D VITAMIN: NEW REFERENCE VALUES
The Department of Bone and Mineral Metabolism of the Brazilian Society of Endocrinology and Metabolism - SBEM, presided by Doctor Carolina Moreira, informed that the normality values of the D Vitamin 25 OH have been discussed for some time. The normal value was above 30 ng/mL and had been proposed by Endocrine Society and SBEM. However, nowadays values from 20 ng/mL are being accepted.
The positioning of the Department after the alteration is the following:
* Above 20 ng/mL is the desirable for the general healthy population;
* Between 30 and 60 ng/mL is the recommended for risk groups such as elderly, pregnant women, patients with osteomalacia, rickets, osteoporosis, secondary hyperparathyroidism, inflammatory diseases, autoimmune and chronic kidney diseases and pre-bariatric;
* Between 10 and 20 ng/mL is considered low at risk of increasing bone remodeling and, due to this, causing loss of bone mass, besides the risk of osteoporosis and fractures;
* Below 10 ng/mL very low and at risk of evolving with defect in bone mineralization, which is osteomalacia and rickets.
The patients, in these cases, present bone pain, muscular weakness and may have fractures; and above 100 ng/mL is considered high at risk of hypercalcemia ( when the amount of calcium in the blood is greater than the normal ) and intoxication.
Patients who are between the dosages from 20 to 30 ng/mL don’t need vitamin reposition and values above 100 ng/mL are toxic, and the reposition must be made with medical assistance.
Prohormone, produced from the action of the B ultraviolet ray on the skin, the D vitamin may be found in foods such as salmon oils, tuna fish and sardine, egg yolk, liver, milk, yogurt and cheeses or in capsules or pills.
In some cases of D vitamin deficiency the patient may be asymptomatic. When the symptoms appear it is important to watch out for fatigue, muscular weakness and chronic pain.
Published on: October 16th, 2017