What are the side effects of vitamin D and are there any contraindications?

December 18, 2019

The importance of vitamin D for the body cannot be overestimated. It is responsible for a number of important biochemical processes:

• helps the absorption of calcium and phosphorus, “opening” the cells of bone tissue, teeth and nails to receive these minerals;
• normalizes blood sugar levels;
• speeds up metabolism;
• synthesizes monocytes, which purify the blood;
• stimulates the synthesis of a number of hormones;
• improves the transmission of impulses between neurons;
• affects the development of the embryo.

With proper consumption of vitamin D, bones and muscles are strengthened, blood composition is improved, dry hair and skin disappears, the risk of the appearance and development of oncology and diabetes is reduced, immunity, efficiency, and concentration are increased, the functioning of the thyroid gland and heart is improved, and blood pressure is regulated.

The importance of vitamin D3 for the body

The main task of cholecalciferol is to ensure the growth of bone tissue. Insufficient intake of the vitamin (especially in children’s bodies) contributes to the development of a serious disease – rickets, which often leads to irreversible changes, namely deformation of bone structures.

Treatment depends on the nature and severity of the disease and is based on D-vitamin therapy.

After entering the body, cholecalciferol is absorbed in the small intestine, providing optimal levels of phosphorus and calcium directly in the blood plasma. Thus, with the regular intake of vitamin compounds from food and the production of the substance by skin cells, joints, bones, and cartilage tissue are strengthened.

The hormone is 1,25-dioxycholecalciferol, which is a breakdown product of D3. The compound accumulates in muscle fibers and kidneys. After entering the intestines, it stimulates the production of protein necessary for transporting calcium to teeth and bones.

Other beneficial properties of cholecalciferol:

• improves erection and potency in men, thyroid activity, concentration;
• increases muscle elasticity, endurance and permeability of mitochondrial membranes of the intestinal epithelium;
• strengthens the immune system;
• participates in the synthesis of insulin;
• stimulates collagen production;
• burns fat tissue, promoting weight loss;
• prevents heart disease;
• prevents the formation of cholesterol plaques;
• enhances the processes of ossification and hair growth;
• improves the condition of the skin by maintaining normal metabolism in epithelial cells;
• prevents the appearance of cancerous tumors;
• regulates blood clotting.

Preparations containing vitamin D3 are recommended for use by children from birth (infants) for the proper formation of bone tissue, as well as by people living in unfavorable climatic conditions (polluted regions, cities with short daylight hours).

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Use of vitamin D

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Benefits of vitamin D according to customers:

• the substance normalizes laboratory parameters 25-(OH)-D;
• increases bone strength;
• improves the condition of tooth enamel and quality of life;
• stimulates hair and nail growth;
• gives vigor;
• normalizes blood glucose levels in diabetes mellitus;
• reduces the risk of colds and acute respiratory viral infections.

There are few negative reviews about supplements. Some buyers complain about the lack of effect from taking it and the presence of side effects. There are also those who do not like the oily taste of solutions.

Daily requirement

The daily dosage of cholecalciferol is:

• for infants and infants up to 1 year – 400 IU (10 mcg);
• for children from 1 to 10 years – 600 IU (15 mcg);
• for adolescents under 18 years of age, as well as adults, pregnant and lactating women – 650 IU (16.25 mcg);
• for older people (over 65 years) – 800 IU (20 mcg).

Until what age should I take vitamin D3 and how should I give it?

To build and renew bone tissue, the human body needs cholecalciferol at any age. To fully meet your daily nutrient requirements, it is important to spend at least 90 minutes daily in the sun with bare areas of the body (arms, legs, back), eat foods containing a beneficial compound (usually of animal origin) or take active supplements during food.

To absorb the synthetic substance, when using a D3-containing drug, it is important to simultaneously eat a fatty product (for example, three grams of butter or five milliliters of vegetable oil).

The body's need for vitamin D3 is influenced by the geography of your residence: the closer to the north, the more cholecalciferol you need. Thus, from the thirty-seventh parallel during the winter period, a person practically does not receive a beneficial connection from natural sunlight.

In addition, it is important to remember that people with dark skin synthesize the vitamin worse, and as a result, to meet their daily needs, it is better for them to live closer to the equator.

According to scientific research, sunscreens interfere with the full production of the nutrient in the upper layers of the epithelium. And a product labeled SPF8 completely blocks the production of the vitamin in the skin.

For diagnostic purposes, the content of cholecalciferol in the body is usually determined together with ergocalciferol and their products produced in serum. The total concentration of compounds normally ranges from one to two nanograms per milliliter.

Increased need for vitamin D

An increased need for calciferol occurs in pregnant and lactating women, in children and adolescents during periods of intensive growth and development. In old age, when natural physiological processes lead to increased fragility of bones, the human body also needs this vitamin more strongly.

The use of medium dosages of vitamin D is mandatory for women who have reached menopause: after the cessation of menstruation, the aging process becomes more active, including the bones begin to suffer significantly and a predisposition to fractures appears.

Vitamin D3 for newborns

Cholecalciferol is a “critically necessary” element for newborn babies, since it is involved in the metabolism of phosphorus and calcium, the main components for the construction of cartilage and bone tissue. Vitamin D3 deficiency in childhood leads to softening of bones and disruption of proper skeletal ontogenesis. In regions with low solar activity, the first symptoms of the disease are easy to miss, since bending of the limbs is a sign of an already advanced form of the disorder.

Causes of development of bone abnormalities in children:

• birth in the winter season;
• prematurity;
• pregnancy with complications;
• taking anticonvulsants;
• metabolic disorders in the baby;
• lack of sunlight.

If a child is at risk of developing rickets, to prevent the appearance of bone abnormalities, you need to seek help from a pediatrician, who, based on the clinical picture, draws up a preventive regimen for taking vitamin D3.

At the same time, it is important for young mothers to clarify the symptoms indicating cholecalciferol deficiency in the baby.

Signs of D3 deficiency in infants:

• change in the shape of the chest;
• disturbing sleep;
• late closure of the fontanel;
• head deformation (appearance of bumps and bulges);
• muscle weakness;
• nervous excitability;
• curvature of the lower extremities (hip dysplasia);
• atopic dermatitis (sometimes with signs of streptoderma).

Along with this, prolonged D3 deficiency in a child leads to slower teething and the formation of malocclusion. When the first symptoms of pathologies are detected, treatment is started immediately, since untimely D3 therapy in infancy threatens complications in adulthood: arthritis, scoliosis, bone curvature, flat feet.

Bone abnormalities occur in 80% of cases in infants born from October to May. In view of this, pediatricians, without waiting for signs of rickets to appear, prescribe cholecalciferol preparations to babies in a preventive dosage already in the first year of life. The daily nutrient intake is selected individually, depending on the condition of the baby, the presence of congenital pathologies, the mother’s diet (for breastfed children), the concentration of vitamin D3 in complementary foods and the child’s sensitivity to it.

From how many months is cholecalciferol prescribed?

If the baby was born at term, vitamin D3 is taken from 3 to 4 weeks of life at a dosage of 500 IU (12.5 mcg) per day (from October to May). For premature babies, the timing of D3 therapy is shifted to 7–10 days of life, which helps accelerate the ontogenesis of bone tissue. If you are underweight, the daily portion of the nutrient reaches 1000 – 1500 IU (25 – 37.5 mcg).

Who should take it?

Indications for the use of vitamin D:

• osteoporosis and osteomalacia;
• pathologies of the osteoarticular system – arthritis, osteochondrosis, osteoarthritis;
• long-term non-healing fractures;
• caries and destruction of tooth enamel;
• decreased thyroid function or body defenses;
• autoimmune diseases.

Women

Vitamin D supplements in low daily doses are indicated to improve the appearance of the skin and stimulate hair and nail growth. Regular intake of dietary supplements helps prolong youth and preserve female beauty. The body of women especially needs supplements during menopause, when there is a sharp decrease in the strength of bone tissue.

Vitamin D is recommended for women for weight loss. The substance speeds up metabolism, reduces fat deposition and reduces insulin resistance.

For men

Vitamin supplements are recommended for athletes and bodybuilders. Cholecalciferol increases the endurance of the male body and increases the effectiveness of training. It also stimulates muscle gain and increases testosterone production.

To old people

People of retirement age should take supplements to prevent vitamin D deficiency, since aging skin cannot synthesize it sufficiently. This substance is also used to reduce the risk of fractures and increase bone strength in osteoporosis.

Medicines for babies

The main sources of cholecalciferol for newborns are mother's milk and sunlight. If a child is bottle-fed, vitamin D3 enters his body together with milk formula. However, “adapted” formulations do not cover the baby’s daily nutrient needs, since most children are mixed-fed.

The balance of cholecalciferol in the baby’s body is determined by the pediatrician based on the condition of the fontanel. If necessary, the doctor prescribes additional D3 therapy.

At the same time, it is important to use “vitamin” preparations with extreme caution, since an overdose threatens demineralization of bone tissue and disruption of calcium metabolism in the intestines.

The optimal source of vitamin D3 for infants is a liquid solution (water or oil). The first type, thanks to its hypoallergenic formula and rapid absorption in the intestines, is used for “weak” newborns with disabilities. At the same time, oil suspensions of the “new generation” are not inferior in effectiveness to previous additives. Which composition is better depends on the specific situation and the characteristics of the child’s body.

Let's take a look at some popular vitamin D3 supplements:

1. Videin is an antirachitic mixture of cholecalciferol and casein based on an oil suspension. Release form: tablets. One capsule contains 500, 1000, 5000 and 10000 IU of vitamin D3. For infants, the tablet is ground into powder and dissolved in milk. The drug is taken after meals (within 10 - 15 minutes) at the same time once a day.
2. Aquadetrim is an aqueous solution of cholecalciferol. The drug is prescribed from the 4th week of life, if the doctor has not moved the timing of administration. The concentration of the active substance in 1 drop is 500 IU, which corresponds to the daily norm for well-developing children. Premature infants are prescribed 2 - 3 drops of solution per day. Before administration, the medicine is dissolved in 5 milliliters of clean water. Aquadetrim is contraindicated in infants with a predisposition to early overgrowth of the fontanelle due to the small size of the anterior crown.
3. Vigantol is an oil solution of vitamin D3. This remedy is prescribed from the 2nd week of life. 1 drop of liquid contains 667 IU of cholecalciferol.
4. Minisan. Produced in the form of an oil suspension (for infants) and chewable tablets (for children from three years old). A drop of liquid contains 100 IU of vitamin D3, and a pill contains 400.
5. Vitamin D3 Devisol is an oil-based solution. The recommended daily dosage of the substance is 5 drops, which totals 400 IU of cholecalciferol. This composition is not used if the baby has allergies or diathesis.
6. D3 Vit baby. The release form of the drug is capsules. The dragee contains 200 IU of vitamin D3. The product is used for the prevention and treatment of bone pathologies in children from birth to 3 years. At the same time, the capsule type of product raises a logical question among mothers: how to eat the vitamin correctly? To extract the nutrient from the pack, turn the special tip on the blister and tear it off. The contents of the capsule are then squeezed into the baby's mouth or mixed with breast milk. At the same time, it is important to ensure that the baby does not swallow the pills.
7. Alpha D3-Teva. The composition is available in capsules containing 20, 40, 80 IU of alfacalcidol (a synthetic precursor of vitamin D3), oil drops and injection solutions. This drug is prescribed to children over 6 years of age, mainly for dysfunction of the endocrine system.

If a baby has a lack of other vitamins and microelements against the background of D3 deficiency, then it is advisable to use multivitamin complexes as a source of cholecalciferol.

Let's look at some of them:

1. Polivit Baby. Drops are prescribed to a child in a dosage of 1 milliliter per day (400 IU of vitamin D3) directly during meals.
2. Vidaylin - M. Produced in the form of syrup for oral administration. 5 milliliters of solution contains 400 IU of cholecalciferol.
3. Multi-Tabs baby. The daily dose for an infant is 1 milliliter, which corresponds to 400 IU of vitamin D3.

Remember, it is important to discuss the advisability of taking a multivitamin with your pediatrician.

Overdose symptoms

Vitamin D overdose can be acute or chronic. In the first case, intoxication occurs due to a single dose of too much calciferol and is more often observed in children. Chronic poisoning develops very slowly and occurs against the background of a long-term excess of the substance in combination with active exposure to the sun and/or consumption of calcium-containing foods.

In case of acute overdose of vitamin D in adults, the following symptoms appear:

• loss of appetite, weight loss;
• intestinal upset, vomiting;
• thirst;
• increased blood pressure, arrhythmia;
• frequent urination;
• muscle cramps.

In severe cases, clouding of the cornea, impaired flow of bile, liver problems, and jaundice are possible.

Despite the unpleasant symptoms, a one-time case of vitamin D overdose is not dangerous. The chronic form of intoxication is much more severe, when the body receives large portions of the substance over several months.

Signs of long-term vitamin D overdose:

• chronic fatigue syndrome, lethargy, drowsiness;
• dyspeptic disorders;
• pain in bones and muscles, leg cramps;
• irritability, aggressiveness, mood swings;
• deterioration of memory and attention;
• dryness, flaking and itching of the skin;
• sleep disturbance.

Symptoms of vitamin D overdose in adults and children are almost the same. Infants experience frequent regurgitation, night cramps, diarrhea, poor weight gain, rapid overgrowth of fontanelles, signs of dehydration, manifested by decreased tissue turgor, and thirst. Skin rashes, itching, and irritation of the dermis may appear.

Watch the video about Vit overdose. D in children:

Vitamin D3 hypovitaminosis

Causes of cholecalciferol deficiency in the human body:

• lack of sunlight;
• violation of vitamin metabolism caused by liver and kidney disease;
• lack of vitamin D3 in the diet;
• poor absorption of the substance in the intestine.

The most serious consequences of calciferol deficiency in the body are: a decrease in the content of phosphorus, calcium in the blood and softening of bone tissue. As a result, people deficient in the sunshine vitamin are more susceptible to fractures. In addition, the development of allergic conditions and frequent respiratory diseases is now associated with subclinical cholecalciferol deficiency.

Characteristic signs of vitamin D3 deficiency in the human body:

• diarrhea;
• insomnia;
• myopia;
• nervousness;
• sweating of the head;
• burning in the mouth;
• decreased levels of minerals in the bones.

In addition to identifying the primary signs of hypovitaminosis, before starting drug therapy, you need to take a blood test to determine the D3 content in the body.
Table No. 1 “Reference values ​​of cholecalciferol in the blood”

A deficiency of cholecalciferol in the body over a long period of time creates favorable conditions for the development of the following painful conditions:

• osteoporosis;
• rickets;
• osteomalacia;
• bronchial asthma;
• depression;
• imbalance;
• cancer;
• rheumatoid arthritis;
• weak immunity;
• epilepsy;
• diabetes.

Remember, in order not to have to treat diseases associated with insufficient intake of the vitamin into the body, you should prevent the development of D-hypovitaminosis. If the disease cannot be prevented, you should consult a doctor.

Please note: illiterate and irrational use of the compound in high doses can lead to intoxication of the body and the development of serious consequences.

Self-medication is dangerous for your health!

Summarize

• Vitamin D is extremely important for your overall health. Even if you eat a healthy diet, you may need supplements to achieve optimal blood levels.
• However, excess consumption can lead to a number of side effects.
• Be sure to avoid excessive doses of vitamin D. Generally, 4,000 IU or less per day is considered safe as long as blood counts are monitored.
• Additionally, to reduce the risk of accidental overdose due to mislabeling, make sure you purchase supplements from reputable manufacturers.
• If you are taking vitamin D supplements and experience any of the symptoms listed in this article, contact your doctor as soon as possible.

Tags: Vitamin D

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Hypercalcemia and hypervitaminosis

With long-term vitamin “cholecalciferol” therapy, hypercalcemia often occurs. As a rule, this condition occurs in the following cases: with simultaneous excessive consumption of foods containing large amounts of calcium (dairy products) or as a result of the administration of high doses of the D3 drug for 2 to 3 months or more, which leads to the accumulation of 25(OH) D3 in serum. At the same time, the concentration of the compound in the blood exceeds the norm by 5 to 10 times. After stopping cholecalciferol intake, high levels of 25(OH)D3, due to accumulation in fat and muscle tissue, persist for up to 90 days.

Hypercalcemia and overdose of vitamin D3 occur with long-term use of such active drugs: dihydrotachysterol, alfacalcidol, calcifediol, calcitriol.

Symptoms of hypervitaminosis:

• constipation;
• anxiety;
• thirst;
• lack of appetite;
• weakness;
• intestinal colic;
• headache;
• polyuria;
• ataxia;
• nausea;
• vomit;
• breathing problems;
• pain in muscles, joints;
• slow heart rate;
• bloating;
• muscle spasms;
• a sharp increase in pressure;
• feverish condition.

To eliminate excess cholecalciferol in the body, first of all, stop taking D-containing drugs and limit the consumption of foods rich in calcium. Then, with severe hypercalcemia, glucocorticoids are used, in particular prednisone. How to take the substance? The drug is used for 14–21 days, 50 mg per day. When taken systematically, it has glucocorticoid, anti-inflammatory, and antiallergic effects. Corticosteroids block the effect of D3 on bones and small intestine.

In no case should the appearance of symptoms of intoxication be ignored, otherwise an overdose of the compound in the body can lead to the development of the following complications:

• calcification of soft tissues, blood vessels, heart valves;
• deposition of calcium salts in the heart, kidneys, intestines;
• the appearance of osteoporosis.

Side effects and precautions when taking vitamin D

If used incorrectly or in excessively large doses of the drug, the following may occur:

• headache;
• muscle weakness;
• feeling of nausea, sometimes vomiting;
• mood swings.

Vitamin D toxicity causes unusual symptoms:

• anorexia;
• weight loss;
• cardiac arrhythmia;
• polyuria.

Some types of drugs can cause allergies or individual intolerance to additional ingredients. You should consult your doctor before use, especially if you are taking other medications.

The best source of vitamin D is natural food, fresh air and sunlight. Having received all this, you will not have to think about whether adults and children should take vitamin supplements, which sometimes contain synthetic substances.

Author: Belyaeva Anna

Article design: Mila Friedan

Indications and contraindications

An increased dosage of cholecalciferol is prescribed in complex therapy for the treatment of the following diseases:

• oncology;
• climatic period in women;
• tuberculosis;
• pancreatitis in the acute stage;
• osteomyelitis;
• rickets;
• convulsive syndrome;
• enteritis;
• arthritis;
• diathesis;
• tropical sprue;
• osteoporosis;
• enterocolitis;
• psoriasis;
• chronic gastritis;
• tetany;
• spasmophilia;
• cirrhosis;
• hypoparathyroidism;
• pseudohypoparathyroidism;
• calcium deficiency in teeth and bone tissue;
• malabsorption syndrome;
• hypoparathyroidism;
• hypophosphatemia, hypocalcemia;
• obstructive jaundice;
• liver failure;
• glutenic enteropathy;
• Crohn's disease;
• persistent diarrhea.

In addition, the need for vitamin D3 increases with hypocalcemia, hypo- and vitamin deficiency, unbalanced diet (raw food diet, vegetarianism), insufficient sun exposure, alcoholism, after surgery, during pregnancy, lactation.

Cholecalciferol is contraindicated in patients with calcium nephrourolithiasis, active form of pulmonary tuberculosis, hypersensitivity to the components of the drug, with prolonged immobilization, hypercalcemia, hypercalciuria, renal osteodystrophy with hyperphosphatemia.

On guard of skin immunity

The skin is the body's first line of defense against viruses, bacteria and pathogens. At the same time, 95% of the dermis consists of protective cells - keratinocytes, involved in immune processes. These organelles have special “sensors” to respond to changes in microbial flora and receive various signals from the outside. After a skin lesion, keratinocytes surrounding the wound increase the cells' genetic coding to create peptides and antimicrobial receptors. Vitamin D3 potentiates the ability of these “agents” to recognize pathogenic microorganisms, resulting in the formation of a protective clot. At the same time, keratinocytes and cholecalciferol create an almost impenetrable barrier to infection inside the skin. However, the full course of such reactions is possible only if there is a sufficient amount of vitamin D3 in the body.

Let's consider the mechanism of activation of cholecalciferol.

Natural production of the nutrient occurs in the deepest layers of the skin: the spinous (stratum spinosum) and germinal (stratum basale), containing maximum concentrations of the compound 7-dehydrocholesterol. This substance, absorbing ultraviolet radiation (type B), changes its structure, as a result of which the prohormone is synthesized - vitamin D3. Cholecalciferol is then transported to the liver to form the next form of vitamin D, calcidiol. When the microbial flora on the skin changes, “sensors” transmit danger signals to the brain, as a result of which the component is transported from the liver to the kidneys, where it is converted into the active form, calcitriol.

After the final conversion, the “sunshine” vitamin again enters the bloodstream, from where, with the help of transport proteins, it is delivered to the organs. In regions with long winters, the natural production of prohormone slows down, provoking the development of D3 hypovitaminosis, and as a result, a weakening of the innate immunity of the skin. Therefore, to maintain the barrier function of the dermis, it is advisable to take medicinal analogues of cholecalciferol. One such drug is topical calcipotriol (calcipotriene), which modulates the differentiation and proliferation of epidermal keratinocytes. This property of the substance is used to normalize inflammatory processes in skin affected by psoriasis and vitiligo.

Vitamin D3, in addition to protecting the dermis, is involved in the processes of growth, regulation and replacement of dead skin cells. If there is a deficiency of this prohormone in the human body, a change in the structure of epidermal cells occurs. At the same time, the outer layers of the skin lose turgor, elasticity and strength, and in some areas dryness and parchment appear. In view of this, cholecalciferol is used in cosmetology as an external agent for strengthening and growing hair.

Vitamin D3, along with oral administration, is added to hair balms, shampoos and serums.

Mask for thick hair with vitamin D3

Ingredients:

• olive oil – 5 milliliters;
• burdock oil – 5 milliliters;
• vitamin D3 (alfacalcidol) – 5-6 drops (half an ampoule).

These components are thoroughly mixed and applied to the root zone for 30 minutes. This mask eliminates excessive dryness of the skin, strengthens hair follicles and gives dull hair additional shine. To obtain a lasting effect, the procedure is used once a week.

Remember, it is important for every person to monitor the intake of vitamin D3 in the body, since it activates over 2,000 genes, which is 10% of the human genotype.

Side effect

The body does not always respond adequately to the intake of vitamin D. Side effects manifest themselves as follows:

• allergic reactions;
• loss of appetite;
• increased blood pressure;
• headache;
• constipation;
• kidney failure;
• arrhythmia;
• arthralgia and others.

With prolonged intake of large dosages of the element, there is a high risk of hypervitaminosis (the consequences were mentioned above).

D3 therapy for postmenopausal osteoporosis

Postmenopausal osteoporosis is a disease characterized by increased bone fragility against the background of declining ovarian function. In women during menopause, the natural production of estrogen decreases, as a result of which the production of cytokines (proteins of the acute phase of inflammation) increases and the activity of osteoclasts (cells that absorb cartilage) increases. Such reactions lead to disruption of cholcalciferol metabolism in the kidneys, intense bone loss, and, as a consequence, the development of osteoporosis.

This disease is manifested by an imbalance in the interconnected processes of bone repair and resorption. In addition, the pathogenesis of the disease is influenced by age-related vitamin deficiency in the body and a decrease in the affinity (strength of molecular bonds) of D-receptors to the “solar” nutrient in target organs. As a result of these reactions, the concentration of parathyroid hormone (PTH) in the blood increases, muscle strength decreases, and the risk of traumatic falls and limb fractures increases.

To prevent osteoporotic changes and preserve mineralization of bone tissue, people of mature age (50 years and older) are prescribed preventive D3 therapy. In this case, it is advisable to use a prodrug form of cholecalciferol - alfacalcidol. This substance, upon entering the body, is converted into the active metabolite of vitamin D3-calcitriol. The prohormone, bypassing endogenous regulation (without the participation of a renal enzyme), rapidly accumulates in the blood serum, resulting in improved absorption of phosphorus and calcium in the small intestine. When needed, calcitriol and parathyroid hormone mobilize calcium ions from bone tissue and regulate its reabsorption in the kidneys.

Treatment with alfacalcidol is used primarily as replacement therapy to eliminate D-deficiency conditions in the body. At the same time, the ability of the vitamin to regulate metabolic processes in muscle tissue, the parathyroid gland, the brain and the immune system determines its therapeutic area of ​​use as a hormonal agent.

Let's look at a detailed description of this drug.

Instructions for use of alfacalcidol

Alfacalcidol stimulates the absorption of phosphorus and calcium in the intestine, activates bone metabolism, suppresses hyperfunction of the parathyroid gland, and potentiates the reabsorption of “building” substances in the kidneys.

Composition: one tablet (capsule) contains 0.25, 0.5 or 1 mcg of alfacalcidol, and 1 milliliter of solution contains 0.5 mcg.

Indications for use: osteoporosis (postmenopausal, juvenile, involutional), steroid osteopathies, renal tubular acidosis, D-resistant rickets, postoperative hyperparathyroid osteodystrophy, conditions requiring correction of calcium-phosphorus metabolism, de Toni-Debreu-Fanconi disease, disorders of cholcalciferol metabolism (tetany, hypocalcemia), chronic renal failure, hypofunction of the parathyroid gland.

In addition, the drug is used to prevent renal osteodystrophy (during hemodialysis) and in rehabilitation therapy after kidney transplantation.

To prevent osteoporosis (senile, postmenopausal, steroid), 0.5-1 mcg of the vitamin is used daily for 2 to 12 months.

For osteomalacia and D-deficiency rickets caused by exogenous cholecalciferol deficiency, prolonged anticonvulsant therapy or diseases of the digestive system, alfacalcidol is prescribed in a dosage of 1-3 mcg per day.

The daily dose of vitamin D3 for patients suffering from hypoparathyroidism or Fanconi syndrome is 2-6 mcg. For osteodystrophy, the daily dose of the drug is 0.07-2 mcg. Children with rickets-like diseases are prescribed from 0.5 to 3 mcg of the drug per day, depending on the body weight and age of the baby. For the treatment of osteomalacia and hypophosphatemic rickets, the daily dose of the drug is increased to 4 - 20 mcg (under medical supervision).

Intensive D3 therapy is used in courses of 10 days with breaks of 2 weeks.

It is advisable to start taking alfacalcidol with minimal portions, monitoring the level of calcium in the urine and blood (once a week). If the substance is well tolerated, the daily dose is increased by 0.25 - 0.5 mcg until the biochemical parameters stabilize, while continuing to monitor the concentration of calcium in the blood plasma (once every 3-5 weeks).

For children weighing up to 20 kg, the daily portion of the vitamin is 0.01 - 0.05 mcg per kilogram of the child’s weight.

For renal osteodystrophy, the therapeutic dosage varies from 0.04 to 0.08 mcg per kilogram of body weight.

If signs of overdose occur while taking alfacalcidol, the daily dosage of the drug is reduced until the symptoms of hypovitaminosis are eliminated.

Interaction with other elements

The human body is a very complex system in which all elements are in constant interaction. And the health and general well-being of a person directly depends on how coordinated their work is. The effectiveness of vitamins can be enhanced by “helper molecules,” or cofactors. These are small compounds that are involved in biochemical processes. The most significant cofactors that enhance the effect of vitamin D include:

• Calcium

  . As already mentioned, vitamin D controls calcium levels in the body. The mineral is well absorbed only with a sufficient amount of calcitriol. Therefore, these two substances are inextricably linked with each other.

• Magnesium

  . This element performs many functions. For example, it is needed to convert food into energy. Magnesium is also involved in the absorption of calcium, phosphorus, sodium, potassium and vitamin D. Magnesium deficiency can be corrected not only with supplements, but also by including foods such as spinach, nuts, seeds, and whole grains in the diet.

• Vitamin K

  . This element is responsible for bone health and also increases blood clotting, so it is simply necessary for the human body. If it is not there, people will begin to die from the slightest injury. Vitamins D and K work together when it comes to proper skeletal development. You can replenish your vitamin K reserves with foods such as kale, spinach, liver, eggs and hard cheese.

• Zinc

  . Multifunctional element. With its participation, the body grows and develops, new cells are formed in it, infections are fought and fats, carbohydrates and proteins are fully absorbed. Zinc also facilitates the absorption of vitamin D and helps calcium enter bone tissue. A person can get this element through meat, vegetables and some grains.

• Bor

  . A person needs very little of this substance, but it is still irreplaceable. Boron is involved in the metabolism and absorption of vitamin D. It is found in peanut butter, wine, avocado, raisins and some leafy vegetables.

• Vitamin A

  . Controls protein synthesis. Together with vitamin D, it participates in the functioning of the genetic code. If a person lacks retinol, the functionality of vitamin D will be impaired. Vitamin A is found in carrots, mangoes, liver, butter, cheese and milk. Retinol is a fat-soluble substance and a powerful antioxidant. If it enters the body from plant foods, then it should be combined with fat-containing foods. This way retinol will be better absorbed.

Sources of Vitamin D3

Let's look at what foods contain cholecalciferol.

1. Fish and products made from it. The largest amount of the vitamin compound is found in fish oil. To meet the daily requirement of an adult (10 mcg), you need to drink eight drops of this substance daily. The most fish oil is found in herring, sardine - 1.5 - 2.5 g per 100 g of product, salmon - 1.3 - 2.2, mackerel - 1.2 - 2.0, halibut - 0.8 - 1 .4, tuna – 0.3 – 1.3 g; cod – 0.2 – 0.3. 5 mg of cod liver, 125 g of black caviar, 200 g of red caviar, 150 g of salmon fillet, 50 g of sprat in oil, 850 g of blue whiting fillet contains the daily norm of cholecalciferol. Additional benefits of fish are an abundance of fatty acids and vitamin A, which provide healing, strengthening effect on the human body. The disadvantages of products in this category include: fat content of products, high cholesterol levels, which poses a potential danger for the development of obesity and problems with blood vessels.
2. Meat and offal. The tenderloin contains a small amount of a beneficial compound (up to 0.2 mcg per 100 g of product), while in beef liver this figure increases to 1.2, in lamb liver - up to 1, in lamb kidneys - up to 0.5. These products are rich not only in vitamin D3, but also in vitamins A, B, K. However, it is important to remember that by consuming only meat and offal, it is extremely difficult to fully satisfy the body’s need for cholecalciferol.
3. Chicken eggs. One yolk contains 2 mcg of cholecalciferol. Goose, quail, and turkey eggs also contain D3, but in very small quantities.
4. Dairy products. 100 g of melted butter contains 1.8 mcg of the nutrient (560 g is required to meet the daily requirement), butter - 1.5 mcg (670 g), Dutch and Swiss cheese - 1 mcg (1000 g). 100 g/ml of fermented baked milk , cottage cheese, milk, kefir, the level of cholecalciferol ranges from 0.05 to 0.1 mcg. Despite the fact that the content of the vitamin compound in these products is small, if you consume a large amount of lactic acid products, you can half satisfy the adult body’s need for the substance (5 mcg).
5. Mushrooms. 100 grifol contains 63 mcg of cholecalciferol (to “repay” the daily requirement of D3, it is enough to eat 16 g of the product daily), chanterelles - 8.8 mcg (130 g), morels - 6.3 mcg (150 g), oyster mushrooms - 2.6 mcg (400 g). However, when purchasing, it is important to consider that the vitamin is produced in the fruiting bodies of only those mushrooms that are grown in the sun. If chanterelles, champignons, and oyster mushrooms developed on farms under “artificial” conditions, ergosterol in them is not converted into D3, and as a result, they do not compensate for the lack of this nutrient in the body.
6. Plant products (horsetail, nettle, alfalfa, parsley) - up to 0.01 mcg of vitamin per 100 g.

Thus, the largest amount of cholecalciferol is found in animal by-products (kidneys, liver) and in fatty sea fish - blue whiting, haddock, cod, salmon, and the smallest amount is in vegetables, berries, fruits, and herbs.

Due to the fact that vitamin D3 is resistant to heat treatment, after boiling and frying foods rich in the beneficial compound, the loss of the nutrient is 2-3%, which does not lead to a significant decrease in the substance in the finished dish.

Products containing vitamin D

How to take vitamin D for adults not only in the form of supplements, but also in the form of natural products, is shown in the table:

Our own “sunshine” vitamin

When creating a diet rich in vitamin D3, it is important to consider that the required amount of cholecalciferol for the human body is difficult to obtain solely from food. For example, it is not always possible to eat 850 g of cod or 1000 g of Swiss cheese every day. Therefore, remember, to cover the daily requirement, it is important to be in the sun more often, since the body is able to synthesize the compound in the skin on its own.

Outdoor sports and a balanced diet are the ideal combination for the proper development and maintenance of bone and muscle tone.

Let's consider what conditions should be observed so that the human body does not experience cholecalciferol deficiency all year round, without being tied to the diet.

1. Walk outside for 2-3 hours every day.
2. In late spring, summer, early autumn, keep as much of the skin as possible open so that sunlight can easily penetrate the upper layers of the epithelium.
3. Temper yourself, take walks in the winter, when the body most acutely lacks vitamin compounds.

Remember, D3 can accumulate in adipose tissue, liver and be consumed during the cold season. From this it follows that in order to have a supply of nutrients in the body for the next 3-6 months, it is enough to take an intensive walk every day in the summer on sunny days.

Health Benefits of Vitamin D

Vitamin D is an element that few foods contain in its natural form. Its peculiarity is that it is produced under the influence of external factors, when sunlight hits the skin, thereby causing the synthesis of vitamin D.

In the body it goes through 2 stages of hydrosilylation. First in the liver, where it is converted to calcidiol. Then - in the kidneys, which produces physiologically active calcitriol.

Vitamin D is available in two substances:

• Vitamin D2 – ergocalciferol;
• Vitamin D3 – cholecalciferol.

When taking the vitamin, it should be borne in mind that both forms are absorbed in the blood equally well, but the D3 form is more effective than the same amount of D2. The role of the vitamin is great, because without it the process of absorption of calcium, necessary for the skeletal system, does not occur.

It is enough for adults to take 2-3 hours of sunbathing a day to increase vitamin D

Vitamin D helps:

• proper distribution of phosphate and calcium in the serum;
• growth of the skeletal system and its remodeling (renewal of the bone skeleton), without which the bones become thin, brittle and deformed;
• preventing childhood rickets and softening (osteomalacia) of bones in adults;
• protection of the skeletal system from osteoporosis;
• stimulation of the growth of normal cells and suppression of malignant ones;
• increasing the performance of nervous, muscular and immune activity;
• reduction of inflammatory processes.

One of the vitamin's main functions is to direct calcium to areas of the body where it is needed, such as bones and teeth. It prevents it from getting into areas where calcium should not be - in soft tissues and arteries. This is why all doctors recommend taking vitamin D together with vitamin K2.

Differences between vitamins D2 and D3

Let's look at the difference between ergocalciferol and cholecalciferol.

1. Vitamin D2 is synthesized by fungi and plants. To supply the body with a useful compound, fruits, vegetables, freshly squeezed juices, milk, and grains should be included in the daily menu. Unlike ergocalciferol, D3 can be produced by the human body independently under the influence of UV rays. In addition, the nutrient contains products of animal origin.
2. Ergocalciferol regulates calcium-phosphorus metabolism, improving the absorption of microelements, and promotes their timely deposition in bones. At the same time, cholecalciferol is involved in the transport of minerals and affects the absorption of phosphoric acid and calcium salts from the small intestine.
3. After splitting into several components, excess compound has a negative effect on the functioning of internal organs. During biochemical reactions, D3 is transformed into calcitriol, which resists the development of cancer cells.

To saturate the body with ergocalciferol and cholecalciferol, experts recommend using natural vitamin sources - products of plant and animal origin. It is recommended to use supplements and synthetic substances as a last resort, for example when treating diseases or long-term vitamin deficiency.

Preparations containing vitamins D2, D3, when stored for more than a year, partially lose their effectiveness (at least 50%). When storing and using them, it is important to follow the manufacturer's instructions.

Indications for taking vitamin D for adults

There is much evidence that vitamin D is key to health because this neuroregulatory steroid hormone affects many genes in the body. Receptors that respond to the vitamin have been found in almost every cell.

The vitamin produces about 200 antimicrobial peptides, the most important among them is the natural antibiotic cathelicidin.

Therefore, vitamin D effectively resists colds and reduces the risks of diseases:

• migraine;
• Alzheimer's disease;
• preeclampsia;
• osteoporosis;

• periodontal disease;
• caries;
• insomnia;
• inflammatory diseases of the stomach;
• type 2 diabetes;
• cancer;
• heart disorders;
• rheumatoid arthritis.

Vitamin D (nutritionists will tell you how to take it in the form of supplements for adults) obtained from sunlight has additional benefits:

• The skin, receiving the vitamin, synthesizes a large amount of cholesterol sulfate, which is important for heart health.
• Under the influence of UV rays, the skin also synthesizes vitamin D3 sulfate. This form is water soluble, unlike oral supplements, so it can move freely through the bloodstream.
• The vitamin obtained from the sun's rays cannot be excessive, since the body is capable of self-regulation.

We must not forget about the role of vitamins in disease prevention. Maintaining normal levels can prevent at least 16 different types of cancer.