Scientific Advisory Committee on Nutrition (SACN)
www.gov.uk/gov...
SACN vitamin D and health report
www.gov.uk/gov...
A reference nutrient intake (RNI) of 10 micrograms (400 units) of vitamin D per day, throughout the year, for everyone in the general population aged 4 years and older
The RNI and safe intakes were developed to ensure that the majority of the UK population has enough vitamin D to protect musculoskeletal health, all year round.
SACN did not take account of sunlight exposure in making recommendations because of the number and complexity of factors that affect skin synthesis of vitamin D.
Vitamin D
Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline (2011)
The Endocrine Society
www.endocrine.org
Journal of Clinical Endocrinology
pubmed.ncbi.nl...
Vitamin D deficiency is very common in all age groups
Few foods contain vitamin D
Task Force recommended supplementation, depending on age and clinical circumstances
Measurement of serum 25-hydroxyvitamin D level, in patients at risk for deficiency
Treatment with supplement recommended for deficient patients
www.healthline...
About 42% of the US population is vitamin D deficient
82% in black people
70% in Hispanics
Nutrients, 15 July 2020
www.mdpi.com/2...
Immunologic Effects of Vitamin D on Human Health and Disease
Calcium and phosphate metabolism, bones
1,25-dihydroxyvitamin D, active form of vitamin D
Immunomodulatory hormone
Innate and adaptive immune systems
Vitamin D receptor and enzymes in;
Lymphocytes
NKs
T lymphocytes
B lymphocytes
Monocytes
Macrophages
Dendritic cells
Vascular endothelial membrane stability
Association with low blood levels of 25-hydroxyvitamin D
Several immune-related diseases and disorders
Psoriasis,
Type 1 diabetes
Multiple sclerosis
Rheumatoid arthritis
Tuberculosis
Sepsis
Respiratory infection
COVID-19
Optimal Serum 25-hydroxyvitamin D
It is advisable to increase vitamin D intake and have sensible sunlight exposure
Maintain serum 25-hydroxyvitamin D at least,
30 ng/mL (75 nmol/L)
and preferably
40-60 ng/mL (100-150 nmol/L)
Recommended dosage for vitamin D intake in individuals who are at risk for vitamin D
Deficiency (1,000 iu = 25 mcg)
Age, years Daily requirement Upper limit
Years Requirement
0 - 1 400 - 1,000 2,000
1 - 18 600 - 1,000 4,000
18 + 1500- 2000 10,000
Obese 4,000 - 6000 10,000
For deficiency 0 - 1 year
2000 IU/day or 50,000 IU/week
of vitamin D2 or D3 for at least 6 weeks
to achieve serum 25(OH)D more than 30 ng/mL (75 nmol/L)
maintenance therapy of 400-1000 IU/d
For deficiency 1 - 18 years
2000 IU/day or 50,000 IU/week of vitamin D2 or D3 for at least 6 weeks
to achieve serum 25(OH)D more than 30 ng/mL (75 nmol/L)
maintenance therapy of 600-1000 IU/d
For deficiency after 18 years
6000 IU/day or 50,000 IU/week
of vitamin D2 or D3 for 8 weeks
to achieve serum 25(OH)D more than 30 ng/mL (75 nmol/L)
maintenance therapy of 1500 -2000 IU/d
Obese and malabsorptive patients
Dosage should be increased by 2-3 times
Respiratory Viral Infection and COVID-19
Outbreak of influenza infection is periodic and usually occurs during the wintertime at higher latitudes
but is sporadic throughout the year in the tropical area
Association between low level of serum 25(OH)D and
incidence and severity of respiratory tract infection in children and adults
A recent meta-analysis of 25 RCTs showed that supplementation of vitamin D2 or D3 can protect against the development of acute respiratory tract infection compared with placebo
www.bmj.com/co...
COVID
Rate of symptomatic infection, morbidity and mortality observed
African American
Obesity
Worldwide on average approximately 40% of children and adults have circulating levels of 25(OH)D less than 20 ng/mL (50 nmol/L)
It is therefore reasonable to institute as a standard of care to give at least one single dose of 50,000 of vitamin D to all COVID-19 patients as soon as possible after being hospitalized
2 окт 2024
