Vit d Deficiency..

8/9/2019 Vit d Deficiency..

1/26

D deficiency

Presented by :

Asmaa


2/26

Vit D

Vitamin D is a group of fat-soluble vitamins.

Vitamin has several important functionsin the body:

It helps to absorb dietary calcium and phosphorusfrom the intestines.

It suppresses the release of parathyroid hormone, ahormone that causes bone resorption.

Vitamin D may have other benefits, such as

improving muscle and immune function.


3/26

Sources of vit D:

1. skin source


4/26

2. nutritional source:


5/26

Vit D deficiency

Vitamin D deficiency is caused by:

decreased exposure to the sun,

an inability of the body to absorb vitamin D,

or a lack of vitamin D in the diet.


6/26

Risk Factors for vit ddeficiency:

Dark Skin

Intestinal malabsorption

Inflammatory Bowel disease Gastric bypass

No sun exposure

Osteomalacia/Fragility Fractures Renal Disease

Old age


7/26

Symptoms of Vitamin Ddeficiency:

Many people have no symptoms of vitamin Ddeficiency until complications are present.Symptoms may also be mild.

Symptoms of vitamin D deficiency include:

Bone pain ,muscle cramps,

weakness and tingling,

loss of height.

difficulty standing up or climbing stairs


8/26

Complications of vitamin Ddeficiency:


9/26

Complications of vitamin Ddeficiency:

Rickets, Osteomalacia,

and osteoporosis .

tetany

other possible complications include:

hypertension,

depression,

cardiovascular disease,

and an increased risk of cancer

f i d


10/26

management of vit ddeficiency:

a. diagnosis :often missed

signs and symptoms develop slowly or arenonspecific.

normal values in adults :

1. A normal level :25OHD concentration >30 ng/mL

2. Vitamin D insufficiency 25OHDconcentration =20 to 30 ng/mL

3. Vitamin D deficiency 25OHD level < 20

ng/mL


11/26

Diagnosis may be suspectedbased on any of the following:

1.A history

2.Symptoms and signs of rickets, osteomalacia, orneonatal tetany

3.Blood test of 25(OH)D (D2+D3) levels

the best way to diagnose deficiency

4. Characteristic bone changes seen on xray

5.serum levels ofCa,

alkaline phosphatase, PTH


12/26

treatment of vit Ddeficiency:

1.summer day sun

2.artificial UVB radiation

3.human Oral vit D


13/26


14/26

available forms of vitamin D supplements are :

ergocalciferol (vitamin D2)

cholecalciferol (vitamin D3).

Vit D3 is better than vit D2:

1. vitamin D3 is the naturally occurring form

2. ergocalciferol is not human, and itsconsumption results in metabolic by-productsnot normally found in humans

3. vit D2 is also two- to four-times less effective

than vit D3


15/26

dose of vit d therapy

depends on:age

body weight

skin colour

patients with malabsorbtion

syndrome.


16/26

Vit d deficiency in theelderly:


17/26

Causes of vit d deficiency inthe elderly:

1. The production of vitamin D from theskin decreases with age.

reduced levels of 7-dehydrocholesterol,

2. Housebound elderly people often do notget adequate exposure to sunlight.

3. Decreased dietary intake, impairedintestinal absorption, and impaired

hydroxylation in the liver and kidneys


18/26

Consequences of vit ddeficiency in the elderly:

1. high bone turnover, bone loss,mineralization defects, and hip andother fractures. Less certain

consequences include myopathy andfalls.

2. osteomalacia:

3. osteoporosis:4. Cancer

5. cardiovascular diseases:


19/26

1. high bone turnover, bone loss,mineralization defects, and hip and

other fractures. Less certainconsequences include myopathyand falls.


20/26

2. osteomalacia:

Osteomalacia is the softening of the bones

due to defective bone mineralization.

Signs and Symptoms:

Bone weakness and pain Muscle weakness

Easy fracturing

Hypocalcaemia


21/26

Biochemical findings

The serum calcium is low

Urinary calcium is low

Serum phosphate is low

Serum alkaline phosphatase is high

Radiological appearances include:Pseudo fractures, also called Loosers

zones.

Protrusio acetabuli, a hip joint disorder

Treatment


22/26

3.osteoporosis: is a disease of bones that leads to

an increased risk of fracture. Inosteoporosis the bone mineraldensity (BMD) is reduced, bone

microarchitecture is disrupted, andthe amount and variety of proteins inbone is altered.


23/26

4. cancer

The effect mechanisms : regulation of the cell cycle,

stimulation of differentiation,

impairment of growth stimuli, inhibition of angiogenesis

and increased apoptosis of malignantcells.

The active vitamin D metabolite 1,25-dihydroxyvitamin D3 (1,25(OH)2D3,Calcitriol) is a major regulator of geneexpression


24/26

Common types of cancerthat vit D can suppress:

1.Colon Cancer

2.Prostate Cancer

3.breast cancer


25/26

. Cardiovascular disease.

Vitamin D receptors have a broadtissue distribution that includes

vascular smooth muscle,endothelium, and cardiomyocytes.

Vitamin D deficiency also alters

hormone levels and immune function,which can increase the risk ofdiabetes, a major contributor tocardiovascular disease,


26/26

Cvs diseases that may becaused by low vit D levels:

Atherosclerosis

Hypertension and MyocardialHypertrophy and infarction

Congestive Heart Failure

Vit d Deficiency..

Documents