How much vitamin d is necessary dosage expected increase in blood concentration
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Vitamin D has been appreciated for its role in calcium homeostasis and bone health since its identification in 1921.1 Even so, 25% to 50% or more of patients commonly encountered in clinical practice are deficient in vitamin D. Recent advances in biochemical assessment, therapeutic goals for vitamin D nutrition for optimal bone health, and the association of vitamin D deficiency with nonskeletal disease have revived interest in this hormone.
Vitamin D consists of 2 bioequivalent forms. Vitamin D2 (D2), also known as ergocalciferol, is obtained from dietary vegetable sources and oral supplements. Vitamin D3 (D3), also known as cholecalciferol, is obtained primarily from skin exposure to ultraviolet B (UVB) radiation in sunlight, ingestion of food sources such as oily fish and variably fortified foods (milk, juices, margarines, yogurts, cereals, and soy), and oral supplements. Aside from rich sources such as oily fish, the vitamin D content of most foods is between 50 and 200 IU per serving. This value varies greatly by region of the world because fortification markedly improves the availability of vitamin D through diet. Both D2 and D3 are biologically inert. Once absorbed from the intestine, they are metabolized in the liver to 25-hydroxyvitamin D [25(OH)D], composed of 25(OH)D2 and 25(OH)D3; 25(OH)D (also called calcidiol) is subsequently converted to 1,25-dihydroxyvitamin D [1,25(OH)2D], also known as calcitriol, in the kidney and select other tissues by the action of the 1α-hydroxylase enzyme. The predominant effects of vitamin D are exerted through the endocrine and autocrine actions of calcitriol via activation of the vitamin D receptor in cells.