Vitamin D

VITAMIN D
Vitamin D
 Fat soluble vitamin
 Our body can synthesize it with help

of sunlight from cholesterol
 Essential for maintaining normal

calcium metabolism
 Is transported in blood bound to

carrier proteins
Forms
 Vitamin D3 (Cholecalciferol)- made in
skin
 Dietary form can be Vitamin D3 or

closely related molecule of plant origin
Vitamin D2 (Ergocalciferol)-Plant/
dietary source
 Transformation occurs in:

Liver
 kidney
Functions
Required to maintain normal blood
levels of calcium & phosphate
needed for:
 Normal mineralization of bone

 Muscle contraction
 Nerve conduction
 General cellular functions in all
cells of body
Mobilization of bone calcium &
phosphorus
Mineralization & formation of
new bone
Plays a role in synthesis of a

prominent non-collagenous protein
found in bone matrix & dentine
associated with new bone
formation
 Bone growth and development:
Involved in calcification of osteoid
tissues. Osteoid is a protein
mixture & when it mineralizes, it
becomes bone
 Enhances Modulation of the

transcription of cell cycle proteins.
 Formation of enzymes
Essential for formation of enzymes
involved in calcium transport &
collagen formation in bone matrix
 Regulation of amino acid levels

in blood
Helps to prevent loss of amino
acids through kidney & regulates
amino acid level & citric acid level
in tissues & bones
 Participate in muscle formation
and metabolism
 Inhibit cancer cell proliferation

& growth
Diminishes spreading of abnormal
intestinal, lymphatic, mammary &
skeletal cells & provides potential
for treatment of skin diseases such
as psoriasis.
 Role in immune system
Active form of Vitamin D acts as
hormone helps in inhibition of
immune responses mediated by T
cells
Regulation of blood pressure

Decrease risk of high blood
pressure
Sources
Retention
A stable vitamin
 Neither cooking nor long-term

storage significantly reduce
vitamin D levels in food
TO SUM UP
Human body can synthesize
vitamin D from _______ in the
presence of________.
________form of vitamin D is
made in skin while ______ form is
received from diet.
Vitamin D is required for
________ of bones.
Give role of vitamin D in

a) Immune system
b) Prevention of tumor
HOME ASSIGNMENT
Vitamin D is needed to maintain
normal serum levels of_______ &
________ minerals.
Vitamin D is a _____compound &

is not destroyed by_______.
Give sources of vitamin D in our

diet.
Write about function of vitamin
D in mobilization of bone calcium &
phosphorous.
________ form of vitamin is

made by our skin.
Deficiency
Either:
Dietary absence of Vit D, or
Lack of UV (sunlight) exposure
Causes bone disease

Rickets in infants / children &
Osteomalacia in adults
Rickets
 Softening of bones in children
potentially leading to fractures
& deformity
 Delayed closure of
fontanelles ;a soft membranous
gap between cranial bones,
softening and reduced
mineralization of the skull.
 Delayed sitting & crawling
 Bossing of skull
 Bow legs
 Enlargement of the
costochondral junction (a
cartilage that attaches front
of ribs to breastbone) with
rows of knobs or beads
forming Rachitic Rosary, pigeon
chest and spinal curvature
 Enlargement of wrist, knee
(knock knees) & ankle joints
 Poorly developed muscles
 Lack of muscle tone
 Pot belly (due to weakness of
abdominal muscles)
 Restlessness & nervous
irritability
 Tetany characterized by low
serum calcium, muscle
twitching, cramps & convulsions
 Delayed dentition
 Malformation of teeth
A glance at signs
Bone pain or tenderness
Dental problems
Muscle weakness (rickety

myopathy or "floppy baby
syndrome")
Increased tendency for fractures

(easily broken bones)
Skeletal deformity
Toddlers: Bowed legs (genu varum)

Older children: Knock-knees (genu
valgum)
Deformities of cranial, spinal & pelvic
Growth disturbance
Hypocalcemia (low level of calcium

in the blood)
Tetany (uncontrolled muscle
spasms all over the body)
Craniotabes (soft skull)
Costochondral swelling (rickety

rosary or rachitic rosary)
At risk population
Breast-fed infants whose mothers
are not exposed to sunlight
Breast-fed infants who are not

exposed to sunlight
Individuals not consuming

fortified milk, such as those who
are lactose intolerant
Osteomalacia
 Adult rickets
 Occurs when
Diet is lacking of Vitamin D &

calcium, in women who have had
many pregnancies
 who subsist on a meager cereal

diet with little exposure to sunshine
♠Symptoms are:
 Softening or demineralization of
bones leading to
Deformities of legs, spine, thorax

& pelvis
As bones soften, weight may cause

bowing of long bones & flattening of
pelvic bone.
 Rheumatic pain in bones of legs
& back
 General weakness with

difficulty in walking
 Spontaneous multiple fractures
 Normal child birth is difficult

due to sacrum and rib
deformities.
Toxicity
♠ Cases of intoxication are rare
♠ Adverse effects of high intakes

include
Hypercalciuria (excessive urinary
calcium excretion)
Hypercalcaemia (high concentration

of calcium in blood)
♠Symptoms are:
 Anorexia
 Nausea & vomiting followed by
 Polyuria (excessive urine)
 Polydipsia (excessive thirst)
 Weakness
 Nervousness
 Pruritis (itchiness)
 Impaired Renal function
 Toxicity may occur in individuals
on excessive amounts of
supplemented vitamins, e.g drinking
milk fortified with inappropriately
high levels of vitamin D3
Dietary Requirements
Indian Council of Medical Research
(ICMR) suggested 200 – 400 IU/d
for Indians
Supplement providing 400 - 800 IU

essential for elderly, particularly
who consume less milk & are totally
home bound
TO SUM UP
Bone disease caused by vitamin D
are___________ and _________.
RDA suggested by ICMR for

vitamin D is__________.
Formation of beads in the rib

bones is called__________.
_________ is the common sign of
rickets.
________is caused in pregnant
women due to lack of vitamin D and
leads to difficult delivery as
________ bone is distorted.
HOME ASSIGNMENT
_________ and _______ are
adverse effects of vitamin D
toxicity.
Tetany is a symptom
of________.
_______ amount of vitamin D
supplementation is essential for
elderly.
Write about signs and at risk
population of vitamin D deficiency
in adults.
Write a short note on Rickets.

Vitamin D

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VITAMIN D

 Our body can synthesize it with help

 Essential for maintaining normal

 Is transported in blood bound to

 Dietary form can be Vitamin D3 or

 Transformation occurs in:

 Normal mineralization of bone

Plays a role in synthesis of a

 Enhances Modulation of the

 Regulation of amino acid levels

 Inhibit cancer cell proliferation

Regulation of blood pressure

 Neither cooking nor long-term

Give role of vitamin D in

Vitamin D is a _____compound &

Give sources of vitamin D in our

________ form of vitamin is

Causes bone disease

Muscle weakness (rickety

Increased tendency for fractures

Toddlers: Bowed legs (genu varum)

Deformities of cranial, spinal & pelvic

Hypocalcemia (low level of calcium

Craniotabes (soft skull)

Costochondral swelling (rickety

Breast-fed infants who are not

Individuals not consuming

Diet is lacking of Vitamin D &

 who subsist on a meager cereal

Deformities of legs, spine, thorax

As bones soften, weight may cause

 General weakness with

 Spontaneous multiple fractures

 Normal child birth is difficult

♠ Adverse effects of high intakes

Hypercalcaemia (high concentration

Supplement providing 400 - 800 IU

RDA suggested by ICMR for

Formation of beads in the rib

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