Vitamin D dosage adjustment for family medicine

Umit Kemal Ugurlu

Keywords: Vitamin D metabolism, Vitamin D supplementation, Vitamin D health outcomes, Vitamin D usage in Primary Health Care, family medicine, Oral dosing, 25(OH)D, 25-hydroxyvitamin D, Laboratory testing

Introduction:
Vitamins are minor but essential substances that organisms are unable to generate on their own. Hormones act as chemical messengers, transporting information from one part of the body to another. 7-Dehydrocholesterol (7-DHC) is a zoosterol that acts as a cholesterol precursor in the serum and is photochemically converted to vitamin D3 in the skin, making it a provitamin-D3. Then, it's activated by the liver and kidneys.
Vitamin D is not only responsible for calcium metabolism and immune function but also protein synthesis, mood regulation, cancer prevention by cell cycle control, insulin sensitivity, asthma, rickets, rheumatoid arthritis, anabolic effects on muscle and neurotropic (Vitamin D crosses the blood–brain barrier, and vitamin D receptors can be located all over the brain, although its exact function is unknown).

Method:
Studies in prominent databases are chosen by keywords. Litarature review is based on up-to-date clinical practices and clinical trails. Tolerance against high doses, doses in loading and maintaining phases are included to generate ideas about timely adequate dosing.

Results:
Vitamin D deficiency is frequently encountered in the family medicine field. Vitamin D deficiency might occur from geographical conditions, skin color, dieting practices, lifestyle, and obesity. Daily recommended vitamin D intake is 600 IU for adults. When exposed to UVB rays, the skin produces up to 25,000 IU of vitamin D every day (McCullough P, 2016). In the same article, it is shown that up to 60.000 IU therapy in a time span of 5 years is well tolerated without supraphysiological levels of vitamin D in serum or hypercalcemia symptoms

Conclusions:
Both sunlight and vitamin D do not bring profit for pharmaceutical companies therefore replenishing Vitamin D outcomes with multiple expensive supplements is widespread a marketing strategy. Our goal in this study is to re-arrange vitamin D dosage and recommended sun exposure time

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