As per the journal Nutrients ”Approximately 70%–100% of the general population in India suffers from Vitamin D3 deficiency leading to increased risk of rickets, osteoporosis, cardiovascular diseases, diabetes, cancer and infections such as tuberculosis. Inadequate sun exposure, deficient intake and ineffective food fortification strategies make Indian population susceptible to Vitamin D deficiency.
Higher prevalence of Vitamin D insufficiency has been a prominent health issue and an independent risk factor for mortality in the general population. Deficient Vitamin D status can be treated by Vitamin D supplementation and for that it is must to know the benefits of vitamin D3 supplementation.
Vitamin D fortification can be a passive way to increase intake in both general and vulnerable population, but in a country like India where Vitamin D fortification is lacking, supplementation is the only alternative.
Multiple supplements of Vitamin D are available in the market. Among these, the two standard forms are Vitamin D3 (alfacalcidol, cholecalciferol and calcitriol) and Vitamin D2 (ergocalciferol). Evidence suggested that Vitamin D3 is considered superior to ergocalciferol in terms of potency, elevating and sustaining 25 (OH) D concentrations and maintaining the storage form of vitamin D.
What is Vitamin D3 and why it is required?
Vitamin D3, cholecalciferol or simply the sunshine vitamin has been touted as a near-miracle. It has emerged as one of the most controversial nutrients of the 21st century, despite its discovery 100 years ago. It is a prohormone produced in the skin on exposure to sunlight. It is derived from 7-dehydrocholesterol by ultraviolet irradiation of the skin.
It can also found naturally in animal food sources such as, e.g., fatty fish (e.g., salmon, mackerel and tuna) cod liver oil, milk, and some vegetarian food sources such as yeast and mushrooms. Notably, dietary sources are not sufficiently rich in their Vitamin D3 content.
Traditionally, Vitamin D3 was required in our body to carry calcium and bone mineral metabolism. It influences bone mineral metabolism and calcium/phosphorus homeostasis by increasing synthesis of mRNA for calcium, alkaline phosphatase, and other proteins.
It also works with parathyroid hormone (PTH), acts on the kidneys, bone, and intestine, and influences gene expression. From last few years the use of vitamin D was only considered in bone mineral and calcium metabolism, but further research has found out that the Vitamin D3 also has roles in cell and immune function.
What are the top benefits of Vitamin D3 supplementation?
The implication of Vitamin D3 deficiency in many chronic, infectious and autoimmune diseases has supported the extraskeletal benefits of Vitamin D3. Supplementation of Vitamin D3 helps in prevention/treatment of some forms of cancer, osteoporosis, rheumatoid arthritis, multiple sclerosis, hypertension, cardiovascular disease, obesity, psoriasis, and psychiatric diseases.
Vitamin D3 and Bone health:
The most prominent function of Vitamin D3 is the absorption of calcium. Adequate calcium absorption helps to maintain a proper level of calcium and phosphorus, both of which promotes the growth and maintenance of healthy, strong bones. It is critical for warding off bone diseases such as rickets in children, osteomalacia in adults and osteoporosis in the elderly.
These disorders lead to weakened and brittle bones which may result in an increased risk of fractures. A clinical study conducted in 2003, indicated a 33% lower rate for fracture and a 22% lower rate for the first fracture at any site in individuals with supplemented with 100,000 IU D3.
Vitamin D3 and Immunity
Vitamin D3 has beneficial effects on inherited immunity or innate immunity. It plays an integral role in activating various essential peptides that triggers a strong innate antimicrobial response. A strong anti-microbial response helps to ward off various infections and in turn, reduces the risk of infections. Cod liver oil, a rich Vitamin D3 source, has been used in the treatment of infectious diseases such as tuberculosis.
There is increasing evidence linking the development of autoimmune diseases and Vitamin D3 deficiency. Autoimmune disorders develop when the body responds against its tissues as foreign pathogens. Autoimmune diseases associated with Vitamin D3 deficiency include multiple sclerosis (MS), diabetes mellitus (DM), rheumatoid arthritis (RA), inflammatory bowel disease and systemic lupus erythematosus (SLE).
These autoimmune responses are mediated by T cells. Vitamin D3 has been found to modulate T cell responses, thereby diminishing the autoimmune responses and risk of autoimmune diseases.
Vitamin D3 and Cardiovascular health
The individual with lower blood levels of Vitamin D3 have increased risk of heart disease, hypertension and stroke. Vitamin D3 receptor is present in the cells of the cardiovascular system, including cardiomyocytes, arterial wall cells, and immune cells. Binding of Vitamin D3 molecule on receptors regulates various genes involved in fundamental processes relevant development of cardiovascular diseases such as cell proliferation, differentiation, apoptosis, and oxidative stress.
The roles of Vitamin D3 are also established in pathways that are integral to cardiovascular function and disease, including inflammation, thrombosis, and the renin-angiotensin system. Researchers indicated that daily Vitamin D3 supplementation using a wide range of doses (i.e. 600 IU, 2,000 IU, 4,000 IU) decreases the stiffness of specific blood vessels after only eight weeks, compared to placebo. However, there is a lack of clinical studies regarding the beneficial effects of Vitamin D3 in cardiovascular diseases.
Vitamin D3 and Cancer
Adults living at higher latitudes are susceptible to develop various types of cancer such as colorectal cancer, prostate cancer, ovarian cancer, breast cancer, lung cancer and esophageal cancer. Retrospective studies have determined that Vitamin D3 levels below 20 ng/mL lead to 30%–50% increased risk of developing and dying of colorectal, prostate, breast, pancreatic, and esophageal cancer.
Vitamin D3 supplementation can be beneficial in the prevention and treatment of cancer. It inhibits and reduces the growth of tumour cells. The actions responsible for anti-cancer effects of Vitamin D3 are inhibition of cell growth, stimulation of cell death, and reduction of inflammation.
Vitamin D3 and Depression
Low levels of Vitamin D3 are associated with depression and seasonal affective disorder (SAD). Vitamin D3 supplementation can reduce depression by the release of neurotransmitters epinephrine and dopamine. It offers significant improvements in mood in overweight and obese people by decreasing parathyroid hormone.
A study published in the American Journal of Clinical Nutrition evaluated that women with higher Vitamin D3 intake had less depression. Vitamin D3 also plays a regulative role in potential mechanisms associated with seasonal affective disorder. It is a disorder common in people living at high latitudes and triggered by low levels of sunlight. Vitamin D3 supplementation can improve the symptoms of seasonal affective disorder by affecting serotonin levels in the brain.
Vitamin D3 and Asthma
Asthma is a chronic disease which includes wheezing, coughing, chest tightness, and shortness of breath. Low levels of Vitamin D3 are linked with increased risk of asthma attacks in children and adults. The role of Vitamin D3 in reducing asthma attacks has been explored. Evidence has suggested that Vitamin D3 can reduce asthma risk by minimizing upper respiratory infections such as flu that can lead to the severity of asthma.
A study published in the Cochrane Review states that “Vitamin D3 supplementation reduced the need for asthma-related hospital admissions and emergency department visits by 50% with the rate of such events falling from 6 % to 3 %.”
Vitamin D3 and Pregnancy
Vitamin D3 deficiency is common among pregnant women and is related to the increased risk of preterm birth, preeclampsia, gestational diabetes and other tissue-specific conditions. It may also be implicated with fatal consequences on fetal growth, dentition, bone density and immune function and risk of infections.
Vitamin D3 supplementation in pregnancy may improve maternal Vitamin D3 status and may help in reducing the risk of preterm birth, preeclampsia, and low birth weight. Also, Vitamin D3 supplementation may improve fetal skeletal development, tooth enamel formation, and perhaps overall fetal growth and development. However, the evidence supporting the benefits and harms of the use of Vitamin D3 supplementation in pregnancy is still limited. Therefore, pregnant women are encouraged to receive adequate nutrition with proper Vitamin D3 supplementation.
Vitamin D3 and Type II Diabetes
Vitamin D3 deficiency is associated with insulin secretion, insulin resistance, and β-cell dysfunction in the pancreas. Vitamin D3 receptors in pancreatic β-cells play an essential role in the progression of type 2 diabetes. Administration of Vitamin D3 restores glucose-stimulated insulin secretion and promotes β-cell survival by altering the generation and effects of cytokines.
It also regulates the function of calbindin, a protein which helps to regulate intracellular calcium, thereby modulating insulin secretion. It also influences the concentration of parathyroid hormone associated with insulin synthesis and secretion in the pancreas.
How much Vitamin D3 is adequate?
Higher intake of Vitamin D3 may lead to hypervitaminosis and other adverse effects. Proper care should be exercised while taking Vitamin D3 supplements. Research suggests that the risk of taking too much Vitamin D3 is scarce; therefore, most of the people need to increase their Vitamin D3 intake. As per the Clinical Practice Guidelines, the adequate dose of Vitamin D3 is as follow:
- Infants (up to 1 year): up to 2,000 IU
- Children and adolescents (1–18 years): up to 4,000 IU
- Adults (> 18 years): up to 10,000 IU
- Pregnant women: up to 4000 IU/day
These levels are based on the results of studies demonstrating that the use of theses amounts within respective age groups was safe, and no adverse effects have been reported.
Vitamin D3 is integral for overall health, and the growing body of research is continually unveiling its significance. The hormone-like molecule supports the entire body from a healthy pregnancy, to bone and muscle integrity, immune and cardiovascular health and many more. Some people may think that sun exposure and diets are sufficient to obtain enough Vitamin D3, but scientific evidence suggests that most people need more amount.
Adequate supplementation, appropriate sun exposure, and consuming food sources of Vitamin D3 provides a balanced approach to achieve optimal amounts of this vital nutrient.
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