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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]
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]
When this molecule is exposed to UVB light from the sun it absorbs the energy in the process of being conveted to vitamin D. The function was to prevent DNA damage, the vitamin molecule at this time being an end product without function. Present day, phytoplankton in the ocean photosynthesize vitamin D without any calcium management function.
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. [3] [4]
Ergocalciferol, also known as vitamin D 2 and nonspecifically calciferol, is a type of vitamin D found in food. It is used as a dietary supplement [3] to prevent and treat vitamin D deficiency [4] due to poor absorption by the intestines or liver disease. [5]
Calcitriol is a hormone and the active form of vitamin D, normally made in the kidney. [8] [9] [10] It is also known as 1,25-dihydroxycholecalciferol.It binds to and activates the vitamin D receptor in the nucleus of the cell, which then increases the expression of many genes. [11]