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Graves’ and Thyroid Disease: The Journey. Vitamin D Yung Chen MD. Vitamin D. What is Vit. D Why we need it How to get it Do you need to supplement How much to take. What is Vitamin D. It is not a Vitamin It is a type of hormone synthesized from Cholesterol
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Graves’ and Thyroid Disease: The Journey Vitamin D Yung Chen MD
Vitamin D • What is Vit. D • Why we need it • How to get it • Do you need to supplement • How much to take
What is Vitamin D • It is not a Vitamin • It is a type of hormone synthesized from Cholesterol • Hormones are chemical messenger between cells • More then 2,700 receptor binding sites in human genome • Vit D is converted to calcidiol in the liver • Kidneys convert to calcitriol the biologic active form
Why we need it • Regulates calcium and phosphate to promote healthy bone • Prevent osteomalacia or rickets • Reduce rick of death in elderly • Prevents premature aging • Low levels associated with multiple sclerosis • Reduction of influenza infections
How to get Vit D • Ultraviolet (UV) B from sunlight on exposed skin • Reduced by skin melanin, sun screen, glass, smog, • Fatty fish like salmon, tuna and fish liver oils • 3 oz. Salmon ~300 iu • Supplement with Vit D3 not D2 • Vit D2 less potent
Do you need to supplement • Easy blood test via Lab Corp or Quest • serum 25-hydroxyvitamin D level • Lab normal range is 30 nmol/L to 140 nmol/L • What is the optimal level? • My level is between 50-60 nmol/L
How much to take • Depends on your serum level and health conditions • <20nmol/L; Take 10,000 iu per day for 2 month then retest • <40nmol/L; Take 5,000 iu per day for 2 month then retest • Monitor every 4-6 months • Vit D is fat soluble and takes time to build up reserves • Keep levels below 100 nmol/L
Vit D toxicity • Non-specific nausea, anorexia, weight loss, polyuria • Kidney and tissue calcification if too much calcium supp • Levels >500 nmol/L is potentially toxic • Stop vit D supplement and monitor symptoms • Levels drop off slowly due to fat soluble
My clinical observations • Reduction of Upper respiratory infections • Reduced joint / bone pain • Improved depression • Better skin, hair, nail • Maybe helpful in weight loss
Conclusion • Get you serum Vit D level tested • Get more sun exposure or take Vit D3 • Monitor levels on supplement • Take extra Vit D3 in the winter months