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The natural, active form of vitamin D is calcitriol (1,25-dihydroxycholecalciferol). This molecule and other naturally occurring forms of vitamin D, including its precursors and metabolites, have been modified to synthesize pharmaceuticals with potentially greater, or selective, therapeutic actions. [1] [2] [3] [4]
Hypercalcemia of malignancy may also occur due to tumor production of vitamin D or parathyroid hormone. These causes are rare and constitute about 1% of all causes of hypercalcemia of malignancy. [22] Hypercalcemia of malignancy usually portends a poor prognosis, and the medial survival is 25–52 days of its development. [22]
Eldecalcitol is an analog of calcitriol, the active form of vitamin D. [1]Commonly used in Japan for the treatment of osteoporosis. [2] Osteoporosis is a common bone disease among the older generation, with an estimated prevalence of over 200 million people. [2]
Alfacalcidol (or 1-hydroxycholecalciferol) is an analogue of vitamin D used for supplementation in humans and as a poultry feed additive. Alfacalcidol has a weaker impact on calcium metabolism [ 3 ] and parathyroid hormone levels [ 4 ] than calcitriol ; but significant effects on the immune system , including regulatory T cells . [ 5 ]
Vitamin D 3 was shown to result from the ultraviolet irradiation of 7-dehydrocholesterol. Although a chemical nomenclature for vitamin D forms was recommended in 1981, [12] alternative names remain commonly used. [3] Chemically, the various forms of vitamin D are secosteroids, meaning that one of the bonds in the steroid rings is broken. [13]
Mapping of several bone diseases onto levels of vitamin D (calcidiol) in the blood [6] Normal bone vs. osteoporosis. Vitamin D deficiency is typically diagnosed by measuring the concentration of the 25-hydroxyvitamin D in the blood, which is the most accurate measure of stores of vitamin D in the body.
In 2021, it was the 235th most commonly prescribed medication in the United States, with more than 1 million prescriptions. [7] [8] Versions are also sold together with vitamin D. [3] In 2020, the combination, calcium/vitamin D was the 215th most commonly prescribed medication in the United States, with more than 2 million prescriptions. [9] [10]
Factors involved in the development of hypercalcemia include excess intestinal absorption of calcium, saturation of the bone's buffering capacity for calcium, decreased renal excretion, and abnormal vitamin D metabolism. [3] [10] [11] Underlying kidney disease is a risk factor for MAS, but even people with healthy kidneys can develop the ...