said it is estimated that up to half of U.S. adults and 30 percent of children and teenagers have vitamin D3 deficiency. Additionally, Vitamin D3 deficiency also alters hormone levels and immune function, which can increase the risk of diabetes, a major contributor to cardiovascular disease, O'Keefe said.

    Recent data from the Framingham Heart Study suggest patients with vitamin D3 levels below 15 nanograms per milliliter were twice as likely to experience a heart attack, stroke or other cardiovascular event within the next five years compared with those with higher levels.

    "Restoring vitamin D3 levels to normal is important in maintaining good musculoskeletal health, and it may also improve heart health and prognosis," O'Keefe said in a statement. "We need large randomized controlled trials to determine whether or not vitamin D3 supplementation can actually reduce future heart disease and deaths. “Vitamin D3 can also be consumed through supplements and food intake. Natural food sources of vitamin D3 include salmon, sardines, cod liver oil, and vitamin D3-fortified foods including milk and some cereals, O'Keefe said. [The findings are published in the Dec. 9 issue of the Journal of the American College of Cardiology.]

    VITAMIN D3 INTAKE SCHEDULES

    A. Adequate Intakes (Als) for Vitamin D3.

    Age

    Children

    Men

    Women

    Pregnancy

    Lactation

    Birth to 13 years

    5 mcg

    (200 IU)

     

     

     

     

    14-18 years

     

    5 mcg

    (200 IU)

    5 mcg

    (200 IU)

    5 mcg

    (200 IU)

    5 mcg

    (200 IU)

    19-50 years

     

    5 mcg

    (200 IU)

    5 mcg

    (200 IU)

    5 mcg

    (200 IU)

    5 mcg

    (200 IU)

    51-70 years

     

    10 mcg

    (400 IU)

    10 mcg

    (400 IU)

     

     

    71+ years

     

    15 mcg

    (600 IU)

    15 mcg

    (600 IU)

     

     

    B.Vitamin D3 in Food.

    Food

    IUs per serving*

    Percent DV**

    Cod liver oil, 1 tablespoon

    1,360

    340

    Salmon, cooked, 3.5 ounces

    360

    90

    Mackerel, cooked, 3.5 ounces

    345

    90

    Tuna fish, canned in oil, 3 ounces

    200

    50

    Sardines, canned in oil, drained, 1.75 ounces

    250

    70

    Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup

    98

    25

    Margarine, fortified, 1 tablespoon

    60

    15

    Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV)

    40

    10

    Egg, 1 whole (vitamin D is found in yolk)

    20

    6

    Liver, beef, cooked, 3.5 ounces

    15

    4

    Cheese, Swiss, 1 ounce

    12

    4

    C. Tolerable Upper Intake Levels (ULs) for Vitamin D3.

    Age

    Children

    Men

    Women

    Pregnancy

    Lactation

    Birth to 12 months

    25 mcg

    (1,000 IU)

     

     

     

     

    1-13 years

    50 mcg

    (2,000 IU)

     

     

     

     

    14+ years

     

    50 mcg

    (2,000 IU)

    50 mcg

    (2,000 IU)

    50 mcg

    (2,000 IU)

    50 mcg

    (2,000 IU)

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