Vitamin d and calcium side effects: Page not available – PMC

22.08.202328.06.2023 by alexxlab

Содержание

Vitamin D – NHS

Vitamin D helps regulate the amount of calcium and phosphate in the body.

These nutrients are needed to keep bones, teeth and muscles healthy.

A lack of vitamin D can lead to bone deformities such as rickets in children, and bone pain caused by a condition called osteomalacia in adults.

Government advice is that everyone should consider taking a daily vitamin D supplement during the autumn and winter.

People at high risk of not getting enough vitamin D, all children aged 1 to 4, and all babies (unless they’re having more than 500ml of infant formula a day) should take a daily supplement throughout the year.

Information:

There have been some reports about vitamin D reducing the risk of coronavirus (COVID-19). But there is currently not enough evidence to support taking vitamin D solely to prevent or treat COVID-19.

Good sources of vitamin D

From about late March/early April to the end of September, most people should be able to make all the vitamin D they need from sunlight.

The body creates vitamin D from direct sunlight on the skin when outdoors.

But between October and early March we do not make enough vitamin D from sunlight. Read more about vitamin D and sunlight.

Vitamin D is also found in a small number of foods.

Sources include:

oily fish – such as salmon, sardines, herring and mackerel
red meat
liver
egg yolks
fortified foods – such as some fat spreads and breakfast cereals

Another source of vitamin D is dietary supplements.

In the UK, cows’ milk is generally not a good source of vitamin D because it is not fortified, as it is in some other countries.

How much vitamin D do I need?

From about late March/early April to the end of September, the majority of people should be able to make all the vitamin D they need from sunlight on their skin.

Children from the age of 1 year and adults need 10 micrograms of vitamin D a day. This includes pregnant and breastfeeding women, and people at risk of vitamin D deficiency.

Babies up to the age of 1 year need 8.5 to 10 micrograms of vitamin D a day.

A microgram is 1,000 times smaller than a milligram (mg). The word microgram is sometimes written with the Greek symbol μ followed by the letter g (μg).

Sometimes the amount of vitamin D is expressed as International Units (IU). 1 microgram of vitamin D is equal to 40 IU. So 10 micrograms of vitamin D is equal to 400 IU.

Should I take a vitamin D supplement?

Advice for adults and children over 4 years old

During the autumn and winter, you need to get vitamin D from your diet because the sun is not strong enough for the body to make vitamin D.

But since it’s difficult for people to get enough vitamin D from food alone, everyone (including pregnant and breastfeeding women) should consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter.

Between late March/early April to the end of September, most people can make all the vitamin D they need through sunlight on their skin and from a balanced diet.

You may choose not to take a vitamin D supplement during these months.

People at risk of vitamin D deficiency

Some people will not make enough vitamin D from sunlight because they have very little or no sunshine exposure.

The Department of Health and Social Care recommends that adults and children over 4 take a daily supplement containing 10 micrograms of vitamin D throughout the year if they:

are not often outdoors – for example, if they’re frail or housebound
are in an institution like a care home
usually wear clothes that cover up most of their skin when outdoors

If you have dark skin – for example you have an African, African-Caribbean or south Asian background – you may also not make enough vitamin D from sunlight.

You should consider taking a daily supplement containing 10 micrograms of vitamin D throughout the year.

Advice for infants and young children

The Department of Health and Social Care recommends that babies from birth to 1 year of age should have a daily supplement containing 8.5 to 10 micrograms of vitamin D throughout the year if they are:

breastfed
formula-fed and are having less than 500ml (about a pint) of infant formula a day, as infant formula is already fortified with vitamin D

Children aged 1 to 4 years old should be given a daily supplement containing 10 micrograms of vitamin D throughout the year.

You can buy vitamin D supplements or vitamin drops containing vitamin D (for under 5s) at most pharmacies and supermarkets.

Women and children who qualify for the Healthy Start scheme can get free supplements containing vitamin D.

See the Healthy Start website for more information.

What happens if I take too much vitamin D?

Taking too many vitamin D supplements over a long period of time can cause too much calcium to build up in the body (hypercalcaemia). This can weaken the bones and damage the kidneys and the heart.

If you choose to take vitamin D supplements, 10 micrograms a day will be enough for most people.

Do not take more than 100 micrograms (4,000 IU) of vitamin D a day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11 to 17 years.

Children aged 1 to 10 years should not have more than 50 micrograms (2,000 IU) a day. Infants under 12 months should not have more than 25 micrograms (1,000 IU) a day.

Some people have medical conditions that mean they may not be able to safely take as much. If in doubt, you should consult your doctor.

If your doctor has recommended you take a different amount of vitamin D, you should follow their advice.

You cannot overdose on vitamin D through exposure to sunlight. But always remember to cover up or protect your skin if you’re out in the sun for long periods to reduce the risk of skin damage and skin cancer.

Page last reviewed: 03 August 2020
Next review due: 03 August 2023

calcium and vitamin D combination

Skip to main navigation

Skip to footer

For

Medicare

For

Providers

For

Brokers

For

Employers

Español

For Individuals & Families:

For Individuals & Families

Medical

Dental

Other Supplemental

Explore coverage through work

How to Buy Health Insurance

Types of Dental Insurance

Open Enrollment vs. Special Enrollment

See all topics

Shop for Medicare plans

Member Guide

Find a Doctor

HomeKnowledge CenterWellness Library
calcium and vitamin D combination

What is the most important information I should know about calcium and vitamin D combination?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is calcium and vitamin D combination?

Calcium is a mineral that is necessary for many functions of the body, especially bone formation and maintenance. Vitamin D helps the body absorb calcium.

Calcium and vitamin D combination is used to treat or prevent a calcium deficiency.

There are many brands and forms of calcium and vitamin D combination available. Not all brands are listed on this leaflet.

Calcium and vitamin D combination may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking calcium and vitamin D combination?

Ask a doctor or pharmacist if this medicine is safe to use if you have:

kidney disease;
kidney stones;
heart disease;
cancer;
high levels of calcium in your blood;
circulation problems; or
a parathyroid gland disorder.

Ask a doctor before using this product if you are pregnant or breast-feeding. Your dose needs may be different during pregnancy or while you are nursing.

How should I take calcium and vitamin D combination?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Check the label of your calcium and vitamin D combination product to see if it should be taken with or without food.

Take the regular tablet with a full glass of water.

The chewable tablet must be chewed before you swallow it.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Calcium and vitamin D may be only part of a complete program of treatment that also includes dietary changes. Learn about the foods that contain calcium and vitamin D.

Your supplement dose may need to be adjusted as you make changes to your diet. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking calcium and vitamin D combination?

Ask a doctor or pharmacist before taking any multivitamins, mineral supplements, or antacids while you are taking calcium and vitamin D combination.

What are the possible side effects of calcium and vitamin D combination?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have signs of too much calcium in your body, such as:

nausea, vomiting, constipation;
increased thirst or urination;
muscle weakness, bone pain; or
confusion, lack of energy, or feeling tired.

Common side effects may include:

an irregular heartbeat;
weakness, drowsiness, headache;
dry mouth, or a metallic taste in your mouth; or
muscle or bone pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect calcium and vitamin D combination?

Calcium can make it harder for your body to absorb certain medicines, and some medicines can make it harder for your body to absorb vitamin D. If you take other medications, take them at least 2 hours before or 4 to 6 hours after you take calcium and vitamin D combination.

Other drugs may affect calcium and vitamin D combination, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

<cipublic-spinner variant=”large”><span>Loading…</span></cipublic-spinner>

Calcium and vitamin D: analysis of possible positive and negative side effects of their use | Nikitinskaya O.A., Toroptsova N.V.

Osteoporosis is one of the most serious and common diseases, especially among women, associated with disability and mortality. Osteoporotic fractures in women occur more frequently than myocardial infarction, stroke, breast cancer [1], and with age there is an increase in the frequency of fractures in both women and men. The lifetime risk of a fracture is 47% in women and 22% in men [2].

Calcium and vitamin D supplements are widely used to prevent and treat osteoporosis. This is determined by the fact that calcium is the main element, along with phosphorus, which is part of the mineral component of the bone – hydroxyapatite, and vitamin D takes an active part in calcium homeostasis in the body. Throughout life, a person constantly needs calcium. It should be remembered that calcium intake should be constantly increased with age in children. The maximum falls on the age of formation of peak bone mass, i.e. for 20 years, the next important stage is the periods of pregnancy, lactation, the onset of menopause in women and the aging of the body, which again requires an increase in calcium intake from food to 1200-1500 mg / day.
Adequate calcium intake during childhood and adolescence is the most important factor for achieving optimal bone mass and size. Lack of calcium during growth leads to a decrease in peak bone mass, which can lead to an increased risk of fractures, even in young people. There is evidence that bone mineral density (BMD) in adult women is directly related to milk intake during childhood and adolescence, and peak bone mass gains of up to 10% can be achieved through adequate calcium intake in childhood. Such an increase in BMD during the formation of peak bone mass can reduce the risk of femoral fractures in later life by 25–50%.
The main source of calcium is milk and dairy products, which contain it not only in maximum quantities, but also in a form that is easier for transport and absorption in the intestines. It is believed that the bioavailability of calcium in food is about 30% with a high individual variability in this value. It should be borne in mind that the actual intake of calcium from food has been declining in recent years due to the desire of the population to adhere to a low-calorie and low-cholesterol diet and varies significantly depending on the country. According to our data obtained through a survey in Moscow, 450 individuals aged 50 years and older average intake of dietary calcium was 680 mg/day, which is half the amount recommended for intake at this age. Questionnaire 1109health workers, conducted by Shilin D.E. et al. in 27 regions of Russia, aged 25–50 also showed low calcium intake among 82% of respondents [3]. Therefore, the intake of calcium with pharmacological additives is relevant for our country.
Vitamin D is directly involved in the regulation of bone remodeling, calcium absorption in the intestine and its excretion by the kidneys. Hypovitaminosis D is associated with a negative calcium balance, decreased bone mineralization, as well as muscle weakness and back pain. Vitamin D deficiency is usually the result of insufficient insolation, which is associated with seasonal deficiency, or insufficient dietary intake. Of the foods richest in vitamin D fatty fish (herring, mackerel, salmon), and in dairy products and eggs it contains a small amount.
Loss of BMD in the elderly is often associated with secondary hyperparathyroidism, which may be partly explained by vitamin D deficiency. this concentration of vitamin D has been shown to reduce the risk of fractures in older men and women [4]. When studying the level of vitamin D in postmenopausal women living in Moscow, we showed that the average level of 25(OH)D was 45. 5 nmol/l, while about 65% of women had severe hypovitaminosis D. We also noted significant fluctuations in the level of vitamin D depending on the season of blood sampling: in December-March, its concentration was 41.4 nmol/l and was significantly lower than in August-October – 60.6 nmol/l (p<0.0001). Thus, vitamin D deficiency requires a compensatory intake of it from the outside, however, with food or by production in the skin during insolation, this is unlikely to be in sufficient quantities, which suggests its additional prescription as a drug to prevent bone loss.
The positive role of calcium and vitamin D intake in reducing the risk of fractures was shown in a meta-analysis based on data from 53,260 patients who participated in 9 RCTs [5]. In 6 RCTs, patients received vitamin D at a dose of 700-800 IU, and in 3 others – 400 IU, in combination with calcium (500-1200 mg / day) or without it, and the duration of therapy was from 24 to 84 months.
In studies in which patients received only vitamin D or placebo, there was no reduction in the risk of peripheral fractures as with a dose of 400 IU (RR 1. 14 [95% CI 0.87-1.49]), so when using 700-800 IU (RR 1.04 [95% CI 0.75-1.46]), which confirms previously reported data that vitamin D without added calcium does not reduce the risk of fractures.
Combination treatment with vitamin D (400 or 700–800 IU/day) and calcium showed a significant 18% reduction in the risk of hip fracture [(RR 0.82 (95% CI 0.71–0.94), p=0 .0005] and a 12% risk of peripheral fractures [(RR 0.88 (95% CI 0.78–0.99), p = 0.036] in treatment groups compared with placebo/no treatment groups. In studies where Vitamin D at 700–800 IU/day had a greater effect on hip fracture risk than 400 IU (21% vs. 18%, respectively).
Thus, studies in recent years have shown that calcium plays an important role in preventing the risk of fractures when it is used in combination with vitamin D, the dose of which should be at least 800 IU / day. This combination reduces the risk of fractures only in the case of 75-80% patient compliance. Currently, only Calcium-D3 Nycomed Forte in 2 tablets contains 800 IU of vitamin D and 1000 mg of elemental calcium. Our study on the long-term use of this drug showed that it is an effective way to prevent OP in postmenopausal women: it increases the BMD of the spine and reduces bone loss in the femoral neck, reduces pain in the spine, which leads to an increase in the physical activity of patients. It is well tolerated and does not increase the risk of kidney stones.
At the same time, calcium plays a key role in a number of other functions of the body, such as cell division and differentiation, conduction of nerve impulses, in the contraction-relaxation cycle of smooth and striated muscles, transmembrane ion reactions, the activity of neurosecretory organs, the production and effects of certain hormones, enzymes and other biologically active substances, blood coagulation system and others. In recent decades, interest has also increased in the extraskeletal effects of vitamin D in connection with the discovery of vitamin D receptors (VDR) and the enzyme 1-a-hydroxylase in various tissues of the body, including cells of the pancreas, immune system, macrophages, vascular endothelium, stomach, and epidermis. , colon and placenta [6]. In these tissues locally 25-hydroxyvitamin D (25(OH)D) is converted into 1,25-dihydroxyvitamin D (1,25(OH)2D), without increasing the level of 1,25(OH)2D in the blood serum. It was shown that 1,25(OH)2D affects gene expression in local tissue, determining its paracrine effect.
In recent years, doctors dealing with the problem of osteoporosis have received great interest in possible side effects when prescribing calcium and vitamin D, and in the first place, possible complications from the cardiovascular system (CVS). At the same time, it has been suggested that high calcium intake may have a positive effect on CVS, since oral calcium in healthy postmenopausal women changes the ratio of high density lipoproteins to low density lipoproteins by almost 20% [7]. However, the results of some studies show that calcium intake reduces the risk of cardiovascular disease (CVD), the data of others – its intake is associated with an increase in the risk of CVD. Thus, the Boston nurses health study showed that women with high calcium intake have a 30% lower risk of ischemic stroke (OR = 0. 69; 95%; 0.5–0.95) compared to those who consumed less calcium [8]. A low risk of cardiovascular diseases has been noted in those regions where the population uses water with a high calcium content [9]. Another study by the Women’s Health Initiative (WHI) did not find a negative effect of calcium supplementation on the risk of CVD in women over 62 years of age [10], but this study must take into account such factors as low adherence to treatment, widespread use of vascular drugs and estrogen.
Another 5-year RCT assessed the risk of CVD in healthy women taking 1 g of calcium citrate (average age 74 years). Significantly more cases of myocardial infarction (MI; p=0.01) were identified, but no increase in the number of strokes (p=0.076) was demonstrated compared with individuals who did not take calcium supplements. When all CVD events (including MI, stroke, sudden death) were pooled, the risk was higher in individuals treated with calcium citrate. Because of the importance of finding a negative role for calcium, the investigators performed an additional search in New Zealand’s national database on hospital admissions of these women for CVD that they may not have reported when they visited the study site. As a result, the significance of the obtained results was at the limit of reliability (p about 0.05). When comparing patients with compliance greater than 60% and the placebo group, there was no increase in the risk of sudden death in individuals receiving calcium. An independent risk factor for CV complications of calcium therapy was the presence of a history of coronary artery disease. In addition, this study had several limitations, most notably the small number of participants for the CV risk study, which were healthy postmenopausal women, 10% of participants were over 80 years of age at enrollment. Similar data were obtained in the study of the appointment of calcium preparations in chronic renal failure, in patients on hemodialysis. Therefore, it can be assumed that older patients may also have had renal insufficiency, and the administration of calcium led to calcification of already altered vessels. This study showed that calcium should be prescribed according to indications, taking into account the presence of comorbidities, including CVD [11].
At the same time, observational cohort studies have demonstrated that calcium has a positive effect on reducing mortality rates. Thus, in the Iowa women’s health study, it was shown that postmenopausal women who received high doses of calcium from food or pharmacological preparations had a 30% lower mortality due to CVD compared with those who received lower doses of calcium [12]. Another UK study found a high inverse correlation between calcium intake and CHD mortality [13].
There is evidence that vitamin D also plays a role in reducing mortality in the population. Thus, in the prospective observational study Third National Health and Nutrition Examination Survey (NHANES III) in adults over the age of 65 years, the risk of all-cause mortality was 45% lower in those study participants whose serum vitamin D level was above 40 ng / ml compared with those individuals whose level did not exceed 10 ng/ml (HR=0.55; 95%, 0.34–0.88) [14]. On the other hand, the results of a meta-analysis of 18 randomized clinical trials (RCTs), in which postmenopausal women took vitamin D at a dose of 300 to 2000 IU / day, showed a decrease in mortality in those who received vitamin D by only 7% (RR = 0 ,93; 95%, 0. 87–0.99) [15]. This difference in mortality reduction in these studies may be due to the fact that there are some differences between RCTs and observational studies. First, the sample size in the RCTs is significantly smaller than in the observational study presented. Second, the primary purpose of most RCTs is other than mortality assessment, so most of these studies are not included in meta-analyses.
The reduction in mortality in observational studies is a reflection, for the most part, of mortality due to cardiovascular events. Thus, in NHANES III, those participants in the study whose serum vitamin D level was above 40 ng/mL had a 58% lower mortality due to CVD compared with those whose vitamin D level was less than 10 ng/mL (HR =0.42;95%, 0.21–0.85) [16]. Similar results were obtained in another observational 8-year cohort study: patients whose vitamin D values were in the high quartile (mean level 28 ng/ml) had lower mortality (HR=0.45; 95%, 0.32 –0.64) compared with those with vitamin D levels in the low quartile (mean level 8 ng/mL) [17].
The NHANES III study also showed an association between vitamin D levels and blood pressure (BP). For example, adolescents with serum vitamin D levels less than 15 ng/mL were twice as likely to have elevated blood pressure compared with those with vitamin D levels greater than 26 ng/mL (OR = 2.4; 95%, 1.3–4.2) [18]. Among adults in the same study, the mean systolic pressure was 3 mmHg and diastolic was 1.6 mmHg. lower in individuals with serum vitamin D (25(OH)D) levels ≥ 85.7 nmol/l compared with those with 25(OH)D levels ≤ 40 nmol/l [19]. Also, this study showed a statistically significant association between the concentration of 25(OH)D and a decrease in systolic pressure [20], between the level of 25(OH)D and various risk factors for CVD, including arterial hypertension (AH) in adults [21]. The level of 25(OH)D was significantly lower in women aged 60 years and older, patients with obesity, hypertension and diabetes mellitus. Hypertension among US adults was 30% more common among those with serum vitamin D levels in the low quintile compared to those with serum levels in the high quintile. Thus, an increase in the risk of hypertension, diabetes mellitus, obesity, and an increase in triglyceride levels was noted in those participants whose serum vitamin D level was less than 21 ng/ml [22].
Two other prospective cohort studies, the Health Professionals’ Follow-Up Study (613 men) and Nurses’ Health Study (1198 women), examined the association between 25(OH)D levels and the risk of developing hypertension. It was shown that the relative risk of hypertension with plasma 25(OH)D <15 ng/ml compared with >30 ng/ml was 6.13 for men and 2.67 for women [23].
Interventional studies on the effect of calcium and vitamin D on the risk of CVD have also shown mixed results. For example, in the work of Krause R. et al. in 145 elderly women after 8 weeks. taking 800 IU of vitamin D3 and 1200 mg of calcium, blood pressure significantly decreased by 9.3%, while taking only calcium preparations reduced blood pressure by only 4% (p = 0.02) [24]. However, in another prospective study, an association between vitamin D intake and the risk of developing hypertension was not obtained [25]. There was also no reduction in BP or risk of hypertension in the Women’s Health Initiative (WHI) study after 7 years of follow-up in the 1,000 mg calcium and 400 IU daily vitamin D group compared with the placebo group, which may be due to poor treatment compliance. since only 60% of individuals took more than 80% of the amount of the prescribed drug, and the heterogeneity of the patients included in the study. At the same time, when analyzing in subgroups, it was found that the risk of developing hypertension was higher among individuals with low levels of vitamin D [26].
To date, numerous studies have demonstrated that calcium supplements not exceeding 1500 mg/day. do not increase the risk of stone formation. On the contrary, some studies have shown that low calcium intake contributes to the formation of stones. The protective effect of calcium may be due to the fact that it binds oxalates and phosphates in the intestine, preventing their excess excretion in the urine.
Among the positive effects of additional intake of vitamin D and calcium can be noted to reduce the risk of developing type 2 diabetes, which was shown in a large prospective cohort study [27].
In addition, there are data from 5 observational studies of vitamin D use in children that demonstrated that vitamin D supplements resulted in a 30% reduction in the risk of type 1 diabetes (OR = 0.71; 95%, 0.6–0). .84) [28].
Data have been obtained on another positive effect of daily intake of vitamin D 1100 IU and calcium 1400-1500 mg / day. in postmenopausal women at the risk of cancer of any localization. A study showed a 77% reduction in the risk of cancer of any location when taking calcium and vitamin D together, while taking vitamin D alone reduced the risk by only 35% [29].].
A meta-analysis of studies on the impact on the development of colon cancer showed that an increase in the level of 25 (OH) D in the blood serum for every 20 ng / ml reduces the chance of cancer by more than 40% (OR = 0.57; 95%, 0.43–0.76) [30]. Calcium intake is also associated with a reduced risk of colon cancer and adenomas, which has been shown in other studies [31]. Although it should be noted that the effect of taking a combination of calcium and vitamin D in reducing the risk of colon cancer has not been confirmed in all RCTs. For example, the WHI trial, which lasted approximately 8 years, failed to document this positive effect of combination therapy, which may be due to the fact that in this study patients received 400 IU of vitamin D, which may not be enough to achieve a protective effect [32] .
Breast cancer is also associated with vitamin D deficiency. A meta-analysis of 7 observational studies showed a lower risk of breast cancer among women who had higher levels of 25(OH)D (OR=0.57; 95%, 0.43– 0.76). As in the case of colon cancer, the risk of breast cancer decreased with calcium supplementation [33].
The appointment of vitamin D preparations also leads to a significant improvement in the psychological state of patients, a decrease in signs of depression [34].
The data presented on the use of calcium and vitamin D preparations show that their administration is justified in patients with reduced bone mineral density in order to prevent osteoporotic fractures. In addition, their appointment has a number of positive aspects due to the possible reduction in the risk of developing a number of comorbid conditions (cancer of any localization, diabetes mellitus). However, one should be aware of possible complications when taking them, and when prescribing, take into account the state of health of the elderly patient as a whole, as well as take into account calcium intake from food. The total intake of calcium from food and pharmacological supplements should not exceed 1800 mg/day.

Literature
1. Cumming SR, Black DM, Rubin SM. Lifetime risk of hip, Colles`, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern med, 1989; 149:2445–2448.
2. Kanis JA, Johnell O, Oden A, et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporosis Int, 2000; 11:669-674.
3. Shilin D.E., Shilin A.D., Adamyan L.V. Calcium intake in women of reproductive age: a pilot study in 27 subjects of the Russian Federation. III Russian congress on osteoporosis. Abstracts of reports. Yekaterinburg, 2008; pp. 48–49.
4. Dawson-Hughes B, Heaney RP, Holick MF, et al. Estimates of optimal vitamin D status. Osteoporosis Int, 2005; 16(7):713–716.
5. Boonen S, Lips P, Bouillon R, et al. Need for additional calcium to reduce the risk of hip fracture with Vitamin D supplementation: evidence from a comparative meta–analysis of randomized controlled trials. J Clin Endocrinol Metab, 2007; 92:1415-1423.
6. Plum LA, DeLuca HF. The functional metabolism and molecular biology of vitamin D action. In: Holick M.F., ed. Vitamin D: Physiology, Molecular Biology, and Clinical Applications. 2nd ed. New York, NY: Humana Press;2010:61–97.
7. Reid IR, Mason B, Horne A, Ames R, Clearwater J, Bava U, et al. Effects of calcium supplementation on serum lipid concentrations in normal older women: a randomized controlled trial. Am J Med 2002;112:343–7.
8. IsoH, Stampfer MJ, Manson JE, Rexrode K, Hennekens CH, ColditzGA, et al. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke 1999;30:1772–9.
9. Dawson EB, Frey MJ, Moore TD, McGanity WJ. Relationship of metal metabolism to vascular disease mortality rates in Texas. Am J Clin Nutr 1978;31:1188–97.
10. Hsia J, Heiss G, Ren H, Allison M, Dolan NC, Greenland P, et al. Calcium/vitamin D supplementation and cardiovascular events. Circulation 2007;115:846–54.
11. Bolland MJ, Barber PA, Doughty RN, Mason B et al. Vascular events in healthy older women receiving calcium supplementation: randomized controlled trial. BMJ 2008; 336:262-266.
12. Bostick RM, Kushi H, WuY, Meyer KA, Sellers TA, Folsom AR. Relationship of calcium, vitamin D, and dairy food intake to ischemic heart disease mortality among postmenopausal women. Am J Epidemiol1999;149:151–61.
13. Knox EG. Ischaemic–heart–disease mortality and dietary intake of calcium. Lancet 1973;ii:1465–7.
14. Ginde AA, Scragg R, Schwartz RS, Camargo CA Jr. Prospective study of serum 25–hydroxyvitamin D level, cardiovascular disease mortality, and all cause mortality in older U.S. adults. J Am Geriatr Soc. 2009; 57(9):1595–1603.
15. Autier P, Gandini S. Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med. 2007;167(16):1730–1737.
16. Ginde AA, Scragg R, Schwartz RS, Camargo CA Jr. Prospective study of serum 25–hydroxyvitamin D level, cardiovascular disease mortality, and all cause mortality in older U.S. adults. J Am Geriatr Soc. 2009;57(9):1595–1603.
17. Dobnig H, Pilz S, Scharnagl H, et al. Independent association of low serum 25-ydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med. 2008;168(12):1340–1349.
18. Reis JP, von Muhlen D, Miller ER III, Michos ED, Appel LJ. Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics. 2009;124(3):e371–e379
19. Scragg R., Sowers M., Bell C. Serum 25–hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. American Journal of Hypertension, 2007, vol. 20, no. 7, pp. 713–719.
20. Judd S. E., Nanes M. S., Ziegler T. R., Wilson P. W. F., and Tangpricha V. Optimal vitamin D status attenuates the age–associated increase in systolic blood pressure in white Americans: results from the Third National Health and Nutrition Examination Survey. The American Journal of Clinical Nutrition, 2008; vol. 87, no. 1, pp. 136–141.
21. Martins D., Wolf M., Pan D., et al. Prevalence of cardiovascular risk factors and the serum levels of 25–hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine, 2007; vol. 167, no. 11, pp. 1159–1165.
22. Martins D, Wolf M, Pan D, et al. Prevalence of cardiovascular risk factors and the serum levels of 25–hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2007;167(11):1159–1165.
23. Forman J.P., Giovannucci E. , Holmes M.D., et al. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension, 2007; vol. 49, no. 5, pp. 1063–1069.
24. Krause R., Buhring M., Hopfenmuller W., Holick M. F., and Sharma A. M., Ultraviolet B and blood pressure. The Lancet, 1998; vol. 352, no. 9129, pp. 709–710.
25. Forman J. P., Bischoff–Ferrari H. A., Willett W. C., Stampfer M. J., and Curhan G. C. Vitamin D intake and risk of incident hypertension: results from three large prospective cohort studies. Hypertension, 2005; .vol. 46, no. 4, pp. 676–682.
26. Margolis K. L., Ray R. M., Van Horn L., et al. Effect of calcium and vitamin D supplementation on blood pressure: the women’s health initiative randomized trial. Hypertension, 2008; vol. 52, no. 5, pp. 847–855.
27. Pittas AG, Dawson-Hughes B, Li T, et al. Vitamin D and calcium in–take in relation to type 2 diabetes in women. Diabetes Care. 2006;29(3):650–656.
28. Zipitis CS, Akobeng AK. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta–analysis. Arch DisChild. 2008;93(6):512–517.
29. (Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: Results of a randomized trial. Am J Clin Nutr 2007; 85:1586–91.
30. Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Metaanalysis: longitudinal studies of serum vitamin D and colorectal cancer risk. Aliment Pharmacol Ther. 2009;30(2):113–125.
31. Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Meta-analysis: longitudinal studies of serum vitamin D and colorectal cancer risk. Aliment Pharmacol Ther. 2009;30(2):113–125.
32. Wactawski–Wende J, Kotchen JM, Anderson GL, et al. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med. 2006;354(7):684–696.
33. Yin L, Grandi N, Raum E, Haug U, Arndt V, Brenner H. Meta-analysis: longitudinal studies of serum vitamin D and colorectal cancer risk. Aliment Pharmacol Ther. 2009;30(2):113–125.
34. Jorde R, Sneve M, Figenschau Y, Svartberg J, Waterloo K. Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008;264(6):599–609.

Nutrition and sleep: Taking care of yourself: Lenta.ru

Vitamin D deficiency is experienced by 52 percent of Russians. Especially often people suffer from this after winter, when they are too little in the sun. Lenta.ru found out from doctors what symptoms indicate a lack of this vitamin, what foods it contains, and whether it is worth taking dietary supplements with its content.

What is vitamin D and why is it important?

Vitamin D is a fat-soluble vitamin that regulates the metabolism of calcium and phosphorus in the human body to support healthy bones. It prevents the development of rickets in children, and protects adults from osteoporosis.

In addition, vitamin D strengthens the immune system and helps reduce the risk of certain diseases, such as multiple sclerosis and diabetes. And last year, Finnish scientists proved that it can even protect a person from breast, blood and colon cancer.

In order to get vitamin D, you need to be in the sun more often (in the summer it is better at the “safe” time – before 11 am and after 4 pm).

It is good to know that vitamin D is found in some fatty foods: salmon, tuna, egg yolks. They can be eaten to cope with its lack at least partially

However, this is not always enough: vitamin D deficiency is common in Russia, especially after a long winter. To fill its deficiency is important for everyone: the elderly, children, and adults.

Photo: AbElena / Shutterstock / Fotodom

Why is vitamin D deficiency dangerous?

Vitamin D deficiency often occurs in autumn and winter due to lack of sunlight. At risk are people living in the northern regions, who receive insufficient ultraviolet radiation for the synthesis of the vitamin in the skin.

Vitamin D deficiency increases the risk of developing various diseases: frequent colds, autoimmune disorders and cardiovascular diseases

Alexander Lavrischev therapist, leading specialist of the Semeynaya clinic network

In babies, vitamin D prevents the development of rickets, a disease associated with impaired growth and bone development and softening. In adolescents and adults – the development of caries and gum pathologies.

In addition, the vitamin protects against osteoporosis (softening of bone tissue due to lack of calcium in the body) and accelerates the healing of fractures.

Photo: FotoHelin / Shutterstock / Fotodom

Myths about vitamin D

There are several myths about vitamin D that are not supported by scientific evidence. Here are some of them.

Myth: Sunlight provides enough vitamin D

This is not entirely true. Most of the day, people tend to be indoors, so they do not have time to “get enough” of the vitamin. In addition, many use sunscreens that interfere with the synthesis of the vitamin in the skin.

Myth: High doses of the vitamin are necessary and safe

Some doctors prescribe high doses of vitamin D to patients, ostensibly to slow down aging. In fact, there is a risk of an overabundance of the vitamin – and this leads to poisoning, abdominal pain and impaired walking stability (the latter is especially dangerous for older people).

How to get vitamin D correctly?

Vitamin D can be obtained from various sources in the human body. But the optimal combination of sunlight (in the summer it is enough to be in the sun for only 15-20 minutes a day), eggs, mushrooms and oily fish in the diet and the intake of nutritional supplements.

The recommended daily intake of vitamin D depends on age, gender and other factors. For our country, a vitamin dosage of 2000 IU per day for an adult is sufficient. However, before starting treatment, you should consult a doctor

Alexander Lavrishchevterapevt, leading specialist of the Semeynaya clinic network

In the case of children, it is important to always consult with a pediatrician. However, this will not be superfluous for adults, especially when it comes to women during pregnancy or taking a higher dosage of the vitamin.

Photo: Look Studio / Shutterstock / Fotodom

Vitamin D overdose

High doses of vitamin D should only be taken with a doctor’s prescription. Otherwise, poisoning and other unpleasant side effects may occur.

The point is not what dose of vitamin D is safe for health, but what concentration of this vitamin in the blood will be achieved. Today it is considered that the dangerous level of vitamin D in the blood lies in the range of 120-150 units and above. This leads to an increase in the concentration of calcium in the blood and subsequent health problems

Aleksandr Lavrischev therapist, leading specialist of the Semeynaya clinic network

Too much vitamin D can cause:

nausea and vomiting;
loose stools, abdominal pain;
weakness, fatigue, loss of consciousness;
body pains;
increased blood pressure;
violation of the heart rhythm up to the stop.

If vitamin D poisoning is suspected, an ambulance should be called immediately.

Photo: Oksana Mizina / Shutterstock / Fotodom

When can a doctor prescribe vitamin D?

A doctor may prescribe vitamin D to treat or prevent various conditions, including:

osteoporosis;
rickets in children;
hypoparathyroidism;
chronic kidney disease;
psoriasis.