hypoparathyroidism is overtreated.
D2 (ergocalciferol)
D3 (cholecalciferol): The naturally occurring form and the form used for low-dose supplementation
Vitamin D3 is synthesized in skin by exposure to direct sunlight (ultraviolet B radiation) and obtained in the diet chiefly in fish liver oils and salt water fish (see table Sources, Functions, and Effects of Vitamins
calcitriolparathyroid hormone (PTH), and serum concentrations of calcium and phosphate.
), but mainly it increases calcium and phosphate absorption from the intestine and promotes normal bone formation and mineralization.
psoriasis, hypoparathyroidism, and renal osteodystrophy1–34, 56, 7) and falls (89).
(See also Overview of Vitamins.)
Physiology references
1. Autier P, Mullie P, Macacu A, et alLancet Diabetes Endocrinol 5 (12):986–1004, 2017. doi: 10.1016/S2213-8587(17)30357-1
2. Manson JE, Cook NR, Lee IM, et alN Engl J Med 380(1):33-44, 2019. doi: 10.1056/NEJMoa1809944
3. Cianferotti L, Bertoldo F, Bischoff-Ferrari HA, et alEndocrine 56:245-261, 2017. doi:10.1007/s12020-017-1290-9
4. Okereke OI, Reynolds CF 3rd, Mischoulon D, et al: Effect of long-term vitamin D3 supplementation vs placebo on risk of depression or clinically relevant depressive symptoms and on change in mood scores: A randomized clinical trial. JAMA 324(5):471-480, 2020. doi: 10.1001/jama.2020.10224
5. Barbarawi M, Kheiri B, Zayed Y, et alJAMA Cardiol 2019 Nov 6]. JAMA Cardiol 4(8):765-776, 2019. doi: 10.1001/jamacardio.2019.1870
6. Yao P, Bennett D, Mafham M, et alJAMA Netw Open 2(12):e1917789, 2019. doi:10.1001/jamanetworkopen.2019.17789
7. Kong SH, Jang HN, Kim JH, et alEndocrinol Metab 37:344-358, 2022. doi:10.3803/EnM.2021.1374
8. Ling Y, Xu F, Xia X, et alClin Nutr 40:5531-5537, 2021. doi:10.1016/j.clnu.2021.09.031
9. Appel LJ, Michos ED, Mitchell CM, et alAnn Intern Med 174:145-156, 2021. doi:10.7326/M20-3812
hypercalcemia. Anorexia, nausea, and vomiting can develop, often followed by polyuria, polydipsia, weakness, nervousness, pruritus, and eventually renal failure. Proteinuria, urinary casts, azotemia, and metastatic calcifications (particularly in the kidneys) can develop.
Hypercalcemia plus risk factors or elevated serum 25(OH)D levels
> 150 ng/mL (> 375 nmol/L). Levels of 1,25-dihydroxyvitamin D, which need not be measured to confirm the diagnosis, may be normal.
IV hydration plus corticosteroids or bisphosphonates
Kidney damage or metastatic calcifications, if present, may be irreversible.
