Table of Recommended Dosages of Vitamin D. Www.endo-society.org/guidelines/final/upload/FINAL-Standalone-Vitamin-D-Guideline.pdf. To address the compelling need for state-of-the-art endocrine Clinical Practice Guidelines (CPGs), the Society has implemented a rigorous and innovative guideline development process. The Society selects topics by examining existing available guidelines and only undertakes development of those subjects for which there are no guidelines or where existing guidelines are either out of date or do not meet the needs of our members. Ordering Information Individual guidelines may be purchased on our online store. Commercial Reprints of Society guidelines are available for order (100 copies or more). Current Guidelines. Vitamin D Deficiency in Adults: When to Test and How to Treat. Dietary Supplement Fact Sheet: Vitamin D. Introduction See QuickFacts for easy-to-read facts about Vitamin D.
Vitamin D 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 D synthesis. Vitamin D 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 D 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 D [1,25(OH)2D], also known as calcitriol [1]. Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. Serum concentration of 25(OH)D is the best indicator of vitamin D status. The U.S. Tijd voor herijking GR-advies vitamine D. Het Amerikaanse Institute of Medicine (IOM) bracht vorige maand nieuwe voedingsnormen uit voor vitamine D.
Deze wijken flink af van de aanbevelingen van de Gezondheidsraad (GR) uit 2008. beeld: Thinkstock Als aanbevolen dagelijkse hoeveelheid vitamine D voor mensen tussen de 1 en de 70 jaar adviseert het IOM nu 600 IE, een verdrievoudiging van de Nederlandse aanbeveling. De Amerikanen hebben de bloedspiegel van vitamine D (25(OH)D) nu vastgesteld op minimaal 50 nmol/l, ongeacht leeftijd en geslacht. Vitamine D wordt geassocieerd met een heleboel mogelijk gunstige effecten, onder meer tegen kanker, hart- en vaatziekten, hypertensie, diabetes, psychische gesteldheid en pre-eclampsie.
Mikky Jöbsis Het artikel: Dietary Reference Intakes for Calcium and Vitamin D Een groep Nederlandse artsen vindt het tijd dat de GR zijn vitamine D-advies herziet: Tijd voor herijking GR advies vitamine D Op 30 november 2010 verschenen de Vitamine D voedingsnormen van het Amerikaanse Institute of Medicine (IOM)1. News Article : Endocrinologists Release Vitamin D Guidelines.
BETHESDA, MD 27 Jun 2011—For optimal health, Americans should maintain a serum vitamin D level of 30–60 ng/mL, a feat that probably requires the use of supplements, according to new clinical practice guidelines from the Endocrine Society. The guidelines appear in the July issue of the Journal of Clinical Endocrinology and Metabolism. Vitamin D insufficiency is defined in the guidelines as a serum 25-hydroxyvitamin D level of 21–29 ng/mL, and vitamin D deficiency occurs when levels are below 20 ng/mL. Studies of vitamin D deficiency and insufficiency cited in the guidelines give variable estimates of the conditions, with rates in different populations ranging from 20% to 100%. The guidelines state that the major cause of vitamin D deficiency is inadequate exposure to natural sunlight. Decreased sun exposure and the use of sunscreens reduce the risk of skin cancer but also sharply limit the production of vitamin D in the skin, the guidelines explain. How much?
IOM. Overzicht Ref. waarden Vit.D3 (25 - OH) Vitamin D guidelines - Imperial Centre for Endocrinology. Loading dose over 3 months: Prescribe colecalciferol (Dekristol) 20,000 IU capsules, one capsule weekly for 12 weeks, then go on to maintenance dose. Consider giving IM ergocalciferol 300,000 IU two injections spaced by 3 months if there are concerns regarding absorption (e.g. in malabsorption). Maintenance dose: Usually between 1000-2000 IU colecalciferol per day depending on weight, e.g. Holland and Barrett Vitamin D3 25 microgram tablets, 1-2 tablets a day, or colecalciferol (Dekristol) 20,000 IU capsules, one capsule every 2 weeks. Higher doses may be required e.g. if the patient is taking drugs that accelerate Vitamin D metabolism or if there are concerns regarding absorption. Maintenance should be continued so long as risk factors for Vitamin D deficiency are present.
Notes on dosing: Note: If the patient is hypercalcaemic they should be referred to the local Endocrinology service for further evaluation. D3 is generally preferred as D2 may be less potent than D3, unit for unit. Monitoring: