“We must reiterate that vitamin D supplementation in deficient subjects, i.e. with a blood dosage below 20 nanograms per milliliter (or 50 nanomols per liter), can determine a great benefit. The threshold indicated as sufficiency is an excellent reference for know whether it is appropriate to supplement or not, but in some categories at risk, such as the elderly, it is always good to think about supplementation since endogenous production is clearly insufficient starting from the age of 65, especially in the winter months”. So Maurizio Rossini, professor of Rheumatology, University of Verona from the stage of the 59th congress of the Italian Society of Rheumatology (Sir) underway in Rimini, during the session dedicated to metabolic diseases of the skeleton in which Vitamin D was discussed.
The scientific review New england journal of medicine (Nejm) – it has been recalled in the various reports – recently published a study (Vital) which evaluated the effects of vitamin D supplementation in reducing the risk of fractures, but in subjects largely non-deficient and non-osteoporotic. The conclusions of the study, on the substantial uselessness of the drug for the reduction of the risk of fracture, had a significant resonance in the media, generating a lot of confusion. “This study is absolutely not adaptable to subjects who are deficient in vitamin D, especially if they are also osteoporotic – clarified Rossini – in which meta-analyses of various studies have confirmed that supplementation with vitamin D, especially if associated with an adequate calcium intake, reduces the risk of any fracture, especially those of the femur.So, the study in question, which I think frankly of little use for this goal, has only demonstrated one obvious thing: if you are not deficient, you do not need vitamin D supplementation to prevent fractures”.
From the same study came other messages, in this case much more interesting, of potential positive extra-skeletal effects of vitamin D supplementation. “In fact, a reduction in the incidence of metastatic and fatal cancer of any type has been observed – adds Rossini – and a reduction in the incidence of autoimmune diseases, such as psoriasis or rheumatoid arthritis. It was also remembered that vitamins D are not all the same. “There is no doubt that cholecalciferol or vitamin D3 currently provides the greatest guarantees in terms of safety and efficacy – concludes the specialist – and it is not true that we need to resort to other vitamin D preparations to correct the deficiency more quickly: it is enough use the correct dose”.
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