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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]
effective in hypercalcemia due to malignancy with elevated vitamin D levels (many types of malignancies raise the vitamin D level). [22] also effective in hypervitaminosis D and sarcoidosis; dialysis usually used in severe hypercalcaemia complicated by kidney failure. Supplemental phosphate should be monitored and added if necessary
It is used to prevent and treat lack of calcium and vitamin D in the elderly, as well for osteoporosis in combination with other medications. [ 1 ] [ 2 ] In 2022, the combination, calcium/vitamin D was the 246th most commonly prescribed medication in the United States, with more than 1 million prescriptions.
The uses of bisphosphonates include the prevention and treatment of osteoporosis, Paget's disease of bone, bone metastasis (with or without hypercalcemia), multiple myeloma, primary hyperparathyroidism, osteogenesis imperfecta, fibrous dysplasia, and other conditions that exhibit bone fragility.
Vitamin D is a group of structurally related, fat-soluble compounds responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, along with numerous other biological functions. [1] [2] In humans, the most important compounds within this group are vitamin D 3 (cholecalciferol) and vitamin D 2 (ergocalciferol). [2] [3]
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 ]
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.
Vitamin D toxicity, or hypervitaminosis D, is the toxic state of an excess of vitamin D. The normal range for blood concentration of 25-hydroxyvitamin D in adults is 20 to 50 nanograms per milliliter (ng/mL).