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Study material: Venous blood
Response time (working day): 14
The test is done on an empty stomach: Yes
Home call service: YesVitamin D (calciferol) is a fat-soluble vitamin. We get it exogenously through vitamin D-rich foods or supplements. It is produced endogenously in the body under the influence of ultraviolet rays.
Exogenously obtained or endogenously produced vitamin D undergoes 2 hydroxylation processes for activation. The first hydroxylation process converts vitamin D to 25-hydroxyvitamin-D, called "calcidiol," and this process takes place in the liver. A second hydroxylation takes place in the kidney to produce the physiologically active form of 1,25-dihydroxyvitamin-D, also known as "calcitriol".
Vitamin D is involved in the absorption of calcium from the intestine and in the creation of adequate concentrations of calcium and phosphorus in the serum, which is important for normal bone mineralization and the prevention of hypocalcemic tetany (involuntary muscle contractions that cause spasms and convulsions). It is also essential for the balance of bone osteoblasts and osteoclasts and bone growth processes. In conditions of vitamin D deficiency, bones become fragile, thin, deformed. Normal concentration of vitamin D in the body protects children from rickets, and adults from osteomalacia and osteoporosis (together with calcium).
In addition to the above, vitamin D has other functions in the body, namely: reduction of inflammatory processes, cell growth, regulation of neuromuscular and immune processes, glucose metabolism. Genes that encode proteins that regulate cell proliferation, differentiation, and apoptosis are regulated in part by vitamin D.
In food products and nutritional supplements, vitamin D is found in two forms: D2 - ergocalciferol and D3 - cholecalciferol, which differ from each other only in their chemical structure. Both forms are easily absorbed in the small intestine. The process of absorption occurs both by simple passive diffusion (from the area of high concentration in the direction of low concentration) and by the participation of intestinal membrane transport proteins (active absorption). The presence of fat in the gut enhances vitamin D absorption, although some forms of vitamin D are absorbed without fat. Neither the aging process nor obesity causes impaired absorption of vitamin D in the intestine.
Serum vitamin D concentration is the main indicator of vitamin D status in the body. The half-life of 25(OH) vitamin D in serum is 15 days. It is this form that is determined in serum and its concentration is expressed both in nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL).
For various conditions (rickets, normal bone function, etc.) ideal levels of vitamin D have not been established, although amounts that correspond to various conditions have been obtained. Corresponds
| Nmol/ლ | Ng/Ml | Health condition |
| <30 | <12 | Vitamin D deficiency, which causes rickets in children and osteomalacia in adults |
| 30 to <50 | from 12 to 19 | Inadequate concentration for bones and general health. |
| ≥50 | ≥20 | Adequate concentration for bones and general health |
| > 125 | > 50 | Excessive concentration, which can be manifested by the toxic effect of vitamin D |
Deficiency is caused by taking a reduced amount of vitamin with food, staying in a closed space for a long time (where direct sunlight cannot reach), kidney damage that cannot convert vitamin 25(OH)D into its active form, disruption of absorption processes in the intestine, etc. Alimentary (nutritional) deficiency of vitamin D often develops in people with milk allergy or lactose intolerance, as well as in vegans and vegetarians.
Vitamin D deficiency in children causes rickets, a disease in which bone mineralization processes are disrupted, leading to skeletal deformities. However, in this disease, general retardation, palpitations, tetanic spasms (due to hypocalcemia), cardiomyopathy, and dental abnormalities are more important.
In adolescents and adults, vitamin D deficiency results in osteomalacia and bone deformities accompanied by pain, hypocalcemic seizures, tetanic spasms, and dental abnormalities.
It is preferable to perform the test on an empty stomach
Study material: Venous blood
Response time: 14 working days
DVitamin deficiency risk groups
D Effect of vitamin on health
Bone health and osteoporosis
Bone tissue undergoes constant renewal. With age, especially in menopausal women, bone resorption processes prevail over renewal processes. Over time, bone density decreases and osteoporosis develops, which is characterized by a decrease in bone mass, deterioration of the structure, tendency to fragility and an increase in the probability of fractures. Osteoporosis is the result of long-term calcium deficiency, however, vitamin D deficiency accelerates this process.
Bone health also depends on the condition of its surrounding muscles, which are involved in maintaining movement and balance. Vitamin D is also an important factor for the normal growth and development of muscle fibers. Vitamin D deficiency can cause muscle weakness, which in turn manifests itself in balance disorders and myopathic pain.
D The effect of vitamin on the elderly
Clinical studies have established that the concentration of calcium and vitamin D in both postmenopausal women and elderly men has a significant impact on their quality of life, although the effect of taking vitamin D as a supplement in osteoporosis has not been fully clinically confirmed.
Cardiovascular diseases
According to current clinical studies, vitamin D participates in the pressure regulation of the renin-angiotensin-aldosterone system, in the renewal of blood vessel wall cells, in inflammatory and fibrotic processes. Vitamin D deficiency is associated with vascular dysfunction, arteriosclerosis, left ventricular hypertrophy, and hyperlipidemia. This is why vitamin D deficiency is associated with cardiovascular disease risks.
Depression
Vitamin D is also involved in the functioning of the central nervous system. Its receptors have been found in both brain neurons and neuroglia, and it is believed to play a role in the pathophysiology of depression. According to research, there may be some association between low serum vitamin D levels and depression. However, clinical data do not confirm the effect of vitamin D supplementation in the treatment of depression.
multiple sclerosis
It is an autoimmune disease of the central nervous system (brain and spinal cord) that damages the myelin sheath around the nerve fibers. Damage to myelin inhibits the flow of impulses, which manifests itself in the form of such disorders as: visual impairment, muscle weakness, spasticity, coordination disorders, tremors, sensory changes, cognitive (mental) changes, and others.
There are a number of epidemiological studies on the presence of multiple sclerosis and serum vitamin D deficiency. There is no clinical study that would confirm a direct link between vitamin D deficiency and multiple sclerosis, however, according to current data (prospective and randomized studies), the degree of disease progression and disability is higher when the concentration of vitamin D is low.
Type 2 diabetes
Vitamin D plays a role in glucose metabolism. It stimulates insulin secretion by acting on D receptors of pancreatic β cells and reduces peripheral insulin resistance by acting on the same D receptors in muscle and liver.
weight
Systematic studies have shown a relationship between excess body weight and vitamin D deficiency. However, studies have shown a relationship between vitamin D supplementation and the degree of weight loss
D Risks associated with excess vitamin
Too much vitamin D is toxic. It enhances the absorption of calcium from the gastrointestinal tract, therefore hypervitaminosis D causes hypercalcemia, hypercalciuria. Hypercalcemia causes calcification (clotting) of soft tissues, including coronary arteries, cardiac arrhythmias, kidney stone disease, dehydration, muscle weakness, and sometimes even death.
Long-term exposure to the sun cannot cause an excess of vitamin D, because the thermal activity of the sun in the skin produces other inactive forms in addition to vitamin D3, or D3 is converted into an inactive form.
Long-term, high-dose administration of calcium and vitamin D preparations may cause hypercalcemia-hypercalciuria and, in some cases, kidney stone disease.
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