Last reviewed by Miljan Krcobic on August 28th, 2018.
Why do we need Vitamin D?
Vitamin D has an important role in bone and calcium homeostasis. It is also in the process of investigation for use in cardiovascular disease, infections, cancer, diabetes,multiple sclerosis,respiratory health, psoriasis and other conditions.
Vitamin D isn’t actually a vitamin at all, but a hormone called “Calcitriol” or Vitamin D3. It is created through the skin from steady sunlight exposure and UV radiance, though you can also intake small amounts of it from certain foods like cod liver oil and liver. The best kind of cod liver is fermented cod liver oil.
Why do we need Calcium?
Calcium is a mineral necessary for life. It plays essenital role in building stronger, denser bones in early life but it also keeps bones healthy and strong later in life. About 99% of the calcium in the human body is localized in the bones and teeth.
However, overload of intracellular calcium can cause oxidative stress and apoptosis of some cells, sometimes causing several diseases. This mineral is also needed for adequate electrical conduction in the heart because calcium replaces natrium as the mineral that depolarizes the cell thus proliferating the action potential.
Calcium ion is important intracellular signal, needed for many cellular functions and processes, including neuronal transmission, muscle contraction, fertilisation, cell growth or proliferation, cellular motility, learning, memory and secretion of saliva.
Consequences of Vitamin D and Calcium deficiency
Vitamin D deficiency results in abnormalities in calcium, phosphorus levels and bone metabolism. Deficiency of Vitamin D may cause a decrease in the absorption of dietary calcium and phosphorus, resulting in an increase in hormone PTH levels.
The PTH-mediated increase impacts osteoclast activity and may cause bone weakness and causes a generalized decrease in bone mineral density (BMD), resulting with osteoporosis and osteopenia. An inadequate levels of calcium and phosphorus in the body will further cause a mineralization defect of bones. In young children such defect results in a variety of skeletal deformities classically known as rickets.
It is also found that low Vitamin D levels may also cause muscle weakness affecting children to have difficulties in standing and walking while the elderly have more frequent falls and increased sway with increased risk of fractures.
Long-term deficiency of calcium can lead to rickets in children and poor blood clotting. In menopausal women, deficiency of calcium can lead to osteoporosis, increasing the risk of falls fractures. While a lifelong deficit of calcium can affect bone and tooth formation, over-retention can cause hypercalcemia, impaired kidney function, and decreased absorption of other minerals. Vitamin D is needed to properly absorb calcium.
What are the main sources of Vitamin D and Calcium?
A major resource of vitamin D for humans is its synthesis after the exposure of the skin to sunlight typically between 10:00 h and 15:00 h in the spring, summer, and fall. Vitamin D which is produced in the skin may last at least twice longer in the blood compared to ingested vitamin D.
When an adult wearing a bathing suit is exposed to one minimal erythemal dose of UV radiation the amount of vitamin D produced is equivalent to ingesting between 10,000 and 25,000 IU.
Different factors can reduce the skin’s production of vitamin D3, including aging, increased skin pigmentation and the topical application of a sunscreen. An alteration of the sun zenith angle caused by a latitude change, season of the year, or time of day may also influences the skin’s production of vitamin D3.
Milk is an excellent source of calcium, ant calcium from milk is excellently absorbed. Soymilk and other vegetable milks contains calcium added with concentrations as high as in milk. Good vegatable sources of calcium are: kelp, wakame, almonds, hazelnuts, sesame, and pistachio, molasses, beans especially soy beans, spinach, figs, quinoa, okra, rutabaga, broccoli, dandelion leaves and kale.
Vitamin D and Calcium dosing
The American Academy of Pediatrics recommends 400 IU/day of vitamin D in infants and adolescents. Clinical data have not yet established definitive recommendations for therapeutic dosages of vitamin D. However, it has been shown that in the elderly, 700 to 1,000 IU/day reduce the risk of falls.
The dose of calcium is different for different patients. It is used as a supplement in the following dosage forms: capsules, chewable tablets, tablets,oral solution, lozenges, oral suspension, syrup. It is available in the form of salt, usually as: calcium carbonate or gluconate
Recommended doses of calcium for the U.S.:
- Adults and teenagers—800 to 1200 milligrams (mg) per day
- Pregnant and breast-feeding females—1200 mg per day.
- Children 4 to 10 years of age—800 mg per day.
- Children birth to 3 years of age—400 to 800 mg per day.
Vitamin D and Calcium combination
Should calcium and vitamin d be taken together? Calcium and vitamin D combination is used to prevent or to treat a calcium deficiency. These two perfectly goes together, as Vitamin D increases absorption of calcium. Appropriate adult doses are 1000 to 1300 mg dailly Calcium and 200 to 800 IU Vitamin D.
Patients should avoid taking any other vitamin or mineral supplements that also contain calcium or vitamin D without doctor’s advice while there are on vitamin D/calcium combination treatment. Antacid administration shoul be also avoided within 2 hours before or after you take calcium and vitamin D combination. Antacids can make it harder your body to absorb calcium and vitamin D.
Patients should ask their doctor or pharmacist if it is safe for you to take these medicines if they have:
- kidney disease
- past or present kidney stones
- heart disease
- high levels of calcium in your blood
- circulation problems
- parathyroid gland disorder
- Patients shouldn’t take calcium and vitamin D without doctor’s advice if they are pregnant or breast-feeding a baby. Your dose needs may be different during this time.
Call your doctor immediately if you have signs of too much calcium in your body, such as:
stomach pain, vomiting, loss of appetite; increased thirst or urination; muscle pain or weakness, joint pain; confusion, and feeling tired or restless.
Common side effects of this combination may also include:
- irregular heartbeat
- metallic taste in your mouth
- muscle or bone pain
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