Vitamins are compounds that are necessary for normal metabolism.
Most vitamins need to be consumed with the exception of vitamin D which
the body can synthesize with the help of ultraviolet rays from the sun.
Vitamins are classified as water soluble and fat soluble. Fat soluble vitamins include: A, D, E and K. Vitamin B and C are water soluble vitamins.
Rickets is the deficiency of vitamin D in children and adolescents and is rare in American today, but was a significant problem in years past. It is a disease where bones do not properly mineralize and it leads to soft bones and deformities of the skeleton. Currently, in the United States there are five cases per one million children.
Rickets is more common in dark skinned infants and in breast fed infants whose mothers have inadequate levels of vitamin D.
In adults vitamin D deficiency may result in osteomalacia, which results in a poorly mineralized skeletal matrix and weak bones. Bone pain and muscle weakness suggest low vitamin D levels. Those with osteomalacia may get bone fractures without a significant injury.
Low levels of vitamin D may be associated with many other conditions including: osteoporosis, multiple sclerosis, diabetes mellitus, heart disease, rheumatoid arthritis, infectious diseases, hypertension, musculoskeletal discomfort and some cancers. The link between these conditions and vitamin D will be discussed in this course.
When vitamin D is taken in - either through food or ultraviolet rays - it is inactive and must go through two hydroxylations in the body for it to be activated. The first activation is in the liver and changes vitamin D to 25-hydroxyvitamin, (calcidiol). The second one occurs in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D, (calcitriol).
Sources:
Vitamin D is obtained though food, sun exposure and supplements. Vitamin D is found in fortified milk, fortified orange juice, fortified cereals and breads and fatty fish (wild salmon, herring and mackerel). It is found in small amounts in cheese, beef liver and egg yolks.
Fortified milk contains 100 international units of vitamin D per serving; it therefore takes 8 glasses of milk to get 800 international units. In the United States, infant formula is fortified with 40-100 international units of vitamin D per 100 kilocalories.
There are two forms of vitamin D: D2 (ergocalciferol) and D3 (cholecalciferol). Both are used to fortify foods. They slightly differ chemically, but from a practical standpoint they are both equal in their effectiveness to raise serum 25-hydroxyvitamin D concentration, but at the higher dosages vitamin D2 is less potent.
Ultraviolet B radiation enters uncovered skin and changes cutaneous 7-dehydrocholesterol to previtamin D3, and then to vitamin D3. Exposure to sunlight cannot cause vitamin D toxicity. When vitamin D is made in the skin from sunlight it lasts in the body 2-3 times longer than when taken as an oral supplement.
Mid day sun provides the optimal sun exposure for vitamin D production whereas early morning and late afternoon sun is less effective for vitamin D production. Vitamin D is not synthesized well in the Northern part of the United States in the winter months. Sunscreen significantly reduces the amounts of conversion to active vitamin D. In addition, cloud cover and pollution will reduce ultraviolet radiation and therefore the amount of vitamin D converted to its active form. Vitamin D cannot be produced through the skin when sun comes through a window. Getting 5-30 minutes of sun exposure to the arms and legs 2 to 3 times a week, in the summer, between the hours of 10 am and 3 pm is enough to get adequate vitamin D for most people.
Tanning beds are somewhat effective in making vitamin D2, but it is not wise to overuse tanning beds. Too much sun exposure increases the risk of skin cancer. In addition, ultraviolet damage to this skin can lead to many aging changes in the skin including increased wrinkling and dryness.
Vitamins are classified as water soluble and fat soluble. Fat soluble vitamins include: A, D, E and K. Vitamin B and C are water soluble vitamins.
Rickets is the deficiency of vitamin D in children and adolescents and is rare in American today, but was a significant problem in years past. It is a disease where bones do not properly mineralize and it leads to soft bones and deformities of the skeleton. Currently, in the United States there are five cases per one million children.
Rickets is more common in dark skinned infants and in breast fed infants whose mothers have inadequate levels of vitamin D.
In adults vitamin D deficiency may result in osteomalacia, which results in a poorly mineralized skeletal matrix and weak bones. Bone pain and muscle weakness suggest low vitamin D levels. Those with osteomalacia may get bone fractures without a significant injury.
Low levels of vitamin D may be associated with many other conditions including: osteoporosis, multiple sclerosis, diabetes mellitus, heart disease, rheumatoid arthritis, infectious diseases, hypertension, musculoskeletal discomfort and some cancers. The link between these conditions and vitamin D will be discussed in this course.
When vitamin D is taken in - either through food or ultraviolet rays - it is inactive and must go through two hydroxylations in the body for it to be activated. The first activation is in the liver and changes vitamin D to 25-hydroxyvitamin, (calcidiol). The second one occurs in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D, (calcitriol).
Sources:
Vitamin D is obtained though food, sun exposure and supplements. Vitamin D is found in fortified milk, fortified orange juice, fortified cereals and breads and fatty fish (wild salmon, herring and mackerel). It is found in small amounts in cheese, beef liver and egg yolks.
Fortified milk contains 100 international units of vitamin D per serving; it therefore takes 8 glasses of milk to get 800 international units. In the United States, infant formula is fortified with 40-100 international units of vitamin D per 100 kilocalories.
There are two forms of vitamin D: D2 (ergocalciferol) and D3 (cholecalciferol). Both are used to fortify foods. They slightly differ chemically, but from a practical standpoint they are both equal in their effectiveness to raise serum 25-hydroxyvitamin D concentration, but at the higher dosages vitamin D2 is less potent.
Ultraviolet B radiation enters uncovered skin and changes cutaneous 7-dehydrocholesterol to previtamin D3, and then to vitamin D3. Exposure to sunlight cannot cause vitamin D toxicity. When vitamin D is made in the skin from sunlight it lasts in the body 2-3 times longer than when taken as an oral supplement.
Mid day sun provides the optimal sun exposure for vitamin D production whereas early morning and late afternoon sun is less effective for vitamin D production. Vitamin D is not synthesized well in the Northern part of the United States in the winter months. Sunscreen significantly reduces the amounts of conversion to active vitamin D. In addition, cloud cover and pollution will reduce ultraviolet radiation and therefore the amount of vitamin D converted to its active form. Vitamin D cannot be produced through the skin when sun comes through a window. Getting 5-30 minutes of sun exposure to the arms and legs 2 to 3 times a week, in the summer, between the hours of 10 am and 3 pm is enough to get adequate vitamin D for most people.
Tanning beds are somewhat effective in making vitamin D2, but it is not wise to overuse tanning beds. Too much sun exposure increases the risk of skin cancer. In addition, ultraviolet damage to this skin can lead to many aging changes in the skin including increased wrinkling and dryness.
Ray Lengel is owner of GeriCEU. Continuing Nursing Education that focuses on long-term care issues can be found at http://www.gericeu.com
