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Nutritional Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Chelsea Kesty, Madeline Hooper, Erin McClure, Emily Chea, Cynthia Bartus
Overview: Approximately 1 billion people are vitamin D deficient, and about half of the global population is vitamin D insufficient. Prevalence is higher in the elderly, breastfed infants, nursing home and hospitalized patients, and obese individuals. Vitamin D deficiency can be caused by decreased dietary intake/absorption, limited endogenous synthesis, and limited sun exposure. It can also be a result of end organ resistance and increased hepatic catabolism by CYP450-inducing medications (e.g., phenobarbital, dexamethasone, and rifampin). Vitamin D deficiencies that are severe enough to trigger secondary hyperparathyroidism as a result of hypocalcemia will experience accelerated bone resorption and phosphaturia. This leads to osteomalacia and osteoporosis in adults and rickets in children.
Immunonutrition Therapy for COVID-19
Published in Srijan Goswami, Chiranjeeb Dey, COVID-19 and SARS-CoV-2, 2022
Srijan Goswami, Ushmita Gupta Bakshi, Dona Khamaru
It is very important to understand the causes of vitamin D deficiency because studies have shown that individuals deficient in vitamin D are more susceptible to infectious diseases like COVID-19. Vitamin D deficiency may occur due to common reasons like inadequate consumption as per recommended dietary intake values, decreased exposure to sunlight, obesity, ageing, and colour of skin. The deficiency may also occur due to underlying conditions like progressive chronic liver diseases (PCLD), chronic kidney disease or renal failure (CKD), CHF, hypertension (HTN), coronary artery disease, and diabetes mellitus (DM). All these diseases are co-morbid conditions associated with COVID-19. There are several groups of pharmacological substances such as laxatives, steroids, cholesterol-lowering drugs, seizure control drugs, anti-tuberculosis medications, and weight loss medications (to name a few) that are known to create vitamin D deficiency. Having a clear understanding of the threshold of low vitamin D, which potentially increases the risk of infection, are critical for treatment purposes. It has been observed that small daily doses of vitamin D are much more beneficial as compared with a large one-time dosage. Organizations like the Food and Nutrition Board and the Endocrine Society recommend the reference ranges presented in Table 16.1 as the appropriate dosages of vitamin D depending on age and sex.
Osteoporosis and vitamin D deficiency
Published in Nadia Barghouthi, Jessica Perini, Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
Vitamin D deficiency is a growing health concern worldwide, largely due to decreased exposure to sunlight.8 Populations at risk include those living at altitudes with less sunlight, darker-skinned races, and obese people.10,12–14 Obese adults (BMI ≥ 30 kg/m2) are at high risk for vitamin D deficiency because the body fat sequesters the fat-soluble vitamin.14
Vitamin D attenuates biofilm-associated infections via immunomodulation and cathelicidin expression: a narrative review
Published in Expert Review of Anti-infective Therapy, 2023
Ruby Benson, Mazhuvancherry Kesavan Unnikrishnan, Shilia Jacob Kurian, Saleena Ummer Velladath, Gabriel Sunil Rodrigues, Raghu Chandrashekar Hariharapura, Anju Muraleedharan, Dinesh Bangalore Venkateshiah, Barnini Banerjee, Chiranjay Mukhopadhyay, Aieshel Serafin Johnson, Murali Munisamy, Mahadev Rao, Benson Mathai Kochikuzhyil, Sonal Sekhar Miraj
Clinical practice frequently encounters numerous cases of vitamin D deficiency. Several epidemiological studies have found a significant negative correlation between vitamin D levels and the incidence of infections caused by biofilm-producing microbes. Biofilm-associated infections constitute a significant global public health hazard because of high morbidity, mortality, and treatment costs. Although evidence strongly links vitamin D deficiency with the risk of biofilm-producing microbial infections, we need robust multi-ethnic clinical trials to understand possible interactions between VDR gene expression, vitamin D status, and infection outcomes. Clinical trials can potentially establish a tailored therapeutic strategy for treating infections with vitamin D. If microbes dysregulate VDR, a loading dose can quickly normalize VDR expression and functionalize vitamin D activity. This is critical because without a loading dose, it can take months to restore optimal vitamin D levels in vitamin D deficient patients. Measuring VDR gene expression can directly shorten the time needed to prevent disabling infections.
Vitamin D levels on sports injuries in outdoor and indoor athletes: a cross-sectional study
Published in The Physician and Sportsmedicine, 2022
Seçkin Şenışık, Ogün Köyağasıoğlu, Nevzad Denerel
Adequate vitamin D levels are essential for bone and muscle health. Vitamin D deficiency or insufficiency is associated with muscle pain, weakness and poor performance, as well as with increased frequency of disease and stress fractures [19]. Muscular and skeletal pain that can accompany individuals with vitamin D deficiency may often be misdiagnosed as fibromyalgia, chronic fatigue syndrome and myositis [8,20–22]. Vitamin D deficiency was found in 93% of patients with nonspecific musculoskeletal pain [21]. It has been reported that vitamin D levels are also related to muscle strength and functions [23]. It has been shown that muscle mass, muscle strength and physical performance are low in people with vitamin D deficiency or insufficiency [24]. Moreover, it has been shown that giving vitamin D supplementation to people or without vitamin D deficiency or insufficiency can increase muscle strength and physical performance [25]. Vitamin D levels have been shown to affect muscle injury rates. Many studies have demonstrated that the incidence of muscle injuries is higher in athletes with vitamin D deficiency [14,20]. Fewer injuries have occured among ballerinas who received vitamin D supplementation compared to those who did not receive supplementation [22,26], and the incidence of injury was found to be lower in summer months when the vitamin D levels were high [26]. It has been found that vitamin D deficiency is associated with an increased risk of fractures, and the frequency of stress fractures is 60% higher in those with vitamin D deficiency [27].
Erythropoietic protoporphyria in pregnancy
Published in Journal of Obstetrics and Gynaecology, 2021
Elizabeth G. Nevins, Ajith Wijesiriwardana
Gene mutations in the ferrochelatase gene cause a deficiency of ferrochelatase enzyme, which is required for the insertion of Fe2+ into protophyrin IX in order to form haemoglobin (Yacquemyn 2003). This causes abnormally high levels of protoporphyrin IX in erythrocytes, plasma, skin and tissues (Ramanujam and Anderson 2015), leading to photosensitivity to UV light which is usually non-scarring but may cause, itching urticaria, erythema, burning and scarring if severe (Schmidt et al. 1974; Puy et al. 2010; Elliott and Mongelli 2014). Abnormalities of haemoglobin synthesis may cause anaemia. Vitamin D deficiency is thought to be due to lack of exposure to sunlight (Elliott and Mongelli 2014). Proactive management of anaemia and vitamin D deficiency, with supplementation, is therefore essential as pregnancy can exacerbate both of these conditions, especially in women with predisposing conditions such as EPP. Up to 5% of patients with EPP will develop liver disease (Bewley et al. 1998) including gallstones, cholestasis, jaundice, hepatotoxicity, cirrhosis and liver failure and monitoring of liver function tests is essential (Schmidt et al. 1974; Tollånes et al. 2011). Porphyrias may cause foetal growth restriction (Tollånes et al. 2011) and, as a result, serial growth scans are also required.