Screening for Vitamin D Deficiency: Is the Goal Disease Prevention or Full Nutrient Repletion?
Authors: Robert P. Heaney
Journal: Annals of Internal Medicine (2015)

Letters19 May 2015Screening for Vitamin D Deficiency: Is the Goal Disease Prevention or Full Nutrient Repletion?Robert P. Heaney, MDRobert P. Heaney, MDFrom Creighton University, Omaha, Nebraska.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5095-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Chausmer identifies rickets and osteomalacia as the only manifestations of vitamin D deficiency and presumably considers their prevention to be the principal effect of vitamin D, which is incorrect. Rickets and osteomalacia are probably the most evident and severe manifestations, but more than 90% of vitamin D acts outside of the calcium and bone economies and is involved in gene transcription essential for the function of most tissues (1). 1,25-Dihydroxyvitamin D [1-25(OH)2D], needed for that function, is not carried to the cells through the blood but is synthesized intracellularly by the tissues concerned precisely when they need ...References1. Heaney RP, Armas LAG. Quantifying the vitamin D economy. Nutr Rev. 2015;73:51-67. CrossrefMedlineGoogle Scholar2. Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science. 2006;311:1770-3. [PMID: 16497887] CrossrefMedlineGoogle Scholar3. Hollis BW, Wagner CL. Clinical review: the role of the parent compound vitamin D with respect to metabolism and function: why clinical dose intervals can affect clinical outcomes. J Clin Endocrinol Metab. 2013;98:4619-28. [PMID: 24106283] doi:10.1210/jc.2013-2653 CrossrefMedlineGoogle Scholar4. Luxwolda MF, Kuipers RS, Kema IP, Dijck-Brouwer DA, Muskiet FA. Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. Br J Nutr. 2012;108:1557-61. [PMID: 22264449] doi:10.1017/S0007114511007161 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Creighton University, Omaha, Nebraska.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2573. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Vitamin D Deficiency: Is the Goal Disease Prevention or Full Nutrient Repletion? Robert P. Heaney and Laura A.G. Armas Screening for Vitamin D Deficiency in Adults: U.S. Preventive Services Task Force Recommendation Statement Michael L. LeFevre and Screening for Vitamin D Deficiency: Is the Goal Disease Prevention or Full Nutrient Repletion? Arthur B. Chausmer Screening for Vitamin D Deficiency: Is the Goal Disease Prevention or Full Nutrient Repletion? Arthur B. Chausmer Metrics Cited byVitamin D Deficiency in Sepsis 19 May 2015Volume 162, Issue 10Page: 739KeywordsAttentionCellsDisclosureInfantsLactationMetabolitesNutrientsVitamin DVitamin D deficiency ePublished: 19 May 2015 Issue Published: 19 May 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...