Diagnosis and treatment of vitamin D deficiency

J. J. Cannell, B. W. Hollis, M. Zasloff, R. P. Heaney

Research output: Contribution to journalReview article

144 Citations (Scopus)

Abstract

The recent discovery - in a randomised, controlled trial - that daily ingestion of 1100 IU of colecalciferol (vitamin D) over a 4-year period dramatically reduced the incidence of non-skin cancers makes it difficult to overstate the potential medical, social and economic implications of treating vitamin D deficiency. Not only are such deficiencies common, probably the rule, vitamin D deficiency stands implicated in a host of diseases other than cancer. The metabolic product of vitamin D is a potent, pleiotropic, repair and maintenance, secosteroid hormone that targets > 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. A common misconception is that government agencies designed present intake recommendations to prevent or treat vitamin D deficiency. They did not. Instead, they are guidelines to prevent particular metabolic bone diseases. Official recommendations were never designed and are not effective in preventing or treating vitamin D deficiency and in no way limit the freedom of the physician - or responsibility - to do so. At this time, assessing serum 25-hydroxy-vitamin D is the only way to make the diagnosis and to assure that treatment is adequate and safe. The authors believe that treatment should be sufficient to maintain levels found in humans living naturally in a sun-rich environment, that is, > 40 ng/ml, year around. Three treatment modalities exist: sunlight, artificial ultraviolet B radiation or supplementation. All treatment modalities have their potential risks and benefits. Benefits of all treatment modalities outweigh potential risks and greatly outweigh the risk of no treatment. As a prolonged 'vitamin D winter', centred on the winter solstice, occurs at many temperate latitudes, ≤ 5000 IU (125 μg) of vitamin D/day may be required in obese, aged and/ or dark-skinned patients to maintain adequate levels during the winter, a dose that makes many physicians uncomfortable.

Original languageEnglish
Pages (from-to)107-118
Number of pages12
JournalExpert Opinion on Pharmacotherapy
Volume9
Issue number1
DOIs
StatePublished - Jan 2008

Fingerprint

Vitamin D Deficiency
Vitamin D
Secosteroids
Therapeutics
Physicians
Medical Economics
Government Agencies
Metabolic Bone Diseases
Sunlight
Solar System
Genes
Neoplasms
Randomized Controlled Trials
Eating
Maintenance
Hormones
Guidelines
Radiation
Incidence
Serum

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Cannell, J. J., Hollis, B. W., Zasloff, M., & Heaney, R. P. (2008). Diagnosis and treatment of vitamin D deficiency. Expert Opinion on Pharmacotherapy, 9(1), 107-118. https://doi.org/10.1517/14656566.9.1.107

Diagnosis and treatment of vitamin D deficiency. / Cannell, J. J.; Hollis, B. W.; Zasloff, M.; Heaney, R. P.

In: Expert Opinion on Pharmacotherapy, Vol. 9, No. 1, 01.2008, p. 107-118.

Research output: Contribution to journalReview article

Cannell, JJ, Hollis, BW, Zasloff, M & Heaney, RP 2008, 'Diagnosis and treatment of vitamin D deficiency', Expert Opinion on Pharmacotherapy, vol. 9, no. 1, pp. 107-118. https://doi.org/10.1517/14656566.9.1.107
Cannell, J. J. ; Hollis, B. W. ; Zasloff, M. ; Heaney, R. P. / Diagnosis and treatment of vitamin D deficiency. In: Expert Opinion on Pharmacotherapy. 2008 ; Vol. 9, No. 1. pp. 107-118.
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