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Low Vitamin D Causes Problems For Acutely Ill Patients
05-06-2009, 12:49 AM,
#1
Low Vitamin D Causes Problems For Acutely Ill Patients
Low Vitamin D Causes Problems For Acutely Ill Patients
http://www.scienced aily.com/ releases/ 2009/04/09043009 1052.htm

ScienceDaily (May 2, 2009) — A group of endocrinologists in Sydney
have observed that very sick patients tend to have very low levels of
Vitamin D. The sicker they are, the lower the levels.

Dr Paul Lee, Professor John Eisman and Associate Professor Jackie
Center, researchers at Sydney's Garvan Institute of Medical Research,
examined a cohort of 42 Intensive Care Unit (ICU) patients. Forty-five
percent turned out to be Vitamin D deficient.

"Until now, the medical community has thought of Vitamin D deficiency
as a chronic condition," said Dr Lee. "Little is known about its acute
complications. "

"Last year, we published several cases showing that Vitamin D
deficiency can cause acute complications in the intensive care unit."

"Recently, Vitamin D has been recognised for its many roles beyond the
musculoskeletal system. It has been implicated in diabetes, in the
immune system, in cancers, in heart disease and in metabolic
syndrome."

"Vitamin D appears to have roles in controlling sugar, calcium, heart
function, gut integrity, immunity and defence against infection.
Patients in ICU suffer from different degrees of inflammation,
infection, heart dysfunction, diarrhoea and metabolic dysregulation –
so vitamin D deficiency may play a role in each of these common ICU
conditions."

"So we did a preliminary study and found that 45% of people in our ICU
were Vitamin D deficient. There may be a bias, in that all patients
were referred to endocrinology, so the numbers may not reflect the
prevalence in a standard ICU cohort. However 45% is still a
significant proportion.

When the team correlated the Vitamin D levels with a disease severity
score, there was a direct correspondence between sickness and Vitamin
D deficiency. In other words, the sicker someone was, the lower the
levels of Vitamin D. Out of the 42 patients studied, there were 3
deaths. The 3 patients who died all had the lowest level of Vitamin D
in the cohort.

"Perhaps when we are well, we have ways to compensate for organ
dysfunction if we run low on Vitamin D," said Lee.

"But when we are very sick, the "sick organs" draw upon any vitamin D
available to function properly, therefore we may need extra Vitamin D
to maintain organ function during critical illness. However, at this
stage, we don't know whether Vitamin D deficiency is just a marker of
ill health, or whether it contributes to disease severity."

Lee believes that the study, while preliminary, is important because
it highlights the fact that Vitamin D deficiency is common in
intensive care units and is associated with disease severity.

The next step will be a randomised control study to investigate
whether Vitamin D has benefits in critically ill patients. In simple
terms, two groups of patients (who are evenly matched) will be
treated, with Vitamin D added to the treatment of one group, but not
the other. The outcomes will then be compared.

So should doctors be trying to raise the Vitamin D levels of their
patients in the meantime?
Dr Lee hopes the randomised study may provide a more definitive answer
to the question. "However, Vitamin D is very safe. It's inexpensive
and has a very large safety window, making toxicity unlikely, unless
there are underlying diseases causing high calcium. Giving vitamin D
to severely deficient patients is very unlikely to cause harm. In
addition, ICU patients are lying in bed for a long time, and are at
risk of bone loss and osteoporosis. So if nothing else, Vitamin D will
help protect their bones."

These findings will be published as a letter in the April 30, 2009 issue of the
New England Journal of Medicine.

Adapted from materials provided by Garvan Institute of Medical Research.
Reply
05-06-2009, 03:07 AM,
#2
Low Vitamin D Causes Problems For Acutely Ill Patients
Excellent article nik. A good source of natural vit D is sunlight so the body will produce it. I think it is morning until 2pm, but it may be 1pm when UVB rays are best. After either 1 or 2pm, the rays are UVA which can cause damage. One of the treatments for NHL is UVB or in my case, NBUVB. I still prefer natural though.
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