Received a research grant from: Mars Symbioscience
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Manson, MD, DrPH, MACP, has disclosed the following relevant financial relationships: Professor of Medicine, Michael and Lee Bell Professor of Women's Health, Harvard Medical School Chief, Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusettsĭisclosure: JoAnn E.
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Received income in an amount equal to or greater than $250 from: Sanofi Novo Nordisk Bayer Amgen Boehringer Ingelheim Esperion Taub, MD, FACC, FASPC, has disclosed the following relevant financial relationships: Professor of Medicine, Division of Cardiovascular Medicine Director, Step Family Foundation Cardiovascular Rehabilitation and Wellness Center, UC San Diego Health System, La Jolla, Californiaĭisclosure: Pam R.
Download vitamin d video free trial#
Can you go over the trial with us?Īuthors and Disclosures Authors Pam R. But there were some other pearls from that trial on some benefits of vitamin D. Taub: Dr Manson, you recently led a very important landmark clinical trial, the VITAL trial, and you showed that vitamin D supplementation did not reduce cardiovascular risk.
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There are some more recently discovered biomarkers and evidence that the bioavailable and free 25-hydroxyvitamin D may provide some additional information, but the research has been quite limited, and certainly from a clinical standpoint, it would be the serum 25-hydroxyvitamin D that's the main biomarker of vitamin D status. Manson, MD, DrPH, MACP: Yes, I agree that there really isn't controversy about that point. Only 1,25-hydroxyvitamin D is useful for inborn and acquired disorders in calcium and vitamin D metabolism. It's often normal or even elevated in a vitamin D–deficient state because of secondary hyperparathyroidism. The active form of vitamin D gives you no insight into your vitamin D status. It's the major circulating form of vitamin D and it's used worldwide by doctors to measure the vitamin D status of patients. The only one to measure is 25-hydroxyvitamin D. Holick: I don't think there's any debate about this. I'd love to get both of your comments on what is the best biomarker to measure vitamin D levels. Taub: One of the things that has come up in many of these clinical trials is the biomarker by which we measure vitamin D. As a result, there are a multitude of association studies that have related vitamin D deficiency with increased risk for autoimmune disorders like type 1 diabetes, multiple sclerosis, and rheumatoid arthritis, and increased risk for cardiovascular disease, neurocognitive dysfunction, infectious diseases, and some malignancies. We think that it does it for the purpose of regulating cellular growth and a variety of genes.
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Then we began to realize that basically every tissue and cell in your body has a vitamin D receptor, and the obvious question is, why would they be there? There's now a large amount of evidence to suggest that immune cells, colon, breast, skin, and other cells in your body can activate vitamin D locally. Therefore, looking at receptors for 1,25-dihydroxyvitamin D, they were found in the intestine, bone, and kidney, which regulate calcium metabolism.
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Originally, we realized that vitamin D is really important for your bone health. We're now recognizing that vitamin D, of course, has to get activated, like you said, first in your liver to 25-hydroxyvitamin D and then in your kidneys to 1,25-dihydroxyvitamin D.