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Current Opinion in Pediatrics Feb 2017The purpose of this review is to examine the prevalence of vitamin D deficiency in pediatric gastrointestinal disease, specifically celiac disease and inflammatory bowel... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to examine the prevalence of vitamin D deficiency in pediatric gastrointestinal disease, specifically celiac disease and inflammatory bowel disease (IBD); to discuss the role of vitamin D and its deficiency in gastrointestinal disease pathophysiology; and to present current literature regarding diagnosis and treatment of vitamin D deficiency in these pediatric gastrointestinal diseases.
RECENT FINDINGS
Vitamin D deficiency is common in children with gastrointestinal symptoms and disease processes. In celiac disease, vitamin D status should be routinely assessed at the time of diagnosis and during subsequent follow up if deficient. There is growing evidence to suggest an inverse association between vitamin D and IBD activity; however, the therapeutic role of vitamin D in IBD patients requires further investigation.
SUMMARY
Suboptimal vitamin D status commonly occurs in children with gastrointestinal disease. It is advisable to check serum 25-hydroxy vitamin D levels in children with newly diagnosed celiac disease and IBD. In celiac disease, vitamin D status should be assessed during subsequent follow up if deficient. In IBD, 25-hydroxy vitamin D levels should be checked at least yearly. Therapy should be provided to maintain a level of greater than 30 ng/ml but less than 100 ng/ml; however, the ideal vitamin D dosing regimen to treat vitamin D deficiency and to maintain this optimum level remains unknown. The role of vitamin D as a therapeutic agent in IBD is still under investigation.
Topics: Celiac Disease; Child; Humans; Inflammatory Bowel Diseases; Prevalence; Vitamin D Deficiency
PubMed: 27930380
DOI: 10.1097/MOP.0000000000000451 -
Pediatric Endocrinology Reviews : PER Aug 2020Vitamin D is important for skeletal growth, bone mineralization and dental health. Vitamin D deficiency is reported in many countries, may have several causes and can... (Review)
Review
Vitamin D is important for skeletal growth, bone mineralization and dental health. Vitamin D deficiency is reported in many countries, may have several causes and can cause rickets in children. A guideline with recommendations of vitamin D supplementation to prevent nutritional rickets was published recently. The vitamin D receptor is present in many cells of the body including cells of the immune system. Many studies have been published on associations between vitamin D deficiency and extra skeletal effects, mainly without proof of causality in intervention studies. This review aims to summarize available evidence of the skeletal and extra-skeletal effects of vitamin D. For the extra-skeletal effects there is proof that vitamin D supplementation can prevent acute respiratory infections in children with vitamin D deficiency and can reduce the rate of asthma exacerbations requiring corticosteroids in children with vitamin D deficiency. The evidence of benefit of vitamin D supplementation is too limited for pediatric patients with other infectious, inflammatory, and autoimmune diseases.
Topics: Child; Dietary Supplements; Humans; Rickets; Vitamin D; Vitamin D Deficiency
PubMed: 32780952
DOI: 10.17458/per.vol17.2020.srb.vitamindpediatricpopulation -
Best Practice & Research. Clinical... Oct 2018Severe vitamin D deficiency can be defined as the dose of vitamin D or serum 25OHD concentrations needed to prevent nutritional rickets or osteomalacia. There is large... (Review)
Review
Severe vitamin D deficiency can be defined as the dose of vitamin D or serum 25OHD concentrations needed to prevent nutritional rickets or osteomalacia. There is large international consensus that these diseases can be prevented by 400 IU of vitamin D/d and 25OHD above 30 nmol/l (12 ng/ml). Vitamin D deficiency can also accelerate the risk of fractures and probably also of falls in elderly subjects but there is no consensus on the required daily doses or minimal 25OHD threshold for these endpoints. The majority of experts consider 800 IU/d and serum 25OHD above 50 nmol/l (20 ng/ml) as sufficient, with a minority opinion aiming for 75 nmol/l or even higher. For other extra-skeletal endpoints, no hard evidence is available to define whether or not this is causally related to vitamin D status. Therefore, for these endpoints no minimal dosage or 25OHD threshold can be defined.
Topics: Aged; Aged, 80 and over; Fractures, Bone; Humans; Rickets; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 30449548
DOI: 10.1016/j.beem.2018.09.014 -
Nutritional Neuroscience Aug 2021Inappropriate vitamin supply is a public health problem and is related to abnormalities in brain development, immune response and, more recently, in changes of gut... (Review)
Review
OBJECTIVES
Inappropriate vitamin supply is a public health problem and is related to abnormalities in brain development, immune response and, more recently, in changes of gut microbial composition. It is known that low levels of vitamin in early life are linked to increased susceptibility to neurodevelopmental disorders, such as Autism Spectrum Disorders (ASD). Unfortunately, the possible peripheral influences of vitamin deficiency that leads to alterations in the gut microbiota-immune-brain axis, one important modulator of the ASD pathology, remain unclear. This narrative review discusses how the impact of vitamin deficiency results in changes in the immune regulation and in the gut microbiota composition, trying to understand how these changes may contribute for the development and severity of ASD.
METHODS
The papers were selected using Pubmed and other databases. This review discusses the following topics: (1) vitamin deficiency in alterations of central nervous system in autism, (2) the impact of low levels of vitamins in immunomodulation and how it can favor imbalance in gut microbiota composition and gastrointestinal (GI) disturbances, (3) gut microbiota imbalance/inflammation associated with the ASD pathophysiology, and (4) possible evidences of the role of vitamin deficiency in dysfunctional gut microbiota-immune-brain axis in ASD.
RESULTS
Studies indicate that hypovitaminosis A, B12, D, and K have been co-related with the ASD neuropathology. Furthermore, it was shown that low levels of these vitamins favor the Th1/Th17 environment in the gut, as well as the growth of enteropathogens linked to GI disorders.
DISCUSSION
GI disorders and alterations in the gut microbiota-immune-brain axis seems to be linked with ASD severity. Although unclear, hypovitaminosis appears to regulate peripherally the ASD pathophysiology by modulating the gut microbiota-immune-brain axis, however, more research is still necessary to confirm this hypothesis.
Topics: Animals; Autism Spectrum Disorder; Avitaminosis; Brain; Gastrointestinal Microbiome; Humans
PubMed: 31506005
DOI: 10.1080/1028415X.2019.1660485 -
Clinics in Geriatric Medicine Aug 2019
Review
Topics: Aged; Aged, 80 and over; Humans; Vitamin B 12 Deficiency
PubMed: 31230733
DOI: 10.1016/j.cger.2019.03.004 -
Obesity Surgery Jan 2015Obesity is increasing vastly in the world, and the number of bariatric surgeries being performed is also increasing. Patients being submitted to bariatric surgeries,... (Review)
Review
Obesity is increasing vastly in the world, and the number of bariatric surgeries being performed is also increasing. Patients being submitted to bariatric surgeries, especially malabsorptive procedures, have an increased risk of developing nutrient deficiencies, which can culminate in symptomatic hypovitaminosis, if supplementation is not done correctly. The eye and the optic system need an adequate level of several vitamins and minerals to perform properly, especially vitamin A, and this article wants to cover the main nutrients involved, the possible ophthalmic complications that can arise by their deficiency, and the management of those complications.
Topics: Avitaminosis; Bariatric Surgery; Dietary Supplements; Eye Diseases; Humans; Minerals; Obesity, Morbid; Postoperative Complications; Vitamin A
PubMed: 25425087
DOI: 10.1007/s11695-014-1472-y -
Revue Medicale Suisse Oct 2022Vitamin B1 also known as thiamin is an essential vitamin assuring body functioning and comes exclusively from food. Vitamin B1 deficiency is an under-diagnosed disease...
Vitamin B1 also known as thiamin is an essential vitamin assuring body functioning and comes exclusively from food. Vitamin B1 deficiency is an under-diagnosed disease because it is less frequently suspected in high income countries. However, its risk factors, like alcohol and malnutrition, are common in the general population. Thiamin deficiency can lead to three clinical entities, Gayet-Wernicke encephalopathy, which can progress to Korsakoff encephalopathy, wet Beriberi and its dry form. These diseases are associated with high mortality and heavy long-term sequelae. Rapid diagnosis enables timely treatment.
Topics: Humans; Thiamine; Vitamins; Thiamine Deficiency; Beriberi; Wernicke Encephalopathy
PubMed: 36314092
DOI: 10.53738/REVMED.2022.18.801.2020 -
Military Medicine May 2022Vitamin D is critically important to numerous physiologic functions, including bone health. Poor vitamin D status is a common but underrecognized problem that... (Review)
Review
Vitamin D is critically important to numerous physiologic functions, including bone health. Poor vitamin D status is a common but underrecognized problem that predisposes the military population to stress fracture and completed fracture. This has significant implications for force health protection, warfighter readiness, attrition, and cost. Despite this, vitamin D deficiency is still underdiagnosed and undertreated in the military. This is a major hindrance to military readiness and one that could easily be modified with awareness, prevention, and early treatment. In this commentary, we review the literature on vitamin D deficiency and critically examine the current status of policies and clinical practice related to vitamin D in the military health system. We offer several practical recommendations to increase awareness and readiness while decreasing musculoskeletal injury and the associated costs.
Topics: Fractures, Stress; Humans; Military Personnel; Vitamin D; Vitamin D Deficiency
PubMed: 34626466
DOI: 10.1093/milmed/usab402 -
The Lancet. Diabetes & Endocrinology Feb 2022
Topics: Dietary Supplements; Humans; Vitamin D; Vitamin D Deficiency
PubMed: 35026160
DOI: 10.1016/S2213-8587(22)00002-X -
The Journal of Clinical Psychiatry Jun 2023Mild vitamin C deficiency is a psychiatrically relevant nutritional state, with symptoms including apathy, fatigue, and low mood. Although complete vitamin C deficiency...
Mild vitamin C deficiency is a psychiatrically relevant nutritional state, with symptoms including apathy, fatigue, and low mood. Although complete vitamin C deficiency has largely been eradicated, mild deficiency remains common in certain populations. Here, we aimed to identify the prevalence of mild vitamin C deficiency in the inpatient psychiatric setting. We identified 221 patients with plasma vitamin C levels collected on an inpatient psychiatric unit serving a metropolitan area between January 1, 2015, and March 7, 2022. We identified demographic (age, sex, race, housing status, Area Deprivation Index [an index of neighborhood disadvantage]), substance use (tobacco use, alcohol use), diagnostic (depressive, bipolar, psychotic, anxiety, substance use, catatonia, neurocognitive, autism spectrum), and micronutrient (folate, vitamin B, vitamin D) risk factors. was used as the diagnostic system. Bayesian log-normal regressions were constructed to predict vitamin C as a function of these risk factors. We used these same models to predict vitamin C as a function of significant risk factors. We found that 64% (141 of 221; 95% confidence interval 57%-70%) of patients met criteria for mild vitamin C deficiency. While we did not identify robust demographic, substance use, or diagnostic-based risk factors, we found that folate and vitamin D strongly predicted vitamin C levels. To test the utility of these predictors, we simulated vitamin C as a function of folate and vitamin D and found that predicted deficiency remained high ( 50%-55%), even when folate/vitamin D were sufficiently replete. We find that vitamin C deficiency is highly prevalent in the inpatient psychiatric setting and remains high even when the relevant risk factor profile is favorable.
Topics: Humans; Vitamin B 12 Deficiency; Folic Acid Deficiency; Inpatients; Bayes Theorem; Folic Acid; Ascorbic Acid Deficiency; Vitamin D; Ascorbic Acid
PubMed: 37339367
DOI: 10.4088/JCP.22m14616