Vitamin D

A nutrient that the body requires in percentages to work and remain healthy. Vitamin D assists the body usage calcium and phosphorus to make strong bones and teeth. It is fat-soluble (can dissolve in fats and oils) and is found in fatty fish, egg yolks, and dairy products. Skin exposed to sunshine can also make Vitamin D. Inadequate Vitamin D can trigger a bone disease called rickets. It is being studied in the prevention and treatment of some kinds of cancer. Also called cholecalciferol. (1 )

Summary

Vitamin D is an important nutrient and hormonal agent with several functions in the body including bone health, policy of serum calcium and phosphate levels, in addition to functions in immune function, cell expansion, distinction, and apoptosis. Appropriately, Vitamin D shortage has actually been connected with a number of health outcomes such as bone illness, diabetes, hypertension, cardiovascular disease, cancer, and autoimmune and contagious disease. Research study has actually turned to examining whether specific genetic versions in Vitamin D metabolic process are associated with Vitamin D status or Vitamin D– related health results. Especially, not least because of advances in innovation and method, a number of massive genetic association studies or candidate gene studies investigated associations between the Vitamin D-related genes dhcr7, nadsyn1, gc, cyp2r1, cyp27b1, and cyp24a1, and Vitamin D receptor and serum levels of Vitamin D.

Vitamin D can be synthesized in the skin, and it helps to assist in intestinal tract ca++ absorption. Ergosterol, which happens in plants, is a Vitamin D precursor. The active type of Vitamin D (1,25( oh) 2d) is a steroid hormonal agent. Renal activation of Vitamin D is controlled by a number of endocrine aspects. Liver and/or kidney disease can lead to a 1,25( oh) 2d shortage. Parathyroid hormone shortage can be dealt with through Vitamin D supplements. Cholecalciferol rodenticide poisoning can trigger symptoms of Vitamin D toxicity. Glucocorticoids and calcitonin can be used to reverse symptoms of Vitamin D toxicity. (2 ).

History

The contemporary history of Vitamin D began in the mid-1800s, when it was seen that city kids were more likely to have rickets than rural kids. Half a century later on, palm reported that children raised in bright environments practically never established rickets. Mccollum isolated Vitamin D, and windaus its precursors, getting the nobel reward. Other researchers later on observed that people with skin cancer had lower frequency of nonskin cancers, which lower overall mortality rates from all internal cancers combined existed in sunnier areas. These observations went largely unnoticed, and the field stagnated till 1970, when maps were produced of cancer death rates. Through study of these maps, cedric and frank garland of johns hopkins university reported a strong latitudinal gradient for colon cancer death rates in 1980, and assumed that greater levels of Vitamin D substances in the serum of people in the south were accountable, which calcium consumption also would lower occurrence. Edward gorham and colleagues performed accomplice and embedded research studies, including the very first research study that discovered an association of a serum Vitamin D compound with reduced cancer danger. William b. Grant then brought outnumerous ecologic research studies that extended the Vitamin D-cancer theory to other cancers. (3 ).

Working mechanism

Vitamin D is carried by means of the blood to the liver, where it is converted into the prohormone calcifediol. Circulating calcifediol may then be converted into calcitriol– the biologically active kind of Vitamin D– in the kidneys.

Whether synthesized in the skin or ingested, Vitamin D is hydroxylated in the liver at position 25 (upper right of the molecule) to form 25-hydroxycholecalciferol (calcifediol or 25( oh) d). This reaction is catalyzed by the microsomal enzyme Vitamin D 25-hydroxylase, the item of the cyp2r1 human gene, and revealed by hepatocytes. As soon as made, the item is launched into the plasma, where it is bound to an α-globulin provider protein named the Vitamin D-binding protein.

Calcifediol is carried to the proximal tubules of the kidneys, where it is hydroxylated at the 1-α position (lower right of the particle) to form calcitriol (1,25-dihydroxycholecalciferol, 1,25( oh) 2d). The conversion of calcifediol to calcitriol is catalyzed by the enzyme 25-hydroxyVitamin D3 1-alpha-hydroxylase, which is the product of the cyp27b1 human gene. The activity of cyp27b1 is increased by parathyroid hormone, and likewise by low calcium or phosphate.

Following the last transforming step in the kidney, calcitriol is launched into the blood circulation. By binding to Vitamin D-binding protein, calcitriol is carried throughout the body, including to the intestinal tract, kidneys, and bones. Calcitriol is the most potent natural ligand of the Vitamin D receptor, which mediates most of the physiological actions of Vitamin D.

In addition to the kidneys, calcitriol is also synthesized by certain other cells, consisting of monocyte-macrophages in the body immune system. When synthesized by monocyte-macrophages, calcitriol acts in your area as a cytokine, modulating body defenses versus microbial intruders by promoting the innate immune system.

Inactivation

The activity of calcifediol and calcitriol can be minimized by hydroxylation at position 24 by Vitamin D3 24-hydroxylase, forming secalciferol and calcitetrol, respectively.

Difference in between substrates

Vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol) share a comparable mechanism of action as outlined above. Metabolites produced by Vitamin D2 are named with an er- or ergo- prefix to differentiate them from the d3-based equivalents (often with a chole- prefix).

Metabolites produced from Vitamin D2 tend to bind less well to the Vitamin D-binding protein.

Vitamin D3 can additionally be hydroxylated to calcifediol by sterol 27-hydroxylase (cyp27a1), but Vitamin D2 can not.

Ergocalciferol can be straight hydroxylated at position 24 by cyp27a1. This hydroxylation likewise results in a higher degree of inactivation: the activity of calcitriol decreases to 60% of initial after 24-hydroxylation, whereas ercalcitriol undergoes a 10-fold reduction in activity on conversion to ercalcitetrol.

It is challenged whether these differences cause a quantifiable drop in efficacy.

Intracellular systems

Calcitriol goes into the target cell and binds to the Vitamin D receptor in the cytoplasm. This activated receptor enters the nucleus and binds to Vitamin D response aspects (vdre) which specify dna sequences on genes. Transcription of these genes is promoted and produces higher levels of the proteins which moderate the results of Vitamin D.

Some reactions of the cell to calcitriol seem too quickly for the classical vdre transcription pathway, causing the discovery of different non-genomic actions of Vitamin D. The membrane-bound pdia3 likely works as an alternate receptor in this path. The classical vdr might still contribute. (4 ).

Advantages of Vitamin D

Vitamin D– nicknamed the “sunshine vitamin” due to its ability to be taken in by the body through sunshine– is a major player in keeping the body healthy. Its primary task, according to the national institutes of health’s office of dietary supplements, is to promote calcium absorption, making it needed for bone growth and bone renovation (when fully grown bone tissue is gotten rid of and brand-new bone tissue is formed). Because of that, a lack of Vitamin D can result in thin, breakable, or misshapen bones. However Vitamin D provides a series of other benefits too, varying from positives for both physical and mental health. Here are nine Vitamin D advantages you require to know about– including ways to get more of the vitamin in your everyday diet plan.

Vitamin D strengthens your bones

Vitamin D is well-known for its bone-building and strengthening powers. “Vitamin D promotes absorption of calcium in your gut, which ultimately allows for regular mineralization of your bones,” jackie newgent, rdn, culinary nutritionist and author of the tidy & easy diabetes cookbook, tells health. Essentially, the calcium that benefits your bones wouldn’t be able to do its task without Vitamin D. “you require Vitamin D for bone growth– and to prevent bones from ending up being breakable.” when teamed with calcium, it can help prevent osteoporosis, a disease that signifies that the density and quality of bone are lowered, she includes.

Vitamin D can assist enhance muscles

Together with its bone-building abilities, Vitamin D is likewise prominent in reinforcing muscles. “absence of Vitamin D in the body can increase the threat of having weak muscles, which in turn increases the threat of falls,” lana nasrallah, mph, rd, scientific diet professional at unc health, informs health. This is particularly essential for the senior. “Vitamin D may assist increase muscle strength hence preventing falls, which is a common problem that leads to significant impairment and death in older grownups.”.

Vitamin D can support the immune system and battle swelling

Dr. Nasrallah includes that Vitamin D can also assist build resistance. “it can support the immune system by eradicating damaging bacteria and infections,” she says. In fact, this function in potentially avoiding infections has become a crucial issue throughout covid-19 pandemic, as scientists have an interest in its potential function in infection outcomes. “there is particular interest in its role in viral infections such as influenza and coronavirus,” barry boyd, md, rdn, a yale medication hematologist, oncologist, and nutritionist, tells health. He indicates a 2017 bmj analysis of 25 randomized control trials comparing Vitamin D supplements to placebos, which discovered that Vitamin D lowered the threat of intense breathing infection.

With either everyday or weekly Vitamin D supplements, especially in people who lacked it. “studies suggest that high latitudes and winter are danger aspects for both low Vitamin D, increased influenza, and other respiratory illness and negative outcomes,” he states. “we now are seeing a similar pattern with higher death rates in covid-19 infections,” though more research study still needs to be done to determine whether the link is causal or merely a connection.

Vitamin D can assist strengthen oral health

Because Vitamin D assists our body absorb calcium, it plays a crucial function in supporting oral health, lowering the danger of dental caries and gum disease. A 2011 evaluation in the journal of the tennessee dental association notes that while the research is scant, there’s an “emerging hypothesis” that the vitamin is beneficial for oral health, due to its effect on bone metabolic process and “its ability to operate as an anti-inflammatory agent and promote the production of anti-microbial peptides.”.

Vitamin D can assist avoid type 1 and type 2 diabetes

While research studies are not conclusive, Vitamin D might be handy for avoiding both type 1 and type 2 diabetes, states newgent. One such study, published in 2006 in the journal diabetes care, found that while Vitamin D on its own did not successfully lower the danger of an excess of sugar in the blood, a combined day-to-day consumption of >> 1,200 mg calcium and >> 800 iu Vitamin D could successfully decrease the threat of type 2 diabetes.

Vitamin D can assist deal with high blood pressure

According to a 2019 review released in the journal current protein & peptide science recommends that Vitamin D may play a role in treatment of hypertension– among the markers of heart disease– says newgent. According to authors of the review, “even short-term Vitamin D shortage might directly raise bp [blood pressure] and promote target organ damage.” the scientists went on to add that, “due to the high correlation between Vitamin D and hypertension, Vitamin D supplementation treatment may be a new insight in the treatment of hypertension.”.

Vitamin D can assist you reduce weight

Dr. Boyd points out that weight problems is a known threat element for low Vitamin D levels– which means more Vitamin D might aid with weight-loss. One 2009 study in the british journal of nutrition discovered that, in obese or obese women with low calcium levels, those who took a day-to-day dose of calcium coupled with Vitamin D were more effective shedding pounds than those who took a placebo supplement, due to an “appetite-suppressing result” of the mix.

Vitamin D can help fight depression

The sun can brighten up your state of mind, therefore can Vitamin D. According to a 2017 review article in the journal neuropsychology, researchers discovered “a considerable relationship between depression and Vitamin D shortage.” while they acknowledged that more research study is required to define the exact workings of it– such as, if low Vitamin D levels are a cause or impact of anxiety– the authors advise “evaluating for and dealing with Vitamin D deficiency in subjects with anxiety” keeping in mind that it is an “simple, economical and may enhance anxiety result.”.

Vitamin D may help in reducing the danger of certain cancers

Dr. Boyd indicates numerous research studies– the majority of which are referenced on the nationwide cancer institute’s (nci) website– that offer some evidence that Vitamin D might have cancer combating powers. “evidence.

Is increasing that Vitamin D supplements may improve cancer outcomes,” he explains. The cancers for which the most human data are offered are colorectal, breast, prostate, and pancreatic cancer.

The nci specifically calls out a few reasons why scientists have an interest in a link between Vitamin D and a reduced risk of cancer. The company mentions that some research reveals that occurrence and death rates for certain cancers were lower amongst individuals residing in southern latitudes, where levels of sunlight exposure are fairly high, than among those living at northern latitudes, though extra research requires to be done to find a specific causal or correlational link between more sunlight exposure and a lower danger of cancer. More speculative proof, per the nci, reveals, that cancer cells and of tumors in mice, Vitamin D has been discovered to have several activities that might slow or avoid the advancement of cancer cells and tumors in mice, including promoting cellular distinction, decreasing cancer cell growth, promoting cell death (apoptosis), and reducing tumor blood vessel development (angiogenesis). (5 ).

Advantages of Vitamin D for males

There are a variety of Vitamin D benefits for males. Lately, Vitamin D has actually been the subject of much scientific study. Research study reveals that Vitamin D is not just essential for bone health. this vital nutrient likewise plays a role in supporting healthy muscle development, testosterone levels, and psychological health. In this short article, we offer details about Vitamin D and share 3 surprising Vitamin D advantages for men.

Vitamin D is important for muscle development.

Vitamin D plays an important role in the advancement of skeletal muscle, which is the muscle connected to bones that help move the body. Adequate Vitamin D is likewise crucial in optimizing muscle strength and efficiency.

Even elite professional athletes can take advantage of sufficient Vitamin D levels. In one research study, researchers took a look at the Vitamin D blood levels of more than 200 college football professional athletes. Almost 60% of these professional athletes had unusual Vitamin D levels, while 10% had a severe shortage. Those professional athletes with lower levels of Vitamin D had a greater frequency of muscle strain and core muscle injury. Appropriate levels of Vitamin D are essential for top-level athletes and weekend warriors alike to enhance muscle strength.

Vitamin D supplements may improve testosterone levels.

The male reproductive tract is called a target area for Vitamin D. Testosterone( a male hormonal agent) plays an important role in bone mass, muscle strength, fat circulation, and even sex drive. One research study found that guys taking Vitamin D supplements had higher testosterone levels than the placebo group.

Vitamin D supplementation might enhance state of mind.

Evidence for a link in between Vitamin D shortage and mental health is growing. Vitamin D receptors are widespread in the brain, consisting of the hippocampus, and it is thought that this nutrient may be a key player in our total psychological wellness. (6 ).

Adverse effects of Vitamin D

Physicians tend to think about Vitamin D levels to be appropriate if there are at least 20 nanograms (ng) of the vitamin per milliliter (ml) of blood. If levels rise above 50 ng/ml, a person might experience unfavorable negative effects.

Nevertheless, most research indicates that the toxicity threshold for Vitamin D is fairly high, around 200– 240 ng/ml.

An individual with levels of Vitamin D in this variety generally consumes between 10,000 and 40,000 international systems (ius) of the vitamin per day.

Below are a few of the most serious negative effects associated with too much exposure to Vitamin D.

Hypercalcemia

Most of the considerable adverse effects connected with Vitamin D toxicity belong to hypercalcemia.

Hypercalcemia is an excess of calcium in the blood. This happens when there are more than 10,4000 ng/ml of calcium in the blood.

Researchers often cite this limit as 10.4 milligrams (mg) of calcium per deciliter of blood or as 0.104 mg/ml.

There is a strong relationship between Vitamin D and calcium. When there are high levels of Vitamin D metabolites in the blood, this increases the quantity of calcium that the intestines soak up.

High levels of Vitamin D metabolites can likewise promote the release of calcium from the bones into the bloodstream.

Having excessive calcium in the blood can result in a vast array of problems and symptoms. Some of the most serious consist of:.

• An anorexia nervosa
• Diarrhea and constipation
• Confusion, disorientation, or trouble believing
• Queasiness and throwing up
• Joint and muscle pain
• Continuous headaches
• Irritability and stress and anxiety
• Inexplicable exhaustion
• Muscle weakness
• Increased thirst and more regular urination
• An irregular heartbeat
• Decreased reflexes
• A metallic taste in the mouth
• Hypertension

Kidney damage

Excess calcium in the blood stream can bind with phosphate and form crystals that deposit in soft body tissues.

These crystals can cause tissue damage and eventually organ damage, depending upon their place, number, and size.

The kidney is especially susceptible to calcium deposits because of its role as a filter and its lots of little passageways.

When calcium deposits get stuck in kidney tissues, nephrocalcinosis can happen. If this condition is serious, it can cause permanent kidney damage and, eventually, kidney failure.

Symptoms of nephrocalcinosis consist of:.

• Queasiness and throwing up
• Fever and chills
• Extreme discomfort in the stomach, the sides of the back, or the groin area, including the testicles in guys

Irregular heart beat and cardiovascular disease

Severe hypercalcemia can minimize or change the ability of the heart’s cells to operate, and individuals with extreme hypercalcemia frequently experience abnormalities in the heartbeat.

A person with severely high levels of calcium or phosphate in the blood might also develop calcium deposits, or plaques, in the arteries or valves of the heart.

In 2012, physicians reported the case of a 70-year-old lady who got calcium injections in the equivalent of 80,000 iu/day over 30 days.

She experienced hypercalcemia and complete heart blockage, which required a permanent pacemaker.

Some signs of heart problems connected with Vitamin D toxicity include:.

• An irregular heartbeat, which may be momentary or consistent
• Chest pain
• Unexplained fatigue
• High blood pressure
• Discomfort when working out
• Dizziness
• Chest pain

Brittle bones and bone discomfort

When there is excessive calcium circulating easily in the blood stream, the body might not have adequate hormones to bind the mineral to the bones effectively.

Vitamin D toxicity can trigger hypercalcemia and subsequent issues with the bones. Some symptoms consist of:.

• Aching or uncomfortable bones
• Instability
• An increased rate of falling
• Bones that are prone to fracture or break
• Severely stooped posture
• Extreme back or joint discomfort
• Loss of height or length of limb

Dehydration

Vitamin D toxicity might trigger dehydration.

Elevated levels of calcium in the blood can harm the kidney’s capability to concentrate urine.

This can result in an individual producing and passing abnormally large quantities of urine, which is called polyuria.

Scientists are not totally sure why this happens. One theory is that high calcium levels lower the results of antidiuretic hormones.

These hormones motivate the kidneys to keep water, and less hormonal agents might lead to larger quantities of diluted urine.

When an individual passes a great deal of diluted urine, they lose big amounts of water and electrolytes. For this reason, an individual with Vitamin D toxicity may be prone to dehydration.

Symptoms of moderate dehydration include:.

• A dry mouth and tongue
• Restlessness
• Irritation
• Sunken eyes
• Increased thirst
• Decreased urinary output
• Reduced tear production and dry eyes
• Skin that is sluggish to return to normal after being pinched

Serious dehydration can lead to lethal conditions. Other signs and symptoms of this condition consist of:.

• A weak or missing pulse
• Low high blood pressure
• Inexplicable exhaustion
• Very little or no urine output
• Unconsciousness

Pancreatitis

Hypercalcemia can cause severe pancreatitis, which is the term for inflammation of the pancreas.

In 2017, researchers released an evaluation of the functions and treatment of Vitamin D toxicity-induced intense kidney injury.

They studied the experiences of 19 people with the toxicity. Each had taken approximately 6,000,000 iu of the vitamin over 1– 3 months.

2 of the 19 people experienced intense pancreatitis as a complication.

Indications of pancreatitis consist of:.

• Upper stomach discomfort that extends to the back
• Queasiness and throwing up
• A rapid pulse
• Weight reduction
• Fever

Lung damage

When high levels of calcium and phosphate in the blood bind to form crystals, these deposit in soft tissues.

The crystals are specifically most likely to deposit in soft-tissue organs that serve as filters, such as the lungs.

If a lot of these calcium salt deposits, or ectopic calcifications, are present in the lungs, they can impair the organ’s function.

Some signs of the resulting lung damage consist of:.

• Coughing
• Problem breathing
• Chest pain (7 )

Dosing

Vitamin D is an essential nutrient. Fish, eggs, and fortified milk are great sources of Vitamin D. The amount that needs to be taken in every day is called the recommended dietary allowance (rda). The rda is 600 iu (15 mcg) daily for people 1-70 years of age and 800 iu (20 mcg) daily for those 71 years and older. While pregnant and breastfeeding, the rda is 600 iu (15 mcg) daily. In kids, the rda depends upon age. Vitamin D is likewise made in the skin after sun exposure. Spending 15-30 minutes in the sun each day ought to be enough to keep normal Vitamin D levels for most people.

Most people need to not consume more than 4000 iu daily unless under the care of a doctor. Speak with a doctor to learn what dosage might be best for a specific condition. (8 ).

Interactions

Possible interactions consist of:.

• Taking Vitamin D and aluminum-containing phosphate binders, which may be used to treat high serum phosphate levels in people with chronic kidney illness, may cause hazardous levels of aluminum in people with kidney failure in the long term.
• The anticonvulsants phenobarbital and phenytoin (dilantin, phenytek) increase the breakdown of Vitamin D and minimize calcium absorption.
• Atorvastatin (lipitor). Taking Vitamin D may impact the way your body procedures this cholesterol drug.
• Calcipotriene (dovonex, sorilux). Do not take Vitamin D with this psoriasis drug. The mix may increase the danger of excessive calcium in the blood (hypercalcemia).
• Cholestyramine (prevalite). Taking Vitamin D with this cholesterol-lowering drug can decrease your absorption of Vitamin D.
• Cytochrome p-450 3a4 (cyp3a4) substrates. Usage Vitamin D very carefully if you’re taking drugs processed by these enzymes.
• Digoxin (lanoxin). Prevent taking high dosages of Vitamin D with this heart medication. High doses of Vitamin D can trigger hypercalcemia, which increases the threat of deadly heart problems with digoxin.
• Diltiazem (cardizem, tiazac, others). Avoid taking high dosages of Vitamin D with this blood pressure drug. High dosages of Vitamin D can cause hypercalcemia, which may lower the drug’s efficiency.
• Orlistat (xenical, alli). Taking this weight-loss drug can reduce your absorption of Vitamin D.
• Thiazide diuretics. Taking these blood pressure drugs with Vitamin D increases your risk of hypercalcemia.
• Taking steroid mediations such as prednisone can decrease calcium absorption and hinder your body’s processing of Vitamin D.
• Stimulant laxatives. Long-lasting use of high doses of stimulant laxatives can minimize Vitamin D and calcium absorption.
• Verapamil (verelan, calan sr). Taking high doses of Vitamin D with this blood pressure drug can trigger hypercalcemia, and may likewise minimize the effectiveness of verapamil. (9 )

Warnings

This medication consists of Vitamin D. Do not take drisdol, calciferol, cholecalciferol, 1,25-dihydroxycholecalciferol, or ergocalciferol if you are allergic to Vitamin D or any ingredients included in this drug.

Stay out of reach of kids. In case of overdose, get medical help or contact a toxin control center immediately.

Cautions

• Ergocalciferol: use with care in kidney impairment (strong caution), heart problem, kidney stones, arteriosclerosis.
• Get serum calcium two times weekly during titration.
• Discontinue if the client ends up being hypercalcemic.
• The presence of tartrazine in some items might cause allergic reactions.
• Vitamin D toxicity might last >> 2 months after therapy is discontinued.
• Limit intake in babies with idiopathic hypercalcemia.
• Concurrent use of heart glycosides.
• Sufficient clinical action to Vitamin D treatment depends on sufficient dietary calcium.
• Keep normal serum phosphorous concentrations in patients treated for hyperphosphatemia to prevent metastatic calcification.
• When dealing with hypoparathyroidism, concomitant treatment with intravenous calcium, parathyroid hormonal agent, and/or dihydrotachysterol might also be needed.
• Grownups with a body mass index (bmi) greater than 30 kg/m ² are at high risk for Vitamin D deficiency due to storage of Vitamin D in fat; dosages higher than recommended day-to-day allowance may be needed but must be thoroughly kept track of to avoid toxicity.
• In kidney problems, supplements with ergocalciferol might be necessary; display closely.
• In patients with rickets, the range in between therapeutic and poisonous dosages is narrow in Vitamin D– resistant clients; change dose based upon scientific response to prevent toxicity.

Pregnancy and lactation

Usage Vitamin D with caution during pregnancy if the advantages exceed the dangers. Animal research studies show threat and human research studies are not readily available, or neither animal nor human research studies are done. Vitamin D is dispersed into breast milk; usage with care while breastfeeding. (10 ).

Conclusion

It is extensively accepted that Vitamin D is important for the upkeep of skeletal health and collecting proof suggests that Vitamin D shortage is an independent danger factor for different extra-skeletal illness consisting of cancer. Whether Vitamin D is simply a marker of threat or has actually some helpful effects on non-skeletal illness stays to be elucidated. Therefore, current suggestions relating to preventive medicine ought to be based upon skeletal results of Vitamin D. While rdas have recently been released for Vitamin D, it is also apparent that there is a big space between these recommendations and the real Vitamin D intake and Vitamin D status in the basic population. Health professionals and public health authorities are, for that reason, motivated to put further focus on combating Vitamin D deficiency. Possible techniques consist of food stronghold for the basic population, Vitamin D supplements in at-risk people such as the senior, and by advocating way of life modifications such as outside physical activity for the avoidance of obesity with careful and well balanced sunshine exposure, and a healthy diet plan. Though, in addition, research studies developed to figure out the most ideal and effective methods in attaining a physiologic and healthy Vitamin D status are urgently needed. (11 ).

References

1. Https://www.cancer.gov/publications/dictionaries/cancer-terms/def/vitamin-d
2. Https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/vitamin-d
3. https://www.sciencedirect.com/science/article/abs/pii/S1047279708003190
4. Https://en.wikipedia.org/wiki/vitamin_d#mechanism_of_action
5. Https://www.health.com/nutrition/vitamins-supplements/vitamin-d-benefits
6. Https://blog.theralogix.com/vitamin-d-benefits-for-men/
7. Https://www.medicalnewstoday.com/articles/322602#side-effects
8. Https://www.webmd.com/vitamins/ai/ingredientmono-929/vitamin-d
9. Https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-20363792
10. Https://www.rxlist.com/consumer_vitamin-d/drugs-condition.htm
11. Https://ar.iiarjournals.org/content/35/2/1161