Fat Soluble Vitamins- Vitamin D

Fat Soluble Vitamins- Vitamin D

Chemical Components of Vitamin D

Vitamin D is an essential fat-soluble chemical compound of the secosteroid group. Human beings cannot synthesize vitamins. They, therefore, need to ingest them to introduce them to the body. However, vitamin D is exceptional. It can be synthesized, and it performs different functions in the body. In addition, exposure to sunlight or dietary intake introduces vitamin D to the body. Sunlight exposure leads to the synthesis of vitamin D3, also known as cholecalciferol. On the other hand, dietary intake leads to the synthesis of vitamin D2, also known as ergocalciferol. These forms of the vitamin are inactive. They are activated in the liver and kidney through hydroxylation. Enzyme 25-Hydroxylase in the liver and 1α-Hydroxylase in the kidney convert D3 and D2 to 1,25-dihydroxy vitamin D. This is the active form of vitamin D, also known as calcitriol.

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Clinical Uses of Vitamin D

Vitamin D influences the function of the immune system. Immune cells have vitamin D receptors. Therefore, vitamin D contributes to their activity. When vitamin D binds to immune cells, it enhances the eradication of pathogens and prevents the over-activity of inflammatory cytokines (Yeh et al., 2020). Another therapeutic use of vitamin D is symptomatic management of Autism Spectrum Disorder (ASD). ASD is a set of neurocognitive disorders characterized by unusual development of communicative, social, or behavioural skills. Vitamin D protects the brain against degeneration. It influences the synthesis of neurotransmitters. Treatment with vitamin D markedly improves the symptoms of ASD (Infante et al., 2020).

The other clinical use of vitamin D is the supplementation of COVID-19 therapy. COVID-19 pathogenesis is an interplay between the virus and the immune system of the host. Therefore, some individuals can be asymptomatic, while others present with severe symptoms of the disease. A virus in the body activates the immune system, which uses several techniques to try and eliminate the infection. Vitamin D improves the level of response of the immune system. Multiple studies show that COVID-19 patients have very low levels of vitamin D (Banerjee et al., 2021). Supplementation of COVID-19 therapy with vitamin D improves symptoms and outcomes of treatment.

Food Sources of Vitamin D

There are multiple food sources of vitamin D. For instance, salmon, smoked or pickled herring, canned sardines, halibut, and mackerel. These are fatty fish with high levels of vitamin D. Other sources are egg yolks, cod liver oil, mushrooms, and tuna. Foods that are fortified with vitamins are also good sources. They include some brands of cereals, juices, and even milk.

Dietary Reference Intakes for Vitamin D

Dietary Reference Intakes (DRIs) are a set of nutrient references intended to act as a guide for adequate nutrition and the foundation for developing nutrient guidelines in the United States (Cowan et al., 2019). They include the Estimated Average Requirement (EAR) and the Recommended Dietary Allowances (RDA). The EAR is used for assessing and planning the diet of a population. It also helps in generating the RDA. The value of RDA is meant to fulfil the needs of almost all people.

Symptoms of Deficiency and Toxicity

Vitamin D deficiency presents with weak, bowed, or bent bones. It also presents bone and muscle aches, fatigue, and deformities of the joint (Amrein et al., 2020). Additionally, there are some comorbidities associated with vitamin D deficiency. They include chronic renal or hepatic disease, obesity, celiac disease, and Crohn’s disease. Further, toxicity is characterized by generalized body weakness, muscle and bone aches, and easy fatiguability. Other symptoms are nausea and vomiting, easy irritability, altered mental status, and coma in extreme cases.

The Spectrum of Age Issues

Children aged below five years and adults above the age of 65 years are at risk of vitamin D deficiency. In children, it is because of poor nutrition. They may not be receiving a balanced diet. In adults, skin vitamin D synthesis decreases with age (Chang & Lee, 2019). When comparing old and young people, there is a drop in the concentration of 7-dehydrocholesterol in the epidermis and a diminished reaction to UV light. This results in a 50% decrease in the synthesis of vitamin D3. These age groups should be well-monitored to avoid the effects of vitamin deficiency.

Conclusion

Vitamin D plays an important role in the therapeutic management of various conditions. It is useful in the management of multiple sclerosis due to its influence on the immune cells and their response to pathogens. Its influence on the immune system also helps in the management of COVID-19. Another role of vitamin D is promoting the development and protection of the brain. This makes it useful in the management of Autism Spectrum Disorders. Vitamin D is a unique multipurpose compound whose functions should continue to be studied.

References

Amrein, K., Scherkl, M., Hoffmann, M., Neuwersch-Sommeregger, S., Köstenberger, M., Tmava Berisha, A., & Malle, O. (2020). Vitamin D deficiency 2.0: an update on the current status worldwide. European journal of clinical nutrition, 74(11), 1498-1513. https://doi.org/10.1038/s41430-020-0558-y

Banerjee, A., Ganguly, U., Saha, S., Chakrabarti, S., Saini, R. V., Rawal, R. K., & Chakrabarti, S. (2021). Vitamin D and immuno-pathology of COVID-19: many interactions but uncertain therapeutic benefits. Expert Review of Anti-infective Therapy, 19(10), 1245-1258. https://doi.org/10.1080/14787210.2021.1905519

Chang, S. W., & Lee, H. C. (2019). Vitamin D and health-The missing vitamin in humans. Pediatrics & Neonatology, 60(3), 237-244. https://doi.org/10.1016/j.pedneo.2019.04.007

Cowan, A. E., Jun, S., Tooze, J. A., Eicher-Miller, H. A., Dodd, K. W., Gahche, J. J., & Bailey, R. L. (2019). Total usual micronutrient intakes compared to the dietary reference intakes among US adults by food security status. Nutrients, 12(1), 38. https://doi.org/10.3390/nu12010038

Infante, M., Sears, B., Rizzo, A. M., Mariani Cerati, D., Caprio, M., Ricordi, C., & Fabbri, A. (2020). Omega-3 PUFAs and vitamin D co-supplementation as a safe-effective therapeutic approach for core symptoms of autism spectrum disorder: case report and literature review. Nutritional neuroscience, 23(10), 779-790. https://doi.org/10.1080/1028415X.2018.1557385

Yeh, W. Z., Gresle, M., Jokubaitis, V., Stankovich, J., van der Walt, A., & Butzkueven, H. (2020). Immunoregulatory effects and therapeutic potential of vitamin D in multiple sclerosis. British journal of pharmacology, 177(18), 4113-4133. https://doi.org/10.1111/bph.15201

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Choose one of the fat-soluble vitamins (i.e., vitamin A, D, E, or K). Using at least three peer-reviewed scientific journal articles, write a 2- to 3-page report discussing the clinical uses of your chosen vitamin.

You should also include information regarding the main chemical components, DRIs, symptoms of deficiency and toxicity, food sources, and any spectrum of age issues. What are your general conclusions regarding the therapeutic use of your chosen vitamin based on your investigation?