What are the implications of Vitamin D3 (cholecalciferol) deficiency?

From the Guidelines

Implications of Vitamin D3 Deficiency

Vitamin D3 deficiency has significant implications for overall health, particularly for bone health and immune function.

• The recommended daily intake of vitamin D3 is 600-800 IU (International Units) for adults, with a maximum tolerated dose of 4,000 IU per day 1.
• Vitamin D deficiency is defined as levels of 25(OH)D3 < 20 ng/ml, and vitamin D insufficiency as 20 – 30 ng/ml 1.
• Treatment for vitamin D deficiency typically involves supplementation with 1,000-2,000 IU of vitamin D3 per day for 2-3 months, followed by maintenance therapy with 600-800 IU per day 1.
• Vitamin D toxicity is uncommon but may occur with daily doses of more than 50,000 IU per day that produce 25(OH)D levels larger than 150 ng/mL 1.
• Medications such as ergocalciferol (Vitamin D2) and calcitriol (Rocaltrol) may also be prescribed in certain cases, with dosages ranging from 50,000 IU per week to 0.5-1.0 mcg per day 1.
• The Institute of Medicine recommends daily dietary vitamin D intake of 600 IU in adults aged 18 to 70 years and 800 IU in adults older than 70 years 1.
• Ultraviolet B exposure may also increase vitamin D levels, but it increases the risk for skin cancer associated with UVB radiation 1.
• Further research is needed to determine the cut point that defines vitamin D deficiency, the sensitivity and specificity of various assays, and whether total serum 25-(OH)D is the best measure of vitamin D deficiency in all populations 1.

From the FDA Drug Label

Vitamin D metabolites promote the active absorption of calcium and phosphorus by the small intestine, thus elevating serum calcium and phosphate levels sufficiently to permit bone mineralization Vitamin D metabolites also mobilize calcium and phosphate from bone and probably increase the reabsorption of calcium and perhaps also of phosphate by the renal tubules. The implications of Vitamin D3 (cholecalciferol) deficiency include:

• Impaired bone mineralization due to decreased absorption of calcium and phosphorus
• Abnormal bone development or disease, such as rickets, as indicated by the use of Cholecalciferol Tablets in the treatment of refractory rickets
• Hypocalcemia or hypophosphatemia due to decreased mobilization of calcium and phosphate from bone and decreased reabsorption by the renal tubules 2

From the Research

Implications of Vitamin D3 Deficiency

The implications of Vitamin D3 (cholecalciferol) deficiency are numerous and can have significant effects on overall health. Some of the key implications include:

• Increased risk of autoimmune diseases, such as multiple sclerosis, as suggested by the concept of acquired vitamin D resistance 3
• Increased risk of chronic liver diseases, such as fibrosis, due to the role of vitamin D in maintaining normal calcium levels and bone health development 4
• Increased risk of osteoporosis and bone diseases, as severe vitamin D deficiency can lead to a multitude of avoidable illnesses, including bone diseases 5
• Increased risk of cardiovascular diseases, such as hypertension, which is being discussed in relation to vitamin D deficiency 5
• Impaired muscle strength and function, as all parameters of muscle strength showed trends in improvements following the administration of vitamin D3 6

Health Consequences

The health consequences of vitamin D3 deficiency can be severe and far-reaching. Some of the key consequences include:

• Increased risk of illnesses, such as autoimmune diseases, bone diseases, and cardiovascular diseases 3, 4, 5
• Impaired muscle strength and function, which can affect overall quality of life 6
• Increased risk of fibrosis and other chronic liver diseases, which can have significant effects on liver function and overall health 4
• Increased healthcare costs, which can result from the inadequate vitamin D status 5

Prevalence of Vitamin D3 Deficiency

The prevalence of vitamin D3 deficiency is a significant public health concern, with many populations around the world experiencing inadequate vitamin D levels. Some of the key findings include:

• 6.7% of papers report 25-hydroxyvitamin D plasma levels below 25 nmol/L, which indicates vitamin D deficiency 5
• 37.3% of papers report 25-hydroxyvitamin D plasma levels below 50 nmol/L, which is considered insufficient 5
• Only 11.9% of papers report 25-hydroxyvitamin D plasma levels above 75 nmol/L, which is the target level suggested by vitamin D experts 5