Vitamin D Deficiency and Excess

DEFINITIONS

Vitamin D has 2 forms:

1. Vitamin D2 (ergokalsiferol) found in yeast
2. Vitamin D3 (kolekalsiferol) contained in fish liver oil and egg yolk.
Vitamin D3 is produced in skin exposed to the skin when ultraviolet light (sunlight).

Milk can be enriched by various forms of vitamin D.

In the liver, vitamin D is changed into a form that can be transported by the blood.
In the kidney, this form of further modified to produce vitamin D hormone, the main function is to enhance the absorption of calcium from the intestine and facilitate normal bone formation.

On the lack of vitamin D, calcium and phosphate levels in the blood decreases, causing bone disease due to absence of calcium and phosphate are sufficient to maintain bone health.
This condition is called rickets (in children) and osteomalacia (in adults).

VITAMIN D DEFICIENCY

Vitamin D deficiency can be caused by exposure to sunlight or by insufficient vitamin D at least in food.

Vitamin D deficiency during pregnancy can cause osteomalacia in pregnant women and rickets in infants who will birth.
Since milk does not contain vitamin D in large numbers, breastfed babies can suffer from rickets, even though living in the tropics if the baby is not getting enough sunlight.

Vitamin D deficiency can occur in older people because their skin produces less vitamin D when exposed to sunlight.

Some forms of rakitisyang rare, is the result of metabolic disorders and diseases of vitamin D is derived.

Muscle spasms (tetani) which is caused by low levels of calcium can be an early sign of rickets in infants.
Larger babies may be too late to learn to sit and crawl, and the closure of the crown (fontanel) experienced delays.

Children age 1 - 4 years can have a curved spine disorder, leg O (hooked into), leg X (curved outward) and the late run.
Children who are older or teens, will feel the pain when walking.

Horizontal pelvic bone in young women caused a narrow birth canal.
In adults lose calcium from bones, especially the spine, pelvis and legs, causing weakness and could result in broken bones.

Diagnosis of rickets or osteomalacia according to:
- The symptoms
- Picture of the bone on the x-ray
- Low levels of calcium, phosphate and vitamin D in the blood.

Rickets and osteomalacia can be treated with vitamin D by mouth (swallowed) as much as 5 times the recommended daily dose, for 2-3 weeks.

The forms of certain inherited rickets, usually will get better when treated with the hormone vitamin D.

EXCESS VITAMIN D

Vitamin D as much as 10 times the recommended daily dose, for several months, can cause poisoning, which resulted in high levels of calcium in the blood.

The first symptoms of vitamin D toxicity are loss of appetite, nausea and vomiting, followed by thirst extraordinary, increased frequency of urination, weakness, anxiety and high blood pressure.

Calcium can be deposited on the entire body, especially in the kidneys, which can cause permanent damage.
Kidney function will be disrupted, causing protein in the urine discarded and urea levels in the blood increases.

Treatment consists of stopping the use of additional vitamin D and follow a diet low in calcium to reduce the effects of high levels of calcium in the blood.

Corticosteroids may be given to reduce the risk of tissue damage.

Ammonium chloride was given to maintain the acidity of urine, thus reducing the risk of calcium stone formation.