Hypervitaminosis D in Kashmiri Population: A Case Series of 11 Patients

Sath, Sulaiman; Shah, Siddharth; Rafiq, Syed Nadeem; Jeelani, Irtifa

doi:10.14445/23939117/ijms-v3i2p101

Cited by 6 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…), to assess the overall vitamin D/calcium status. Properly utilizing these data could provide cost-beneficial approaches for patients and maximize efficacy while minimizing adverse effects [ 149 ]. Considering the high cost of 25(OH)D measurements and their unavailability to most people worldwide, laboratory testing is not essential [ 20 ].…”

Section: Pharmacodynamics and The Underlying Mechanisms Of Calcitriolmentioning

confidence: 99%

Physiological Basis for Using Vitamin D to Improve Health

Wimalawansa

2023

Biomedicines

View full text Add to dashboard Cite

Vitamin D is essential for life—its sufficiency improves metabolism, hormonal release, immune functions, and maintaining health. Vitamin D deficiency increases the vulnerability and severity of type 2 diabetes, metabolic syndrome, cancer, obesity, and infections. The active enzyme that generates vitamin D [calcitriol: 1,25(OH)2D], CYP27B1 (1a-hydoxylase), and its receptors (VDRs) are distributed ubiquitously in cells. Once calcitriol binds with VDRs, the complexes are translocated to the nucleus and interact with responsive elements, up- or down-regulating the expression of over 1200 genes and modulating metabolic and physiological functions. Administration of vitamin D3 or correct metabolites at proper doses and frequency for longer periods would achieve the intended benefits. While various tissues have different thresholds for 25(OH)D concentrations, levels above 50 ng/mL are necessary to mitigate conditions such as infections/sepsis, cancer, and reduce premature deaths. Cholecalciferol (D3) (not its metabolites) should be used to correct vitamin D deficiency and raise serum 25(OH)D to the target concentration. In contrast, calcifediol [25(OH)D] raises serum 25(OH)D concentrations rapidly and is the agent of choice in emergencies such as infections, for those who are in ICUs, and for insufficient hepatic 25-hydroxylase (CYP2R1) activity. In contrast, calcitriol is necessary to maintain serum-ionized calcium concentration in persons with advanced renal failure and hypoparathyroidism. Calcitriol is, however, ineffective in most other conditions, including infections, and as vitamin D replacement therapy. Considering the high costs and higher incidence of adverse effects due to narrow therapeutic margins (ED50), 1α-vitamin D analogs, such as 1α-(OH)D and 1,25(OH)2D, should not be used for other conditions. Calcifediol analogs cost 20 times more than D3—thus, they are not indicated as a routine vitamin D supplement for hypovitaminosis D, osteoporosis, or renal failure. Healthcare workers should resist accepting inappropriate promotions, such as calcifediol for chronic renal failure and calcitriol for osteoporosis or infections—there is no physiological rationale for doing so. Maintaining the population’s vitamin D sufficiency (above 40 ng/mL) with vitamin D3 supplements and/or daily sun exposure is the most cost-effective way to reduce chronic diseases and sepsis, overcome viral epidemics and pandemics, and reduce healthcare costs. Furthermore, vitamin D sufficiency improves overall health (hence reducing absenteeism), reduces the severity of chronic diseases such as metabolic and cardiovascular diseases and cancer, decreases all-cause mortality, and minimizes infection-related complications such as sepsis and COVID-19-related hospitalizations and deaths. Properly using vitamin D is the most cost-effective way to reduce chronic illnesses and healthcare costs: thus, it should be a part of routine clinical care.

show abstract

Section: Pharmacodynamics and The Underlying Mechanisms Of Calcitriolmentioning

confidence: 99%

Physiological Basis for Using Vitamin D to Improve Health

Wimalawansa

2023

Biomedicines

View full text Add to dashboard Cite

show abstract

“…Research has claimed that its dysregulation can lead to the development of numerous diseases, affecting the cardiovascular system, musculoskeletal system, and nervous system. [35][36][37][38][39] Optimal health benefits of exogenous and endogenous vitamin D might not be achieved without the adequate presence of magnesium, as the bioactivity of vitamin D is a magnesium-dependent process. 33,34 The purpose of this review article is to present the biological significance of magnesium in vitamin D metabolism and its therapeutic importance to minimize complications related to vitamin D deficiency.…”

mentioning

confidence: 99%

Role of Magnesium in Vitamin D Activation and Function

Uwitonze¹,

Razzaque²

2018

J Am Osteopath Assoc

273

207

View full text Add to dashboard Cite

Nutrients usually act in a coordinated manner in the body. Intestinal absorption and subsequent metabolism of a particular nutrient, to a certain extent, is dependent on the availability of other nutrients. Magnesium and vitamin D are 2 essential nutrients that are necessary for the physiologic functions of various organs. Magnesium assists in the activation of vitamin D, which helps regulate calcium and phosphate homeostasis to influence the growth and maintenance of bones. All of the enzymes that metabolize vitamin D seem to require magnesium, which acts as a cofactor in the enzymatic reactions in the liver and kidneys. Deficiency in either of these nutrients is reported to be associated with various disorders, such as skeletal deformities, cardiovascular diseases, and metabolic syndrome. It is therefore essential to ensure that the recommended amount of magnesium is consumed to obtain the optimal benefits of vitamin D.

show abstract

“…Adicionalmente, a hipercalcemia crônica pode levar à formação de cálculos e nefrocalcinose (17,39). Relatos de casos discutindo quadros como este, têm sido cada vez mais descritos na literatura, sobretudo, em decorrência de uma conjunção de fatores como: a automedicação estimulada por uma legislação que permite o fácil acesso da população a suplementos vitamínicos, a prescrição de altas doses dessa vitamina por profissionais de saúde sem antes se estabelecer um diagnóstico preciso, além da manipulação deste insumo quando em desacordo as BPM (9,(14)(15)(16)(17)(18)(19)(20). .…”

Section: Forma Farmacêuticaunclassified

“…Há a probabilidade de ocorrer intoxicação quando doses superiores a 10.000 UI de Vitamina D2 ou D3/dia são administradas por vários meses a anos (13). Assim, uma dose tóxica de Vitamina D mediante a suplementação é uma possibilidade real, haja vista, inclusive, que vários relatos de caso têm sido publicados, associando efeitos colaterais tóxicos vinculados a altas dosagens de vitamina D (14)(15)(16)(17)(18). Adicionalmente, outros relatos de caso envolvem a intoxicação por colecalciferol em decorrência de erros na manipulação (9,19,20 A dispensação de medicamentos na farmácia magistral é de particular importância, visto que é possível manipular ativos em diferentes dosagens, associações e formas farmacêuticas, a depender da prescrição (23).…”

Section: Introductionunclassified

Colecalciferol: Uma Análise Crítica De Produtos Manipulados E Industrializados

Chagas

Ferrucci

Carvalho

et al. 2018

Infarma

View full text Add to dashboard Cite

Profissionais de saúde tem prescrito cada vez mais vitamina D, visto que sua deficiência representa um problema de saúde coletiva mundial. Adicionalmente, indivíduos têm utilizado esta substância para outros fins além daqueles ligados ao metabolismo mineral, apesar da escassez de dados científicos sobre seu papel na prevenção de outras doenças. Este trabalho analisou a prescrição, manipulação e uso do colecalciferol em apresentações magistrais e comerciais nacionais. Farmácias magistrais de Recife, PE informaram as formas farmacêuticas manipuladas contendo colecalciferol para administração oral; consultas eletrônicas ao site da Anvisa e ao software INTUITIVE®, utilizado pela Farmácia Escola Carlos Drummond de Andrade (FECDA), permitiram que as apresentações comerciais/manipuladas, no período do estudo, fossem elencadas e analisadas. Foram realizadas consultas a bases de dados visando estabelecer uma análise crítica e atual diante dos achados. Foi verificada uma ampla preocupação no estabelecimento dos níveis sanguíneos adequados desta vitamina na população por parte dos profissionais de saúde habilitados, visto que 29 diferentes especialistas prescreveram colecalciferol manipulado. Também foi constatada uma maior quantidade de dosagens e formas farmacêuticas magistrais quando comparadas com as apresentações comerciais do mercado nacional. No mais, garantir que estas prescrições estejam embasadas nas necessidades de cada paciente, requer exames sanguíneos e utilização de guias reconhecidos, o que, associado ao acompanhamento farmacoterapêutico, poderá contribuir para o sucesso terapêutico.

show abstract

Hypervitaminosis D in Kashmiri Population: A Case Series of 11 Patients

Cited by 6 publications

References 18 publications

Physiological Basis for Using Vitamin D to Improve Health

Physiological Basis for Using Vitamin D to Improve Health

Role of Magnesium in Vitamin D Activation and Function

Colecalciferol: Uma Análise Crítica De Produtos Manipulados E Industrializados

Contact Info

Product

Resources

About