Vitamin D and Calcium

Size: px
Start display at page:

Download "Vitamin D and Calcium"

Transcription

1 Vitamin D and Calcium American Association of Clinical Endocrinologists Marina Del Rey, CA September 15, 2018 Albert Shieh, MD MS Assistant Clinical Professor Department of Medicine Division of Endocrinology UCLA

2 None Conflicts of Interest

3 What is the role of vitamin D in the musculoskeletal system

4 Vitamin D in the Media d deficiency supplements.html

5 USPSTF 2018: Vitamin D +/ Calcium and Fractures US Preventive Services Task Force. Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community Dwelling AdultsUS Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(15): doi: /jama

6 Vitamin D Synthesis and Metabolism 7-dehydrocholesterol UVB skin 37 vitamin D3 25-hydroxyvitamin D3 CYP27b1 liver 1,25-dihydroxyvitamin D3 kidney, placenta, macrophages, bone? CYP24a1 CYP24a1 side chain cleavage VDR

7 Classical Vitamin D Endocrinology Heaney, R. P. (2008). Vitamin D and calcium interactions: functional outcomes. The American journal of clinical nutrition, 88(2), 541S 544S.

8 Classical Vitamin D Endocrinology Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G. Relationship Between Serum Parathyroid Hormone Levels, Vitamin D Sufficiency, and Calcium Intake. JAMA. 2005;294(18): doi: /jama

9 Classical Vitamin D Endocrinology Priemel, M., von Domarus, C., Klatte, T. O., Kessler, S., Schlie, J., Meier, S.,... & Amling, M. (2010). Bone mineralization defects and vitamin D deficiency: Histomorphometric analysis of iliac crest bone biopsies and circulating 25 hydroxyvitamin D in 675 patients. Journal of Bone and Mineral Research, 25(2),

10 Who Benefits from Vitamin D and Calcium US Preventive Services Task Force. Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community Dwelling AdultsUS Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(15): doi: /jama

11 Who Benefits from Vitamin D and Calcium? Dawson Hughes B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997;337(10):

12 Who Benefits from Vitamin D and Calcium? Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med, 1992;327:

13 Who Benefits from Vitamin D and Calcium? Macdonald, H. M., Reid, I. R., Gamble, G. D., Fraser, W. D., Tang, J. C., & Wood, A. D. (2018). 25 Hydroxyvitamin D Threshold for the Effects of Vitamin D Supplements on Bone Density Secondary Analysis of a Randomized Controlled Trial. Journal of Bone and Mineral Research.

14 How much vitamin D do we need?

15 Recommended 25(OH)D Targets Recommended 25OHD Outcome of Interest (ng/ml) Institute of Medicine 20 Skeletal health Endocrine Society 30 Skeletal health National Osteoporosis Foundation 30 Skeletal health American Geriatrics Society 30 Skeletal health Falls Ross, A. C., Manson, J. E., Abrams, S. A., Aloia, J. F., Brannon, P. M., Clinton, S. K.,... & Shapses, S. A. (2011). The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. The Journal of Clinical Endocrinology & Metabolism, 96(1), Holick, M. F., Binkley, N. C., Bischoff Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P.,... & Weaver, C. M. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 96(7), J Am Geriatr Soc 62: , 2014.

16 Recommended Vitamin D Intake Institute of Medicine years 71+ years Endocrine Society years 71+ years National Osteoporosis Foundation years 71+ years Vitamin D 600 IU 800 IU IU IU IU IU Calcium 1000 mg (M); 1200 mg (F) 1200 mg N/A American Geriatrics Society 65+ years >1000 IU N/A 1000 mg (M); 1200 mg (F) 1200 mg Ross, A. C., Manson, J. E., Abrams, S. A., Aloia, J. F., Brannon, P. M., Clinton, S. K.,... & Shapses, S. A. (2011). The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. The Journal of Clinical Endocrinology & Metabolism, 96(1), Holick, M. F., Binkley, N. C., Bischoff Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P.,... & Weaver, C. M. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 96(7),

17 Target 25(OH)D in Patients on Anti resorptive Therapy (Taking Bisphosphonates) bisphosphonates) Carmel, A. S., Shieh, A., Bang, H., & Bockman, R. S. (2012). The 25 (OH) D level needed to maintain a favorable bisphosphonate response is 33 ng/ml. Osteoporosis International, 23(10),

18 Target 25(OH)D in Patients on Anti resorptive Therapy Holick, M. F., Siris, E. S., Binkley, N., Beard, M. K., Khan, A., Katzer, J. T.,... & de Papp, A. E. (2005). Prevalence of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. The Journal of Clinical Endocrinology & Metabolism, 90(6),

19 What are ways to correct vitamin D deficiency?

20 Vitamin D2 vs. D3 Source D2 Plant sources UV irradiation of ergosterol Molecular weight Binding affinity for DBP Less More D3 Animal sources UV irradiation of 7 dehydrocholesterol Half life of 25(OH)D days days Jones, K. S., Assar, S., Harnpanich, D., Bouillon, R., Lambrechts, D., Prentice, A., & Schoenmakers, I. (2014). 25 (OH) D2 half life is shorter than 25 (OH) D3 half life and is influenced by DBP concentration and genotype. The Journal of Clinical Endocrinology & Metabolism, 99(9),

21 D2 v D3: 1,000 IU daily x11 weeks Holick, M. F., Biancuzzo, R. M., Chen, T. C., Klein, E. K., Young, A., Bibuld, D.,... & Tannenbaum, A. D. (2008). Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25 hydroxyvitamin D. The Journal of Clinical Endocrinology & Metabolism, 93(3),

22 D2 v. D3: 2,000 IU/day x8 weeks Lehmann, U., Hirche, F., Stangl, G. I., Hinz, K., Westphal, S., & Dierkes, J. (2013). Bioavailability of vitamin D2 and D3 in healthy volunteers, a randomized placebo controlled trial. The Journal of Clinical Endocrinology & Metabolism, 98(11),

23 D2 v. D3: 4,000 IU daily x14 days Trang, H. M., Cole, D. E., Rubin, L. A., Pierratos, A., Siu, S., & Vieth, R. (1998). Evidence that vitamin D3 increases serum 25 hydroxyvitamin D more efficiently than does vitamin D2. The American journal of clinical nutrition, 68(4),

24 D2 v D3: 50,000 IU weekly x10 weeks Shieh, A., Chun, R. F., Ma, C., Witzel, S., Meyer, B., Rafison, B.,... & Adams, JS. (2016). Effects of high dose vitamin D2 versus vitamin D3 on total and free 25 hydroxyvitamin D and markers of calcium balance. The Journal of Clinical Endocrinology & Metabolism, jc 2016.

25 Vitamin D3 vs. 25(OH)D3 D3 25(OH)D3 Intestinal absortpion 79% 93% Hydrophobic/hydrophilic More hydrophobic More hydrophilic Half life days days Volume of distribution Larger Smaller Quesada Gomez, J. M., & Bouillon, R. (2018). Is calcifediol better than cholecalciferol for vitamin D supplementation?. Osteoporosis International, 1 15.

26 D3 vs 25(OH)D3: 60 mcg vs. 20 mcg/day Shieh, A., Ma, C., Chun, R. F., Witzel, S., Rafison, B., Contreras, H. T.,... & Adams, J. S. (2017). Effects of cholecalciferol vs calcifediol on total and free 25 hydroxyvitamin D and parathyroid hormone. The Journal of Clinical Endocrinology & Metabolism, 102(4),

27 When Might 25(OH)D3 Be More Effective than D3? Obesity Fat malabsorption Decreased CYP2R1 efficiency CKD

28 Is free 25(OH)D a better marker of vitamin D status than total 25(OH)D?

29 Total vs. Free 25(OH)D Albuminbound 12% Free <1% DBP bound 87%

30 Free Hormone Hypothesis Blood Most tissues Megalin expressing tissues Blood DBP 25OHD DBP 25OHD Alb 25OHD Alb 25OHD DBP 25OHD DBP 25OHD 25OHD 25OHD 25OHD 25OHD Cell 25OHD Cell Megalin 25OHD DBP 25OHD 1,25(OH) 2 D 1,25(OH) 2 D Vitamin D Receptor Vitamin D Receptor

31 Total vs. Free 25(OH)D in Multi racial/ethnic Populations Nielson, C. M., Jones, K. S., Chun, R. F., Jacobs, J., Wang, Y., Hewison, M.,... & Pauwels, S. (2016). Role of assay type in determining free 25 hydroxyvitamin D levels in diverse populations. New England Journal of Medicine, 374(17),

32 Correlations Between Total and Free 25(OH)D Nielson, C. M., Jones, K. S., Chun, R. F., Jacobs, J. M., Wang, Y., Hewison, M.,... & Pauwels, S. (2016). Free 25 hydroxyvitamin D: impact of vitamin D binding protein assays on racial genotypic associations. The Journal of Clinical Endocrinology & Metabolism, 101(5),

33 Associations of Change in Total vs. Free 25(OH)D with Change in PTH Total 25D Unadjusted Adjusted for D2 v. D3 Adjusted for D2 v. D3, change in 1,25D & calcium Free 25D Unadjusted Adjusted for D2 v. D3 Adjusted for D2 v. D3, change in 1,25D & calcium Percent change in PTH (95% CI) per unit increment change in serum total v. free 25D Mean (95% CI) p value ( 1.124, 0.110) ( 1.230, 0.197) ( 1.269, 0.273) ( 6.247, 0.519) ( 6.463, 0.268) ( 6.594, 0.175) Shieh, A., Chun, R. F., Ma, C., Witzel, S., Meyer, B., Rafison, B.,... & Hewison, M. (2016). Effects of high dose vitamin D2 versus D3 on total and free 25 hydroxyvitamin D and markers of calcium balance. The Journal of Clinical Endocrinology & Metabolism, 101(8),

34 When Might Free 25(OH)D Be More Useful Than Total 25(OH)D? Liver cirrhosis Older adults (multiple co morbidities) Pregnancy

35 How does 25(OH)D assay affect clinical care?

36 Common 25(OH)D Assays Immunoassay High variability Measures 25(OH)D2 and 25(OH)D3 together Some assays underestimate 25(OH)D2 LC:MS:MS Considered gold standard Less variability Measures 25(OH)D2 and 25(OH)D3 individually

37 25(OH)D: Immunoassay vs. LC:MS:MS Binkley, N., & Carter, G. D. (2017). Toward clarity in clinical vitamin D status assessment: 25 (OH) D assay standardization. Endocrinology and metabolism clinics of North America.

38 How much calcium do we need?

39 Recommended Calcium Intake Institute of Medicine years 71+ years Endocrine Society years 71+ years National Osteoporosis Foundation years 71+ years Vitamin D 600 IU 800 IU IU IU IU IU Calcium 1000 mg (M); 1200 mg (F) 1200 mg N/A American Geriatrics Society 65+ years >1000 IU N/A 1000 mg (M); 1200 mg (F) 1200 mg Ross, A. C., Manson, J. E., Abrams, S. A., Aloia, J. F., Brannon, P. M., Clinton, S. K.,... & Shapses, S. A. (2011). The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. The Journal of Clinical Endocrinology & Metabolism, 96(1), Holick, M. F., Binkley, N. C., Bischoff Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P.,... & Weaver, C. M. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 96(7),

40 Calcium and Cardiovascular Disease

Vitamin D. Vitamin functioning as hormone. Todd A Fearer, MD FACP

Vitamin D. Vitamin functioning as hormone. Todd A Fearer, MD FACP Vitamin D Vitamin functioning as hormone Todd A Fearer, MD FACP Vitamin overview Vitamins are organic compounds that are essential in small amounts for normal metabolism They are different from minerals

More information

The Role of the Laboratory in Metabolic Bone Disease

The Role of the Laboratory in Metabolic Bone Disease The Role of the Laboratory in Metabolic Bone Disease Howard Morris PhD, FAACB, FFSc(RCPA) President, IFCC Professor of Medical Sciences, University of South Australia, Clinical Scientist, SA Pathology

More information

Update on vitamin D. J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska USA

Update on vitamin D. J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska USA Update on vitamin D J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska 68131 USA Cali, Colombia 2016 definitions DRIs are the recommended dietary reference intakes

More information

Vitamin D Replacement ROCKY MOUNTAIN MEETING NOV 2013 BANFF W.COKE UNIVERSITY OF TORONTO

Vitamin D Replacement ROCKY MOUNTAIN MEETING NOV 2013 BANFF W.COKE UNIVERSITY OF TORONTO Vitamin D Replacement ROCKY MOUNTAIN MEETING NOV 2013 BANFF W.COKE UNIVERSITY OF TORONTO Disclosures: (Academic Mea Culpa) No financial conflicts I have no expertise re: Vitamin D. OBJECTIVES: 1) Review

More information

The Low Blood Level of 25-Hydroxy Vitamin D in African American Women: Is It Clinically Significant?

The Low Blood Level of 25-Hydroxy Vitamin D in African American Women: Is It Clinically Significant? Cronicon OPEN ACCESS The Low Blood Level of 25-Hydroxy Vitamin D in African American Women: Is It Clinically Significant? NUTRITION Review Article Fafa Huberta Koudoro 1#, Ria S Roberts 1#, Mark S Elliott

More information

Vitamin D: Conflict of Interest Statement Corporate. Outline 7/5/2016

Vitamin D: Conflict of Interest Statement Corporate. Outline 7/5/2016 Vitamin D: What s New and Not? Clifford J Rosen MD Maine Medical Center Research Institute rosenc@mmc.org Conflict of Interest Statement Corporate NO STOCKS or EQUITY Editor UpToDate, New England Journal

More information

Osteoporosis Update DR. SYLVIE OUELLETTE RHEUMATOLOGIST

Osteoporosis Update DR. SYLVIE OUELLETTE RHEUMATOLOGIST Osteoporosis Update DR. SYLVIE OUELLETTE RHEUMATOLOGIST Disclosures! Speaker programs! AbbVie, Amgen! Research! Amgen, Novartis! Education/ conference support! Amgen, Roche! Advisory Boards! AbbVie, Amgen,

More information

Vitamin D 2 Is as Effective as Vitamin D 3 in Maintaining Circulating Concentrations of 25-Hydroxyvitamin D

Vitamin D 2 Is as Effective as Vitamin D 3 in Maintaining Circulating Concentrations of 25-Hydroxyvitamin D ORIGINAL ARTICLE Endocrine Care Vitamin D 2 Is as Effective as Vitamin D 3 in Maintaining Circulating Concentrations of 25-Hydroxyvitamin D Michael F. Holick, Rachael M. Biancuzzo, Tai C. Chen, Ellen K.

More information

Vitamin D Insufficiency

Vitamin D Insufficiency T h e n e w e ngl a nd j o u r na l o f m e dic i n e clinical practice Vitamin D Insufficiency Clifford J. Rosen, M.D. This Journal feature begins with a case vignette highlighting a common clinical problem.

More information

Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Objectives

Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Objectives Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Bess Dawson-Hughes, MD Disclosures: Amgen, DSM, Nestle, Opko, Pfizer, Roche, Tricida Interrelationships of muscle

More information

FOR CONSUMERS AND PATIENTS

FOR CONSUMERS AND PATIENTS AVAILABILITY OF VITAMIN D FOR CONSUMERS AND PATIENTS Prof. Heike A. Bischoff-Ferrari, MD, DrPH Centre on Aging and Mobility, University of Zurich Dept. of Rheumatology, University Hospital Zurich Overview

More information

Supplementary Information to Chapter 36

Supplementary Information to Chapter 36 REVIEW ON VITAMIN-D NEW INSIGHTS Elmer Verner McCollum (1879-1967) was the first to discover the antirachitic vitamin which he named as vitamin D in the early part of 20th century (1919). He had earlier

More information

V t i amin i n D a nd n d Calc l iu i m u : Rol o e l in i n Pr P eve v nt n io i n and n d Tr T eatment n of o Fr F actur u es and n d Fa F ll l s

V t i amin i n D a nd n d Calc l iu i m u : Rol o e l in i n Pr P eve v nt n io i n and n d Tr T eatment n of o Fr F actur u es and n d Fa F ll l s Vitamin D and Calcium: Role in Prevention and Treatment of Fractures and Falls Osteoporosis 21: New Insights In Research, Diagnosis, and Clinical Care Deborah Sellmeyer, MD Director, Johns Hopkins Metabolic

More information

Vitamin D and Calcium Therapy: how much is enough

Vitamin D and Calcium Therapy: how much is enough Vitamin D and Calcium Therapy: how much is enough Daniel D Bikle, MD, PhD Professor of Medicine VA Medical Center and University of California San Francisco DISCLOSURE Nothing to disclose 1 RECOMMENDATIONS

More information

Vitamin D Status of an Outpatient Clinic Population

Vitamin D Status of an Outpatient Clinic Population Calcif Tissue Int (2001) 69:263 267 DOI: 10.1007/s002230010054 2001 Springer-Verlag New York Inc. Vitamin D Status of an Outpatient Clinic Population L. Margiloff, 1 S. S. Harris, 2 S. Lee, 3 R. Lechan,

More information

The Endocrine Society Guidelines

The Endocrine Society Guidelines Vitamin D and Calcium Therapy: how much is enough DISCLOSURE Daniel D Bikle, MD, PhD Professor of Medicine VA Medical Center and University of California San Francisco Nothing to disclose RECOMMENDATIONS

More information

Vitamin D Deficiency. Decreases renal calcium excretion. Increases intestinal absorption Calcium. Increases bone resorption of calcium

Vitamin D Deficiency. Decreases renal calcium excretion. Increases intestinal absorption Calcium. Increases bone resorption of calcium Vitamin D Deficiency Deborah Gordish, MD Assistant Professor of Clinical Internal Medicine Lead Physician Lewis Center Primary Care Associate Division Director General Internal Medicine The Ohio State

More information

ORIGINAL ARTICLE. R. A. Lyons & A. Johansen & S. Brophy & R. G. Newcombe & C. J. Phillips & B. Lervy & R. Evans & K. Wareham & M. D.

ORIGINAL ARTICLE. R. A. Lyons & A. Johansen & S. Brophy & R. G. Newcombe & C. J. Phillips & B. Lervy & R. Evans & K. Wareham & M. D. Osteoporos Int (2007) 18:811 818 DOI 10.1007/s00198-006-0309-5 ORIGINAL ARTICLE Preventing fractures among older people living in institutional care: a pragmatic randomised double blind placebo controlled

More information

Dr Seeta Durvasula.

Dr Seeta Durvasula. Dr Seeta Durvasula seeta.durvasula@sydney.edu.au 1 Avoid sun skin cancer risk Australia has highest rates of skin cancer in the world Epidemic of Vitamin D deficiency Lack of Vitamin D increases risk of

More information

Importance of Vitamin D in Healthy Ageing. Peter Liu, B Pharmacy Market Development Manager DSM Nutritional Products Asia Pacific 11 th November 2014

Importance of Vitamin D in Healthy Ageing. Peter Liu, B Pharmacy Market Development Manager DSM Nutritional Products Asia Pacific 11 th November 2014 Importance of Vitamin D in Healthy Ageing Peter Liu, B Pharmacy Market Development Manager DSM Nutritional Products Asia Pacific 11 th November 2014 Healthy life expectancy the challenge! Life expectancy

More information

Elecsys bone marker panel. Optimal patient management starts in the laboratory

Elecsys bone marker panel. Optimal patient management starts in the laboratory bone marker panel Optimal patient management starts in the laboratory Complete solution for osteoporosis The most complete bone metabolism panel on a single platform bone marker assays are important diagnostic

More information

VITAMIN D IN HEALTH AND DISEASE

VITAMIN D IN HEALTH AND DISEASE VITAMIN D IN HEALTH AND DISEASE Margus Lember University of Tartu, Estonia ESIM, Saas Fee, January 16, 2014 l It`s most healthy to live on the southern side of a mountain l Hippokrates of Kos 460-370 BC

More information

VITAMIN D IN HEALTH & DISEASE. Boyd C.Hoddinott B Sc, MD, MPH Logan County Health Commissioner

VITAMIN D IN HEALTH & DISEASE. Boyd C.Hoddinott B Sc, MD, MPH Logan County Health Commissioner VITAMIN D IN HEALTH & DISEASE Boyd C.Hoddinott B Sc, MD, MPH Logan County Health Commissioner Summary Foods in North America were fortified with vitamin D to reduce the occurrence of rickets. This appeared

More information

Alex Chin. Opinion Letter VITAMIN D ANA. Dr. Alex Chin T2L 2K8. in laboratory

Alex Chin. Opinion Letter VITAMIN D ANA. Dr. Alex Chin T2L 2K8. in laboratory Vitamin D Analyte of thee Millennium OPINION LETTER VITAMIN Alex Chin D ANA Calgary Laboratory Services, Calgary, Alberta Canadaa & Department of Pathology and Laboratory Medicine, University of Calgary,

More information

Overview of the conference Vitamin D and Health in the 21st Century: an Update 1 4

Overview of the conference Vitamin D and Health in the 21st Century: an Update 1 4 Overview of the conference Vitamin D and Health in the 21st Century: an Update 1 4 Patsy M Brannon, Elizabeth A Yetley, Regan L Bailey, and Mary Frances Picciano ABSTRACT We summarize the key findings,

More information

Monocyte Innate Immune Response to Vitamin D

Monocyte Innate Immune Response to Vitamin D Monocyte Innate Immune Response to Vitamin D SIAM Life Science 2012 Session MS40 Signaling: Vitamin D in Monocytes and Receptor Clustering in Mast Cells Hewison and Adams laboratory UCLA-Orthopaedic Hospital

More information

Vitamin D Hormone Du Jour

Vitamin D Hormone Du Jour Vitamin D Hormone Du Jour J R Minkoff MD, FACP Endocrinology Clinical Professor of Family and Community Medicine UCSF Why Is Vitamin D Important? Musculo-skeletal effects Possible other effects Immunomodulatory

More information

ORIGINAL ARTICLE. O. M. Gutiérrez & W. R. Farwell & D. Kermah & E. N. Taylor

ORIGINAL ARTICLE. O. M. Gutiérrez & W. R. Farwell & D. Kermah & E. N. Taylor DOI 10.1007/s00198-010-1383-2 ORIGINAL ARTICLE Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey

More information

Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine

Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine meek.shon@mayo.edu 2016 MFMER 3561772-1 Update on Vitamin D Shon Meek MD, PhD 20 th Annual Endocrine Update January 30-Feb 3, 2017 Disclosure Relevant

More information

A Pooled Analysis of Vitamin D Dose Requirements for Fracture Prevention

A Pooled Analysis of Vitamin D Dose Requirements for Fracture Prevention T h e n e w e ngl a nd j o u r na l o f m e dic i n e original article A Pooled Analysis of Vitamin D Dose Requirements for Fracture Prevention Heike A. Bischoff-Ferrari, M.D., Dr.P.H., Walter C. Willett,

More information

OSTEOMALACIA UPDATE. Nothing to Disclose. Daniel D Bikle, MD, PhD Professor of Medicine University of California and VA Medical Center San Francisco

OSTEOMALACIA UPDATE. Nothing to Disclose. Daniel D Bikle, MD, PhD Professor of Medicine University of California and VA Medical Center San Francisco OSTEOMALACIA UPDATE Daniel D Bikle, MD, PhD Professor of Medicine University of California and VA Medical Center San Francisco Nothing to Disclose 1 Case History 59 YO WM referred for evaluation of diffuse

More information

VITAMIN D ACTS THROUGH several pathways to influence

VITAMIN D ACTS THROUGH several pathways to influence JOURNAL OF BONE AND MINERAL RESEARCH Volume 22, Supplement 2, 2007 doi: 10.1359/JBMR.07S209 2007 American Society for Bone and Mineral Research Therapy of Osteoporosis With Calcium and Vitamin D Bess Dawson-Hughes

More information

Clinical Policy: Measurement of Serum 1,25-dihydroxyvitamin D

Clinical Policy: Measurement of Serum 1,25-dihydroxyvitamin D Clinical Policy: Reference Number: CP.MP.152 Last Review Date: 12/17 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description

More information

Hellenic Endocrine Society position statement: Clinical management of Vitamin D Deficiency. Spyridon Karras MD, Phd Endocrinologist

Hellenic Endocrine Society position statement: Clinical management of Vitamin D Deficiency. Spyridon Karras MD, Phd Endocrinologist Hellenic Endocrine Society position statement: Clinical management of Vitamin D Deficiency Spyridon Karras MD, Phd Endocrinologist Pregnancy We recommend a minimum intake of 600 international units of

More information

REVIEW ARTICLE. Prevention of Nonvertebral Fractures With Oral Vitamin D and Dose Dependency

REVIEW ARTICLE. Prevention of Nonvertebral Fractures With Oral Vitamin D and Dose Dependency REVIEW ARTICLE Prevention of Nonvertebral Fractures With Oral Vitamin D and Dose Dependency A Meta-analysis of Randomized led Trials Heike A. Bischoff-Ferrari, DrPH; Walter C. Willett, DrPH; John B. Wong,

More information

BAD TO THE BONE. Peter Jones, Rheumatologist QE Health, Rotorua. GP CME Conference Rotorua, June 2008

BAD TO THE BONE. Peter Jones, Rheumatologist QE Health, Rotorua. GP CME Conference Rotorua, June 2008 BAD TO THE BONE Peter Jones, Rheumatologist QE Health, Rotorua GP CME Conference Rotorua, June 2008 Agenda Osteoporosis in Men Vitamin D and Calcium Long-term treatment with Bisphosphonates Pathophysiology

More information

Vitamin D and Inflammation

Vitamin D and Inflammation Vitamin D and Inflammation Susan Harris, D.Sc. Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University Boston, MA Vitamin D Liver 25(OH)D storage form nmol/l=ng/ml x 2.5 Renal 1,25(OH)

More information

Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management

Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management There is growing interest in the importance

More information

JBMR. Serum 25-hydroxyvitamin D [25(OH)D] concentration may or

JBMR. Serum 25-hydroxyvitamin D [25(OH)D] concentration may or ORIGINAL ARTICLE JBMR Impact of Calcium and Vitamin D Insufficiencies on Serum Parathyroid Hormone and Bone Mineral Density: Analysis of the Fourth and Fifth Korea National Health and Nutrition Examination

More information

Review Article. Vitamin D, bones and muscle: myth versus reality

Review Article. Vitamin D, bones and muscle: myth versus reality Review Article Vitamin D, bones and muscle: myth versus reality DOI: 10.1111/ajag.12408 8 Gustavo Duque Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western

More information

Disclosure 7/2/2018. Consultant : Ultragenyx, Alexion, Ferrings. Research grant support: Ultragenyx, Shire, Amgen. Clinical Trial : Ultragynyx, Amgen

Disclosure 7/2/2018. Consultant : Ultragenyx, Alexion, Ferrings. Research grant support: Ultragenyx, Shire, Amgen. Clinical Trial : Ultragynyx, Amgen Pisit (Duke) Pitukcheewanont, MD, FAAP Clinical Director, Pediatric Bone Program, Center for Diabetes, Endocrinology & Metabolism Children s Hospital Los Angeles Professor of Clinical Pediatrics The Keck

More information

Evidence Synthesis Number 118. Screening for Vitamin D Deficiency: Systematic Review for the U.S. Preventive Services Task Force Recommendation

Evidence Synthesis Number 118. Screening for Vitamin D Deficiency: Systematic Review for the U.S. Preventive Services Task Force Recommendation Evidence Synthesis Number 118 Screening for Vitamin D Deficiency: Systematic Review for the U.S. Preventive Services Task Force Recommendation Prepared for: Agency for Healthcare Research and Quality U.S.

More information

Objectives. Polypharmacy Seminar. Causes of Polypharmacy. Polypharmacy 8/05/12. National Prescribing Curriculum Module

Objectives. Polypharmacy Seminar. Causes of Polypharmacy. Polypharmacy 8/05/12. National Prescribing Curriculum Module Polypharmacy Seminar Objectives On completion of this module you should be able to: state the major guiding principles in rational prescribing recognise, and substantiate, over-prescribing or inappropriate

More information

Steroid hormone vitamin D: Implications for cardiovascular disease Circulation research. 2018; 122:

Steroid hormone vitamin D: Implications for cardiovascular disease Circulation research. 2018; 122: Steroid hormone vitamin D: Implications for cardiovascular disease Circulation research. 2018; 122:1576-1585 November 20, 2010: Canadian and US government request the Institute of Medicine to provide a

More information

The discovery of Vitamin D and the elimination of rickets has been considered as one of Medicine s Greatest Achievements.

The discovery of Vitamin D and the elimination of rickets has been considered as one of Medicine s Greatest Achievements. The discovery of Vitamin D and the elimination of rickets has been considered as one of Medicine s Greatest Achievements. SIR EDWARD MELLANBY 1 8 8 4-1 9 5 5 A D I E T C H A R A C T E R I S T I C O F S

More information

THE NEW ZEALAND MEDICAL JOURNAL

THE NEW ZEALAND MEDICAL JOURNAL THE NEW ZEALAND MEDICAL JOURNAL Vol 116 No 1179 ISSN 1175 8716 Efficacy of an oral, 10-day course of high-dose calciferol in correcting vitamin D deficiency Fiona Wu, Toni Staykova, Anne Horne, Judy Clearwater,

More information

CIC EDIZIONI INTERNAZIONALI. Vitamin D supplementation in fractured patient: how, when and why. Mini review

CIC EDIZIONI INTERNAZIONALI. Vitamin D supplementation in fractured patient: how, when and why. Mini review Vitamin D supplementation in fractured patient: how, when and why Giovanni Iolascon, MD a G. Di Pietro, MD b F. Gimigliano, MD, PhD c Department of Orthopedics and Rehabilitation, Second University of

More information

Boston University

Boston University Boston University OpenBU Theses & Dissertations http://open.bu.edu Boston University Theses & Dissertations 2014 Evaluation of the bioavailability and metabolism of vitamin D2 in a mushroom supplement

More information

1. Optimal Vitamin D Levels in Health and Disease: Current Understanding Based on IOM Guidelines

1. Optimal Vitamin D Levels in Health and Disease: Current Understanding Based on IOM Guidelines 1. Optimal Vitamin D Levels in Health and Disease: Current Understanding Based on IOM Guidelines Sue Shapses, PhD Clifford J. Rosen, MD Case 1-1 A 78-year-old white female presents with a chief complaint

More information

Draft Laboratory Testing for Vitamin D Deficiency Version 4.0

Draft Laboratory Testing for Vitamin D Deficiency Version 4.0 Draft Laboratory Testing for Vitamin D Deficiency Version 4.0 Authors Dr Gerard Boran, Consultant Chemical Pathologist, Tallaght Hospital, Dublin 24, Ireland. Dr. Jansen Seheult, Clinical Pathology Resident,

More information

Benefits of Calcium and Vitamin D: Building and Maintaining Healthy Bones

Benefits of Calcium and Vitamin D: Building and Maintaining Healthy Bones Benefits of Calcium and Vitamin D: Building and Maintaining Healthy Bones Prepared by Annette Dickinson, Ph.D. Council for Responsible Nutrition June 2002 There is no question that a generous intake of

More information

Vitamin D and Systemic Lupus Erythematosus: Bones, Muscles, and Joints

Vitamin D and Systemic Lupus Erythematosus: Bones, Muscles, and Joints Curr Rheumatol Rep (2010) 12:259 263 DOI 10.1007/s11926-010-0106-1 Vitamin D and Systemic Lupus Erythematosus: Bones, Muscles, and Joints Nancy E. Lane Published online: 29 April 2010 # The Author(s) 2010.

More information

OPINION. Definition and Significance

OPINION. Definition and Significance 2017, 64 (1), 1-10 OPINION Advance Publication doi: 10.1507/endocrj.EJ16-0548 Assessment criteria for vitamin D deficiency/insufficiency in Japan proposal by an expert panel supported by Research Program

More information

Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents

Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents Osteoporos Int (2008) 19:663 671 DOI 10.1007/s00198-007-0465-2 ORIGINAL ARTICLE Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing

More information

Vitamin D and Fracture Reduction: An Evaluation of the Existing Research Susan E. Brown, PhD, CNS

Vitamin D and Fracture Reduction: An Evaluation of the Existing Research Susan E. Brown, PhD, CNS Reduction: An Evaluation of the Existing Research Susan E. Brown, PhD, CNS Abstract This article re-evaluates the literature on vitamin D and fracture reduction, highlighting the relevance of new understandings

More information

Vitamin D Deficiency in the United States: How Common is it?

Vitamin D Deficiency in the United States: How Common is it? Utah State University DigitalCommons@USU Undergraduate Honors Theses Honors Program 5-2010 Vitamin D Deficiency in the United States: How Common is it? Christine N. Arnold Utah State University Follow

More information

Effects of vitamin D deficiency and daily calcium intake on bone mineral density and osteoporosis in Korean postmenopausal woman

Effects of vitamin D deficiency and daily calcium intake on bone mineral density and osteoporosis in Korean postmenopausal woman Original Article Obstet Gynecol Sci 2017;60(1):53-62 https://doi.org/10.5468/ogs.2017.60.1.53 pissn 2287-8572 eissn 2287-8580 Effects of vitamin D deficiency and daily calcium intake on bone mineral density

More information

When does prolonged vitamin D intake confer a risk for health?

When does prolonged vitamin D intake confer a risk for health? When does prolonged vitamin D intake confer a risk for health? Glenville Jones, Ph.D Craine Professor of Biochemistry, Dept Biomedical & Molecular Sciences Professor, Department of Medicine Queen's University,

More information

The Relationship Between Serum 25(OH)D and Parathyroid Hormone Levels

The Relationship Between Serum 25(OH)D and Parathyroid Hormone Levels CLINICAL RESEARCH STUDY The Relationship Between Serum 25(OH)D and Parathyroid Hormone Levels Walid Saliba, MD, MPH, a Ofra Barnett, PhD, a Hedy S. Rennert, MPH, a Idit Lavi, MA, a Gad Rennert, MD, PhD

More information

Calcium and Vitamin D Supplementation in Postmenopausal Women. Winthrop University Hospital, Bone Mineral Research Center, Mineola, New York 11501

Calcium and Vitamin D Supplementation in Postmenopausal Women. Winthrop University Hospital, Bone Mineral Research Center, Mineola, New York 11501 JCEM ONLINE Hot Topics in Translational Endocrinology Endocrine Care Calcium and Vitamin D Supplementation in Postmenopausal Women John F. Aloia, Ruban Dhaliwal, Albert Shieh, Mageda Mikhail, Shahidul

More information

A Review of Vitamin D Supplementation in the Adult Patient ACPE UAN: H01-P

A Review of Vitamin D Supplementation in the Adult Patient ACPE UAN: H01-P A Review of Vitamin D Supplementation in the Adult Patient ACPE UAN: 0171-9999-15-053-H01-P Joshua Hirschhorn, PharmD Candidate, Class of 2015. South Carolina College of Pharmacy, MUSC Campus. Kristy L.

More information

Non classical effects of vitamin D Jean-Claude Souberbielle, hôpital Necker, Paris, France

Non classical effects of vitamin D Jean-Claude Souberbielle, hôpital Necker, Paris, France Non classical effects of vitamin D Jean-Claude Souberbielle, hôpital Necker, Paris, France few significant dietary sources intestine UVB (290-315 nm) skin 7-dehydrocholesterol Pre-vitamin D3 intestine

More information

THE IMPORTANCE OF ADEQUATE

THE IMPORTANCE OF ADEQUATE ORIGINAL CONTRIBUTION Relationship Between Serum Parathyroid Hormone Levels, Vitamin D Sufficiency, and Calcium Intake Laufey Steingrimsdottir, PhD Orvar Gunnarsson, MD Olafur S. Indridason, MD, MHS Leifur

More information

Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People

Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People For the Motion: Professor Roger Francis, Institute for Ageing and Health, Newcastle University,

More information

Vitamin D Supplementation for Pain

Vitamin D Supplementation for Pain Vitamin D Supplementation for Pain Christan M. Thomas, PharmD; Peter Campbell, PharmD US Pharmacist. 2015;40(3):43 46. www.medscape.com Abstract and Introduction Abstract Vitamin D, a fat soluble vitamin

More information

CALCIUM INTAKE MAY be one of the many factors that

CALCIUM INTAKE MAY be one of the many factors that 0021-972X/05/$15.00/0 The Journal of Clinical Endocrinology & Metabolism 90(2):707 711 Printed in U.S.A. Copyright 2005 by The Endocrine Society doi: 10.1210/jc.2004-1380 Lack of Effect of Calcium Intake

More information

Steven A Abrams, Keli M Hawthorne, and Zhensheng Chen

Steven A Abrams, Keli M Hawthorne, and Zhensheng Chen Supplementation with 1000 IU vitamin D/d leads to parathyroid hormone suppression, but not increased fractional calcium absorption, in 4 8-y-old children: a double-blind randomized controlled trial 1 4

More information

Nutrition and Functionality: Key Partners in Ageing

Nutrition and Functionality: Key Partners in Ageing Nutrition and Functionality: Key Partners in Ageing Chairman: Professor Heike Bischoff-Ferrari Proceedings from the Nestlé Nutrition Institute Satellite Symposium at the XIXth IAGG World Congress of Gerontology

More information

JBMR. Vitamin D and calcium are both required for maintenance of

JBMR. Vitamin D and calcium are both required for maintenance of ORIGINAL ARTICLE JBMR Bone Mineralization Defects and Vitamin D Deficiency: Histomorphometric Analysis of Iliac Crest Bone Biopsies and Circulating 25-Hydroxyvitamin D in 675 Patients Matthias Priemel,

More information

The Vitamin D Gap. Vitamin D intake guidelines were established to prevent. Estimating an adequate intake of vitamin D. FEATURE VITAMIN D GAP

The Vitamin D Gap. Vitamin D intake guidelines were established to prevent. Estimating an adequate intake of vitamin D. FEATURE VITAMIN D GAP The Vitamin D Gap Estimating an adequate intake of vitamin D. By Laurence Montgomery, ND and George Tardik, ND Vitamin D intake guidelines were established to prevent rickets in children and osteomalacia

More information

Robin M Daly, Nicole Petrass, Shona Bass, and Caryl A Nowson

Robin M Daly, Nicole Petrass, Shona Bass, and Caryl A Nowson The skeletal benefits of calcium- and vitamin D 3 fortified milk are sustained in older men after withdrawal of supplementation: an 18-mo follow-up study 1 3 Robin M Daly, Nicole Petrass, Shona Bass, and

More information

Vitamin D, Sunlight Exposure, and Bone Density in Elderly African American Females of Low Socioeconomic Status

Vitamin D, Sunlight Exposure, and Bone Density in Elderly African American Females of Low Socioeconomic Status Vol. 42, No. 1 47 Clinical Research and Methods Vitamin D, Sunlight Exposure, and Bone Density in Elderly African American Females of Low Socioeconomic Status Sally P. Weaver, PhD, MD; Cindy Passmore,

More information

Current Concepts in the Evaluation and Management of Abnormal Parathyroid Hormone (PTH) Levels Shireen Fatemi, M.D. April, 2012.

Current Concepts in the Evaluation and Management of Abnormal Parathyroid Hormone (PTH) Levels Shireen Fatemi, M.D. April, 2012. Current Concepts in the Evaluation and Management of Abnormal Parathyroid Hormone (PTH) Levels Shireen Fatemi, M.D. April, 2012 Disclosures I have no financial relationships with commercial interests,

More information

THE SUNSHINE VITAMIN. Maureen Molini, MPH, RDN, CSSD University of Nevada Reno Student Health Services

THE SUNSHINE VITAMIN. Maureen Molini, MPH, RDN, CSSD University of Nevada Reno Student Health Services THE SUNSHINE VITAMIN Maureen Molini, MPH, RDN, CSSD University of Nevada Reno Student Health Services Vitamin vs. Prohormone Technically not a vitamin since it isn t obtained solely through diet Synthesized

More information

Calcium, Vitamin D and Bisphosphonates: Disclosures. Benefits, Risks and Drug Holiday. Calcium YES or NO? Calcium Bad News!!

Calcium, Vitamin D and Bisphosphonates: Disclosures. Benefits, Risks and Drug Holiday. Calcium YES or NO? Calcium Bad News!! Calcium, Vitamin D and Bisphosphonates: Benefits, Risks and Drug Holiday Disclosures I am disclosing financial relationships as follows: Global Advisory Boards: Amgen, Lilly, Merck, Novartis Research grants:

More information

MS Society of Canada Recommendations on Vitamin D in MS 1

MS Society of Canada Recommendations on Vitamin D in MS 1 MS Society of Canada Recommendations on Vitamin D in MS Many people affected by MS have questions about vitamin D, and whether it can prevent MS or be used to help stop the disease from getting worse.

More information

Endocrine Regulation of Calcium and Phosphate Metabolism

Endocrine Regulation of Calcium and Phosphate Metabolism Endocrine Regulation of Calcium and Phosphate Metabolism Huiping Wang ( 王会平 ), PhD Department of Physiology Rm C516, Block C, Research Building, School of Medicine Tel: 88208252 Email: wanghuiping@zju.edu.cn

More information

Vitamin D & Cardiovascular Disease

Vitamin D & Cardiovascular Disease Vitamin D & Cardiovascular Disease Disclosures None Vitamin D Objectives: Discuss the basics of vitamin D metabolism Discuss the role of vitamin D deficiency in the development of coronary disease Review

More information

NIH Public Access Author Manuscript J Am Coll Nutr. Author manuscript; available in PMC 2009 August 20.

NIH Public Access Author Manuscript J Am Coll Nutr. Author manuscript; available in PMC 2009 August 20. NIH Public Access Author Manuscript Published in final edited form as: J Am Coll Nutr. 2008 April ; 27(2): 274 279. Body size and serum 25 hydroxy vitamin D response to oral supplements in healthy older

More information

The 2002 guidelines for the management of osteoporosis

The 2002 guidelines for the management of osteoporosis CMAJ Review Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada (summary) David A. Hanley MD, Ann Cranney MB BCh, Glenville Jones PhD, Susan J. Whiting PhD,

More information

Vitamin D for the Prevention of Osteoporotic Fractures

Vitamin D for the Prevention of Osteoporotic Fractures TITLE: Vitamin D for the Prevention of Osteoporotic Fractures AUTHOR: Jeffrey A. Tice, MD Assistant Professor of Medicine Division of General Internal Medicine Department of Medicine University of California

More information

Vitamin D: Is it a superhero??

Vitamin D: Is it a superhero?? Vitamin D: Is it a superhero?? Dr. Ashraf Abdel Basset Bakr Prof. of Pediatrics 1 2 History of vitamin D discovery Sources of vitamin D and its metabolism 13 Actions of vitamin D 4 Vitamin D deficiency

More information

Who should receive calcium and vitamin D supplementation?

Who should receive calcium and vitamin D supplementation? Age and Ageing Advance Access published August 8, 2012 Age and Ageing 2012; 0: 1 5 The Author 2012. Published by Oxford University Press on behalf of the British Geriatrics Society. doi: 10.1093/ageing/afs094

More information

Associations Between Change in Total and Free 25-Hydroxyvitamin D With 24,25-Dihydroxyvitamin DandParathyroidHormone

Associations Between Change in Total and Free 25-Hydroxyvitamin D With 24,25-Dihydroxyvitamin DandParathyroidHormone CLINICAL RESEARCH ARTICLE Associations Between Change in Total and Free 25-Hydroxyvitamin D With 24,25-Dihydroxyvitamin DandParathyroidHormone Albert Shieh, 1 Christina Ma, 2 Rene F. Chun, 3 Jonas Wittwer-Schegg,

More information

JMSCR Vol 06 Issue 12 Page December 2018

JMSCR Vol 06 Issue 12 Page December 2018 www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.157 A comparative study of two

More information

Original Communication Wintertime vitamin D insufficiency is common in young Canadian women, and their vitamin D intake does not prevent it

Original Communication Wintertime vitamin D insufficiency is common in young Canadian women, and their vitamin D intake does not prevent it (2001) 55, 1091 1097 ß 2001 Nature Publishing Group All rights reserved 0954 3007/01 $15.00 www.nature.com/ejcn Original Communication Wintertime vitamin D insufficiency is common in young Canadian women,

More information

Vitamin D and inflammation

Vitamin D and inflammation Vitamin D and inflammation Z Albar Rheumatology Division, Internal Medicine Department, University of Indonesia School of Medicine/Cipto Mangunkusumo General Hospital ABSTRACT The discovery that most body

More information

Vitamin D and osteoporosis in chronic kidney disease

Vitamin D and osteoporosis in chronic kidney disease DOI 10.1007/s40620-017-0430-x REVIEW Vitamin D and osteoporosis in chronic kidney disease Paul Lips 1 David Goldsmith 2 Renate de Jongh 1 Received: 9 May 2017 / Accepted: 4 August 2017 / Published online:

More information

Vitamin D in Cattle: Calcium and Beyond. Corwin D. Nelson, Ph.D. Assistant Professor of Physiology Department of Animal Sciences

Vitamin D in Cattle: Calcium and Beyond. Corwin D. Nelson, Ph.D. Assistant Professor of Physiology Department of Animal Sciences OH HO OH Vitamin D in Cattle: Calcium and Beyond Corwin D. Nelson, Ph.D. Assistant Professor of Physiology Department of Animal Sciences Seminar Outline 1. Basics of vitamin D metabolism and genomic actions

More information

Vitamin D Deficiency in Adults: When to Test and How to Treat. Kurt A. Kennel, MD; Matthew T. Drake, MD, PhD; and Daniel L.

Vitamin D Deficiency in Adults: When to Test and How to Treat. Kurt A. Kennel, MD; Matthew T. Drake, MD, PhD; and Daniel L. CONCISE REVIEW FOR CLINICIANS VITAMIN D DEFICIENCY IN ADULTS Vitamin D Deficiency in Adults: When to Test and How to Treat Kurt A. Kennel, MD; Matthew T. Drake, MD, PhD; and Daniel L. Hurley, MD Recent

More information

Study of the Association between Serum Vitamin D 25(OH) D levels, Muscle Strength and fall among Elderly.

Study of the Association between Serum Vitamin D 25(OH) D levels, Muscle Strength and fall among Elderly. DOI: 10.21276/aimdr.2017.3.2.ME7 Original Article ISSN (O):2395-2822; ISSN (P):2395-2814 Study of the Association between Serum Vitamin D 25(OH) D levels, Muscle Strength and fall among Elderly. Karthik

More information

VITAMIN D AND THE ATHLETE

VITAMIN D AND THE ATHLETE VITAMIN D AND THE ATHLETE CONSIDERATIONS FOR THE PRACTITIONER Written by Bruce Hamilton, Qatar Vitamin D is a steroid hormone that has previously been given little attention, partially as a result of its

More information

Skeletal Manifestations

Skeletal Manifestations Skeletal Manifestations of Metabolic Bone Disease Mishaela R. Rubin, MD February 21, 2008 The Three Ages of Women Gustav Klimt 1905 1 Lecture Outline Osteoporosis epidemiology diagnosis secondary causes

More information

Clinician s Guide to Prevention and Treatment of Osteoporosis

Clinician s Guide to Prevention and Treatment of Osteoporosis Clinician s Guide to Prevention and Treatment of Osteoporosis Published: 15 August 2014 committee of the National Osteoporosis Foundation (NOF) Tipawan khiemsontia,md outline Basic pathophysiology screening

More information

Emerging Areas Relating Vitamin D to Health

Emerging Areas Relating Vitamin D to Health ILSI SEA Region Vit D Conference, Australia, June 2012 (www.ilsi.org/sea Region) Emerging Areas Relating Vitamin D to Health Peter R Ebeling MD FRACP NorthWest Academic Centre and Dept Endocrinology The

More information

The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis

The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis Mark J Bolland, Andrew Grey, Greg D Gamble, Ian R Reid Summary Background Vitamin D insufficiency

More information

Views and Practice. Vitamin D and dermatology. Source of vitamin D

Views and Practice. Vitamin D and dermatology. Source of vitamin D Hong Kong J. Dermatol. Venereol. (2014) 22, 124-129 Views and Practice Vitamin D and dermatology SC Ng and TS Cheng The role of vitamin D has been well-established in calcium homeostasis and bone health

More information

Vitamin D Deficiency. Micol Rothman, MD Assistant Professor of Medicine Clinical Director Metabolic Bone Program University of CO-Denver

Vitamin D Deficiency. Micol Rothman, MD Assistant Professor of Medicine Clinical Director Metabolic Bone Program University of CO-Denver Vitamin D Deficiency Micol Rothman, MD Assistant Professor of Medicine Clinical Director Metabolic Bone Program University of CO-Denver 50 yo woman referred for osteoporosis What is striking about her

More information

VITAMIN D STATUS OF AMERICAN ADULTS AGE 18 YEARS AND OLDER: NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY and Kayla K.

VITAMIN D STATUS OF AMERICAN ADULTS AGE 18 YEARS AND OLDER: NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY and Kayla K. VITAMIN D STATUS OF AMERICAN ADULTS AGE 18 YEARS AND OLDER: NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY 2001-2002 and 2003-2004 Kayla K. Scherf A Thesis Submitted to the Graduate College of Bowling

More information

Outline. The Role of Vitamin D in CKD. Essential Role of Vitamin D. Mechanism of Action of Vit D. Mechanism of Action of Vit D 7/16/2010

Outline. The Role of Vitamin D in CKD. Essential Role of Vitamin D. Mechanism of Action of Vit D. Mechanism of Action of Vit D 7/16/2010 Outline The Role of Vitamin D in CKD Priscilla How, Pharm.D., BCPS Assistant Professor National University of Singapore Principal Clinical Pharmacist National University Hospital (Pharmacy and Nephrology,

More information