The Truth About Vitamin D Deficiency

Should we be evaluating patients for vitamin D deficiency in the hospital? Can giving vitamin D prevent COPD exacerbations? And should all patients with seizure disorders receive vitamin D supplementation? In this video we will take a look at the thresholds for treating, how to treat, the difference between ergocalciferol and cholecalciferol, and the evidence for supplementing vitamin D in COPD, seizure disorders, multiple sclerosis, and other conditions!

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[sanbetski]

Fun fact: dont check 25 OH if pts w renal insufficiency. Check 1, 25 Dihydroxy instead for accurate levels

[ricyha]

I'm not a medical student, but I do work in health care. After health podcasts, I really enjoy your content. This might sound weird - but I especially like to turn on a video of yours while eating. I appreciate your ability to deliver information digestible not only for medical students but the average literate person.
While I'm here, I might as well ask: do you follow any longevity individuals like Peter Attia or Rhonda Patrick; If so, what are your thoughts on them?

[Jbaler]

Love the videos, current registered nurse and also going to be a MS1 soon, your content will be incredibly helpful through core and audition rotations. Thanks a lot!

[mickeyauau]

Great video! Perhaps a video on b12 deficiency and the recommended work up? There’s often confusion on what labs to get

[ch_jay]

please share more dotphases like that one!!! dotphases is the way to go

[rawhidekid]

A nurse practitioner prescribed d3 for me. I noticed a big difference in a week.

[mickeyauau]

What diagnosis code do you recommend to use in outpatient setting to screen for vitamin D def?

[rameshkrishnaraj]

I cover six skilled nursing facilities and I’m responsible for 700 elderly patients and this is a great piece of information to have a cost-effective intervention with vitamin D supplementation can save a lot of orbit related to pathologic fracture aspirations. Patient have lowered seizure threshold secondary to CVA so they are on antiepileptics as well definitely useful.

[coder]

My vitamin D level is 73ng/mL do you recommend getting it lowered ?

[faylouise]

Vitamin D cholecalciferol is a photosynthesis that occurs only in epidermal cells on 7dehydrocholesterol that reside there, and only with UVB + heat, synthesis of cholecalciferol may be able to be made, it is a mechanical molecular configuration change. It is not made from cholesterol, the cholecalciferol vitamin D3 is the limiting substrate for all other conversions of metabolite and is considered a nutrient, .

Remember " If your shadow is longer than you are, you won't be able to make vitamin D at all".

Simply look at shadows, if they are the same length, or shorter, then it is vitamin D time, .

But keep in mind air quality, length of time of exposure, and that the skin that is older, or gets sun tanned, will have less ability to synthesize. The better areas for skin exposure are the belly, back, thighs,
and NOT the face, arms and lower legs.

There are no plant-sourced vitamin d cholecalciferol or ergocalciferol, you can get vitamin d2 ergocalciferol from appropriate sun exposure on some phytoplankton, algae, mushrooms (fungi), lichen, and depending on species some vitamin D3, being produced in vegan cholecalciferol supplements.



Ergocalciferol Vitamin d2 was identified and made into supplementation as a 'prescription' long before any laws were enacted into today's laws keeping vitamins and pharmaceutical supplements separate.
And to this day it stands as a 'prescription'.
That is all, it stays in the drs prescription list, the term "prescription" is misleading as using the word prescription denotes superiority and safety over a doubtful supplement, inacting and activating wide-held prejudices and beliefs.

The fact that 60 years or more on, and better science and the development of vitamin d3 cholecalciferol supplementation is now as easily available as water, that was something that did not exist before 1997.

The use of Ergocalciferol vitamin d2 was widely used for treatment, but is seen more now in research as a convenience of metabolite identification, because man, mammals don't endogenously make it it is foreign to our physiology and has to be supplemented, as such it is easy to use for research purposes.

And still is utilized by doctors, as it is there to be prescribed, in their prescription list.
Their education doesn't account for it.

Being that it is 2024 many doctors are better read, but their education on this topic is an individual investment, not something that comes top down.

Most simply go by guidelines, the guidelines often incorporate ergocalciferol in large dosing intervals for a short time without then retesting, and then simply recommending follow-up with daily 400-800iu cholecalciferol vitamin D3.

Depending on the individual doctors' interests, and the guidelines in their practice, patients will be told to either buy vitamin D3 over the counter, or their dr will prescribe a short-term vitamin D3 cholecalciferol of 20, 000iu, or will prescribe ergocalciferol vitamin D2 50, 000iu short term.

Just buy it yourself, daily intake of between 5000iu - 10, 000iu is a good place to start. Retest in three months and adjust.

Testing is important.