Does Vitamin D Sufficiency Equate to a Single Serum 25-Hydroxyvitamin D Level or Are Different Levels Required for Non-Skeletal Diseases?
Nutrients 2013, 5(12), 5127-5139; doi:10.3390/nu5125127
Simon Spedding 1,* , Simon Vanlint 2, Howard Morris 1,3 and Robert Scragg 4
1 Division of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
2 Discipline of General Practice, School of Population Health, University of Adelaide, Adelaide, SA 5005, Australia
3 SA Pathology, PO Box 14, Rundle Mall, Adelaide, SA 5000, Australia
4 School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
Comments by Vitamin D Life
Have noticed that some health problems require very high levels to treat
- Multiple Sclerosis 150 ng, Ato0immune 100 ng,
More vitamin D also needed to treat than to prevent, Perhaps due to
- Genes are altered by the disease (Cancer for example) which restrict the amount of vitamin D getting to the cells
- Disease consumes Vitamin D
- Disease makes for poor gut function, which reduces the amount of vitamin D getting to the blood
Download the PDF from Vitamin D Life
Objective: Clarify the concept of vitamin D sufficiency, the relationship between efficacy and vitamin D status and the role of Vitamin D supplementation in the management of non-skeletal diseases. We outline reasons for anticipating different serum vitamin D levels are required for different diseases. Method: Review the literature for evidence of efficacy of supplementation and minimum effective 25-hydroxyvitamin D (25-OHD) levels in non-skeletal disease. Results: Evidence of efficacy of vitamin supplementation is graded according to levels of evidence.
Minimum effective serum 25-OHD levels are lower for skeletal disease, e.g.,
- rickets (25 nmol/L),
- osteoporosis and fractures (50 nmol/L), than for
- premature mortality (75 nmol/L) or non-skeletal diseases, e.g.,
- depression (75 nmol/L),
- diabetes and cardiovascular disease (80 nmol/L),
- falls and respiratory infections (95 nmol/L) and
- cancer (100 nmol/L).
Conclusions: Evidence for the efficacy of vitamin D supplementation at serum 25-OHD levels ranging from 25 to 100 nmol/L has been obtained from trials with vitamin D interventions that change vitamin D status by increasing serum 25-OHD to a level consistent with sufficiency for that disease. This evidence supports the hypothesis that just as vitamin D metabolism is tissue dependent, so the serum levels of 25-OHD signifying deficiency or sufficiency are disease dependent.