Discussie over vitamine D

Denk aan vitamine D, vitamine B12, selenium, coeliakie, bijnier, vitiligo, gewrichten en vasculitis
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laura
Berichten: 3071
Lid geworden op: 11 sep 2013, 22:42
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Re: Discussie over vitamine D

Bericht door laura » 05 dec 2016, 14:17

Lees hele artikel met link: Vitamin D deficiency is not associated with early stages of thyroid autoimmunity


Abstract

Context Vitamin D deficiency has been identified as a risk factor for a number of autoimmune diseases including type 1 diabetes and multiple sclerosis.

Objective We hypothesized that low levels of vitamin D are related to the early stages of autoimmune thyroid disease (AITD).

Design Two case–control studies were performed. In the cross-sectional study A, euthyroid subjects with genetic susceptibility for AITD but without thyroid antibodies were compared with controls. Cases were subjects from the Amsterdam AITD cohort (euthyroid women who had first- or second-degree relatives with overt AITD) who at baseline had normal TSH and no thyroid antibodies; controls were healthy women examined at the same period. In the longitudinal study B, subjects who developed de novo thyroid peroxidase antibody (TPO-Ab) were compared with those who did not. Cases and controls were subjects from the Amsterdam AITD cohort who at baseline had normal TSH and no thyroid antibodies and during follow-up developed TPO-Ab (cases) or remained without thyroid antibodies (controls). Controls in both studies were matched for age, BMI, smoking status, estrogen use, month of blood sampling, and in study B for the duration of follow-up.

Results Serum 25(OH)D levels were as follows: study A: 21.0±7.9 vs 18.0±6.4 ng/ml (78 cases vs 78 controls, P=0.01); study B: baseline, 22.6±10.3 vs 23.4±9.1; follow-up 21.6±9.2 vs 21.2±9.3 ng/ml (67 cases vs 67 controls, NS).

Conclusions Early stages of thyroid autoimmunity (in study A genetic susceptibility and in study B development of TPO-Ab) are not associated with low vitamin D levels.
laura

Kijk voor meer informatie ook eens op Schildkliertje.

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ineke
Berichten: 410
Lid geworden op: 08 nov 2014, 17:53

Zwangere met vitamine D tekort meer kans op kind met autisme

Bericht door ineke » 11 dec 2016, 13:25

Onderzoek Erasmus MC > Generation R Studie

Onderaan link naar volledig publicatie in Springer Nature



Persbericht - Rotterdam, 07 december 2016
Zwangere met vitamine D tekort meer kans op kind met autisme
Op zesjarige leeftijd vertonen deze kinderen vaker afwijkend gedrag


Vrouwen met een te lage vitamine D spiegel tijdens hun zwangerschap vergroten daarmee het risico op autisme bij hun kinderen. Op zesjarige leeftijd hebben deze kinderen twee keer vaker problemen met sociale interactie en vertonen zij afwijkend gedrag in vergelijking met leeftijdsgenootjes.
Dit blijkt uit onderzoek van Australische wetenschappers in samenwerking met onderzoekers van het Erasmus MC op basis van gegevens uit de grootschalige Generation R studie in Rotterdam. De onderzoekers publiceerden hun bevindingen onlangs in wetenschappelijk tijdschrift Molecular Psychiatry.


Dat vitamine D belangrijk is voor gezonde botten is bekend. Ook dat het een belangrijke rol speelt in de ontwikkeling van de hersenen.
“Ons onderzoek levert het bewijs dat een tekort aan vitamine D bij zwangeren al voor de geboorte van kinderen het risico op autisme vergroot”, zegt bijzonder hoogleraar Psychiatrie Henning Tiemeier.

“Een te lage vitamine D spiegel van de moeder tijdens de zwangerschap verstoort een optimale ontwikkeling van de hersenen van deze kinderen. Op zesjarige leeftijd vertonen deze kinderen twee keer vaker symptomen die horen bij autisme. Ze maken bijvoorbeeld weinig oogcontact tijdens sociale interactie met anderen. Ook vertonen zij afwijkend gedrag in hun bewegingen, het zogeheten repetitief stereotype gedrag”.


De onderzoekers gebruikten de gegevens van meer dan 4000 kinderen uit de Generation R Studie, waarvan de vitamine D concentraties in het bloed van de moeders werden gemeten bij 20 weken zwangerschap en kort na de geboorte uit de navelstreng.
Tiemeier: “Deze twee momenten geven ons een consistent beeld van de situatie, want 16 procent van de moeders had een te lage vitamine D spiegel. Dat wil zeggen een concentratie onder de 25 nmol/L vitamine D in het bloed. Bij de geboorte had één op de drie kinderen en lage vitamine D spiegel, maar de lage waarde van de moeder tijdens de zwangerschap blijkt het meest van invloed op de afwijkende symptomen die de kinderen op latere leeftijd vertonen.”


In Nederland adviseert de Gezondheidsraad zwangeren om vitamine D te slikken. Tiemeier: “Onze resultaten bevestigen dat dit advies goed is en dat je daarmee schade in de ontwikkeling van de hersenen tijdens de zwangerschap kunt voorkomen, die mogelijk niet op een later moment te herstellen is. Wij hebben geen aanwijzingen in ons onderzoek dat kinderen met autisme baat hebben bij extra vitamine D.”


Generation R is een grootschalige bevolkingsstudie naar de groei, ontwikkeling en gezondheid van 10.000 kinderen in Rotterdam. De publicatie is online terug te vinden op de website van wetenschappelijk tijdschrift Molecular Psychiatry.


Bron: Erasmus MC Rotterdam




Abstract van het onderzoekartikel:
Gestational vitamin D deficiency and autism-related traits: the Generation R Study

There is intense interest in identifying modifiable risk factors associated with autism-spectrum disorders (ASD).
Autism-related traits, which can be assessed in a continuous fashion, share risk factors with ASD, and thus can serve as informative phenotypes in population-based cohort studies.
Based on the growing body of research linking gestational vitamin D deficiency with altered brain development, this common exposure is a candidate modifiable risk factor for ASD and autism-related traits.

The association between gestational vitamin D deficiency and a continuous measure of autism-related traits at ~6 years (Social Responsiveness Scale; SRS) was determined in a large population-based cohort of mothers and their children (n=4229). 25-hydroxyvitamin D (25OHD) was assessed from maternal mid-gestation sera and from neonatal sera (collected from cord blood). Vitamin D deficiency was defined as 25OHD concentrations less than 25?nmol?l?1.
Compared with the 25OHD sufficient group (25OHD>50?nmol?l?1), those who were 25OHD deficient had significantly higher (more abnormal) SRS scores (mid-gestation n=2866, ?=0.06, P<0.001; cord blood n=1712, ?=0.03, P=0.01).

The findings persisted (a) when we restricted the models to offspring with European ancestry, (b) when we adjusted for sample structure using genetic data, (c) when 25OHD was entered as a continuous measure in the models and (d) when we corrected for the effect of season of blood sampling.
Gestational vitamin D deficiency was associated with autism-related traits in a large population-based sample. Because gestational vitamin D deficiency is readily preventable with safe, cheap and accessible supplements, this candidate risk factor warrants closer scrutiny.


Volledig artikel
Open

Table 1.
Raw counts and proportions of parental and offspring variables (N=4229).
http://www.nature.com/mp/journal/vaop/n ... gure-title

Table 2.
Prevalence of deficiency in mid-gestation and cord 25OHD samples
http://www.nature.com/mp/journal/vaop/n ... gure-title

Table 3.
Association between mid-gestation and cord 25OHD deficiency and social responsiveness scale
http://www.nature.com/mp/journal/vaop/n ... gure-title


Conclusions
25OHD deficiency assessed either at mid-gestation or at birth was associated with an increase in autism-related traits in 6-year-old children.
The association between developmental vitamin D deficiency and autism-related traits may have important implications from a public health perspective.
It is feasible that a safe, cheap and publicly accessible vitamin D supplement in at-risk groups may reduce the prevalence of this risk factor.
Just as prenatal folate supplementation has reduced the incidence of spina bifida, we speculate that prenatal vitamin D supplementation may reduce the incidence of ASD.


Link volledig artikel:
http://www.nature.com/mp/journal/vaop/n ... 16213a.pdf



.

ineke
Berichten: 410
Lid geworden op: 08 nov 2014, 17:53

Zwangere met vitamine D tekort meer kans op kind met autisme

Bericht door ineke » 11 dec 2016, 14:54

Item in EenVandaag op woensdag 7 december j.l.:
Autisme door tekort vitamine D
http://gezondheid.eenvandaag.nl/tv-item ... vitamine_d


Factsheet Vitamine D via EenVandaag
Vitamine D deficiëntie en mogelijke gevolgen
dr Jos Wielders, november 2016
http://www.eenvandaag.nl/uploads/doc/vi ... volgen.pdf



.

ineke
Berichten: 410
Lid geworden op: 08 nov 2014, 17:53

Re: Discussie over vitamine D

Bericht door ineke » 24 dec 2016, 15:57

Volledig artikel.
25 hydroxyvitamine D deficientie en de relatie met autoimmuun Schildklierziekte bij ouderen




MDPI is a publisher of peer-reviewed, open access journals.
Open Access
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Int. J. Environ. Res. Public Health 2016, 13(9), 850; doi:10.3390/ijerph13090850
25 Hydroxyvitamin D Deficiency and Its Relationship to Autoimmune Thyroid Disease in the Elderly
Giovanna Muscogiuri 1
, Daniela Mari 2,3
, Silvia Prolo 2,3
, Letizia M. Fatti 4
, Maria Celeste Cantone 2
, Paolo Garagnani 5,6
, Beatrice Arosio 2,3
, Carolina Di Somma 7
and Giovanni Vitale 2,8,*
1 I.O.S. & COLEMAN Srl, Via Alcide De Gasperi, 107,109,111, Acerra (NA) 80011, Italy
2 Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Via Della Commenda 9/12, Milan 20122, Italy
3 Geriatric Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Pace, 9, Milan 20122, Italy
4 Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Piazzale Brescia 20, Milan 20149, Italy
5 Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via San Giacomo 12, Bologna 40126, Italy
6 Interdepartmental Center “L. Galvani” (C.I.G.), University of Bologna, Via San Giacomo 12, Bologna 40126, Italy
7 IRCCS SDN, Napoli Via Gianturco 113, Naples 80143, Italy
8 Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino (MI) 20095, Italy
*Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 22 June 2016 / Revised: 4 August 2016 / Accepted: 8 August 2016 / Published: 26 August 2016

Abstract
Background:
Low 25(OH) vitamin D levels have been associated with several autoimmune diseases and recently with autoimmune thyroiditis (AT).
The aim of the study was to investigate the association of AT with low 25(OH) vitamin D levels in the elderly.

Methods:
One hundred sixty-eight elderly subjects (mean age: 81.6 ± 9.4 years) were enrolled.
Serum levels of 25(OH) vitamin D, anti-thyroid peroxidase (TPO-Ab), anti-thyroglobulin (TG-Ab) antibodies, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured.

Results:
The prevalence of AT was significantly higher in subjects with vitamin D deficiency (25(OH) vitamin D < 20 ng/mL) when compared with subjects with normal 25(OH) vitamin D (25(OH) vitamin D ≥ 20 ng/mL) levels (28% vs. 8%, respectively, p = 0.002).

Patients with AT and vitamin D deficiency had a comparable hormonal profile compared to patients with AT and vitamin D sufficiency in terms of TSH (p = 0.39), FT3 (p = 0.30), FT4 (p = 0.31), TG-Ab (0.44) and TPO-Ab (0.35). Interestingly, a significant correlation between 25(OH) vitamin D and TPO-Ab (r = −0.27, p = 0.03) and FT3 (r = 0.35, p = 0.006) has been found in subjects with AT while no correlation was found between 25(OH) vitamin D levels and TG-Ab (r = −0.15, p = 0.25), TSH (r = −0.014, p = 0.09) and FT4 (r = 0.13, p = 0.32).

Conclusions:
These findings suggest that vitamin D deficiency was significantly associated with AT in the elderly. Therefore, the screening for AT should be suggested in subjects with vitamin D deficiency

Tabel 1.
Clinical and hormonal data stratified according to the vitamin D levels (mean ± SD).

Figuur 1.
Correlations between 25(OH)D concentration and TPO-Ab (r = −0.27, p = 0.03) (A) and FT3 (r = 0.35, p = 0.006) (B).

5. Conclusions
In conclusion, within the limitations of a cross-sectional design, the present study shows that vitamin D deficiency was associated with AT in the elderly.
Future longitudinal cohort studies along with prospective interventional trials may contribute to better clarifying if vitamin D supplementation may have a role in the prevention and/or therapy of AT in the elderly.


Volledig artikel:
http://www.mdpi.com/1660-4601/13/9/850/pdf


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laura
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Re: Discussie over vitamine D

Bericht door laura » 25 dec 2016, 11:20

ineke schreef:Conclusions:These findings suggest that vitamin D deficiency was significantly associated with AT in the elderly. Therefore, the screening for AT should be suggested in subjects with vitamin D deficiency
Zou de conclusie wellicht moeten luiden dat die 70-plussers - (mean age: 81.6 ± 9.4 years) - vaker naar buiten moeten in de zon?
laura

Kijk voor meer informatie ook eens op Schildkliertje.

Raadpleeg altijd een arts als je twijfelt over je gezondheid.
Het Schildklierforum kan niet worden beschouwd als vervanging van een consult of een behandeling.

ineke
Berichten: 410
Lid geworden op: 08 nov 2014, 17:53

Re: Discussie over vitamine D

Bericht door ineke » 25 dec 2016, 13:09

laura schreef:
ineke schreef:Conclusions:These findings suggest that vitamin D deficiency was significantly associated with AT in the elderly. Therefore, the screening for AT should be suggested in subjects with vitamin D deficiency
Zou de conclusie wellicht moeten luiden dat die 70-plussers - (mean age: 81.6 ± 9.4 years) - vaker naar buiten moeten in de zon?
:)

Waar is de zon :mrgreen:
Onderstaand - hier onder in een soort overzicht over vitamine D deficientie - een map van Europa waarop je kan zien dat vit. D-tekort ook in zuidelijk Europa voorkomt, dus waar meer zon is.
Wel minder, maar toch ook daar met meer zon komt vit. D tekort voor.



ODIN

ODIN is an EU funded project that consists of a multi-disciplinary team of 30 partners from 18 countries, which commenced a 4-year program of research in November 2013.
ODIN aims to provide high quality scientific evidence to prevent vitamin D deficiency in European citizens and improve nutrition and public health through food




VITAMIN D
Vitamin D is essential for human health. It controls various processes in the body and its primary role is to participate in the regulation of metabolism of calcium and phosphorus.
Vitamin D has the potential to regulate – directly or indirectly – more than 200 different genes responsible for many biological processes of the human body.


Its main effects are:
• participation in the management of bone density and health of teeth
• strengthening of the immune system
• maintenance of proper skeletal development of the foetus during pregnancy and prevention of low birth weight
• promotion of increased production of breast milk during lactation


• ODIN Publications
• Vitamin D deficiency in Europe – Pandemic?
http://www.odin-vitd.eu/public/116-euro ... eficiency/


Zie alle overige publicaties:
http://www.odin-vitd.eu/public/67-publications/




Nieuws:
New RCT data on vitamin D requirements in children
ODIN publishes new randomized controlled trial data on dietary requirements for vitamin D in 4-8 year old children..

Estimation of the dietary requirement for vitamin D in white children aged 4–8 y: a randomized, controlled, dose-response trial1,2
http://ajcn.nutrition.org/content/early ... 7.abstract

Estimation of the dietary requirement for vitamin D in adolescents aged 14–18 y: a dose-response, double-blind, randomized placebo-controlled trial1,2
http://ajcn.nutrition.org/content/early ... 5.abstract


Meer nieuws:
http://www.odin-vitd.eu/health/




European-vitamin-d-deficiency-map
Prevalence of vitamin D deficiency in Europe using standardised 25-hydroxyvitamin D (25(OH)D) data.
The Cork Centre for Vitamin D and Nutrition Research together with the Office of Dietary Supplements at NIH who lead the Vitamin D Standardization Program (VDSP) and several collaborating European partners have applied protocols for standardizing 25(OH)D data in a number of important European population studies.

Standardized 25(OH)D data allow for more meaningful comparisons within and across European countries and also for a better estimate of true prevalence estimates of vitamin D deficiency to be generated. These new important data are presented in summary in this new interactive map. Select the population/country you are interested in by pressing on the flag symbol. The flags representing different populations are colour coded based on prevalence of vitamin D deficiency (see key below). Copyright Cashman & Higgins 2016
<5% vitamin D deficiency / 5-10% vitamin D deficiency / 10-15% vitamin D deficiency / 15-20% vitamin D deficiency / >20% vitamin D deficiency

http://www.odin-vitd.eu/public/7-europe ... iency-map/



Vitamin D Winter Map coming soon !




FACTS AND FIGURES
Vitamin D facts
Vitamin D is the nutrient that has captured the attention of the scientific community, regulatory agencies, the food industry and the public alike over the past 15 years. While there are many controversial issues in relation to vitamin D requirements and the impact of vitamin D intake and status on human health, there is a general agreement that prevention of vitamin D deficiency is a public health priority.


Background of the problem
The major source of vitamin D in humans is sunshine. Several environmental factors, such as latitude and prevailing weather conditions, determine whether sunshine of sufficient strength is available to stimulate the conversion of 7-dehydrocholesterol in the skin to pre-cholecalciferol. Personal attributes, such as skin pigmentation, age, attire, sunscreen, working environment, physical activity and sun exposure behaviour can also prevent or impede vitamin D synthesis.


European context
Vitamin D occurs in the diet, both naturally and as nutritional supplements. Vitamin D intakes are typically low as it occurs naturally in few foods and, when present, is often in low concentrations.

A substantial fraction of the European population, including all who reside at latitudes greater than around 40°N, rely on body stores and dietary vitamin D to maintain a healthy vitamin D status all year round. Given that body stores are dependent on sun exposure, the importance of food in maintaining vitamin D status is a corollary of sunshine deficit.

In Europe in particular, there is increasing evidence that the dietary supply is currently unable to offset the seasonal sunshine deficit, which increases with latitude and the duration of winter. While nutritional supplements contribute a high proportion to total vitamin D intake among users, supplement intake is voluntary, and tends to be highest among infants and elderly adults and lowest among children, adolescents and young adults, who are also at risk of deficiency.

A high proportion of European residents are at risk of not maintaining a healthy vitamin D status all year round. The risk is increased in persons who have low habitual sunshine exposure, diminished ability to synthesize or metabolize cholecalciferol, whose food intake is low or who have higher vitamin D requirements.
Such risk factors are all relatively common attributes that apply to individuals with dark or ageing skin, those who avoid the sun or comply with sun protection guidance, those who work or attend school indoors during the day, adults on energy-restricted diets or young children whose dietary intake is relatively small and those who may have increased vitamin D requirements due to pregnancy, lactation or growth. In short, the groups at risk of low vitamin D status represent a sizeable majority of the school going and working population in Europe, and include all age, sex and life-stages and both white and dark-skinned persons, regardless of habitual diet and body size.


Vitamin D status
ODIN has published the first internationally comparable data on vitamin D status across the lifecycle in 11 European countries.


This new ODIN data has established that the prevalence of vitamin D deficiency is 13%, that is one in eight Europeans. This is a key starting point in tackling vitamin D deficiency in Europe.
To read the full, freely available publication, a summary of these new findings or to view our new European vitamin D deficiency interactive map, click on the links on the left hand side of this page.




Website met alle publicaties en informatie over vitamine D:
http://www.odin-vitd.eu/public/



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ineke
Berichten: 410
Lid geworden op: 08 nov 2014, 17:53

Publiekscampagne botkwaliteit en vitamine D - landelijke campagne

Bericht door ineke » 15 jan 2017, 12:00

Publiekscampagne botkwaliteit en vitamine D - landelijke campagne


De KNMP viert dit jaar haar 175e jubileum. In dit kader start op 30 januari een landelijke publiekscampagne over sterke botten.
Met daarin bijzondere aandacht voor de rol van vitamine D.
Apothekers delen een gratis informatieboekje uit: Het sterkebottenboekje.


De KNMP grijpt het jubileumjaar aan om de landelijke publiekscampagne te lanceren. Een campagne die het belang onderstreept van vitamine D voor een hoge botkwaliteit en fractuurpreventie.
Dat betreft vitamine D in het geneesmiddelenvergoedingssysteem, met name voor risicogroepen.
En zelfzorg zoals beschreven in de nieuwe Zelfzorgrichtlijn Vitamine D die per januari 2017 op de KNMP Kennisbank staat. De campagne positioneert de apotheker als toegankelijke farmaceutisch zorgverlener en loopt tot 1 maart.


De KNMP ontwikkelde een ‘sterkebottentest’ (live per 30 januari) die het Nederlandse publiek online kan invullen.
Hieruit volgt een persoonlijk advies over het gebruik van vitamine D-suppletie. Ook verschijnt na het invullen een code waarmee deelnemers een informatieboekje kunnen ophalen in de apotheek:
Het sterkebottenboekje. Met daarin leesbare en praktische informatie over de rol van vitamine D bij het behoud van botkwaliteit.



De sterkebottencampagne - dit gebeurt er:
1.De sterkebottencampagne begint op maandag 30 januari.
Dan gaat op www.apotheek.nl/vitamineD de sterkebottentest live.

2.Online banners op diverse (nieuws)websites en op online platforms, zoals Facebook, generen aandacht voor de sterkebottentest.

3.Na een klik op de online banner kan de bezoeker via de test checken of hij een mogelijk risico heeft op een vitamine D-tekort. Bijvoorbeeld omdat hij niet genoeg buiten komt, een getinte huid heeft, of ouder is dan 70 jaar. Na het invullen van de test volgt een persoonlijk vitamine D-advies en verschijnt een code. Deze vindt u in de verpakking van de boekjes.

4.Iedereen met de code mag Het sterkebottenboekje ophalen in de apotheek. Een boekje van 64 pagina’s, geschreven door Paul Poley onder supervisie van het Geneesmiddel Informatiecentrum van de KNMP, ter waarde van 7,95 euro. Over hoe te werken aan een goede botkwaliteit, met voldoende vitamine D, calcium en beweging.




Dit betekent het voor apothekers:
1.In week 3 van 2017: ontvangst Het sterkebottenboekje in de apotheek.
Apotheken ontvangen 30 exemplaren van Het sterkebottenboekje. Of meer, indien de ketens en formules daartoe hebben verzocht.

2.Maandag 30 januari 2017: poster ophangen in de apotheek
De poster bij de editie van het Pharmaceutisch Weekblad van vrijdag 13 januari kan vanaf maandag 30 januari worden opgehangen in de apotheek.

3.30 januari 2017 en verder: boekjes uitdelen.
U en uw team kunnen het boekje meegeven als iemand de code noemt.



Vitamine D, de apotheek en het team
Het apotheekteam kan aan de balie extra vragen verwachten over vitamine D tijdens de campagne. Op 18 januari verschijnt daarom een extra editie van het Apotheekteam Magazine over de sterkebottencampagne en over vitamine D.

Bron: KNMP




De Zelfzorgrichtlijn vitamine D behandelt onderstaande vragen:
- Wat zijn de effecten van een vitamine D-tekort op de gezondheid?
- Wat is de rol van de zon bij de aanmaak van vitamine D en welke adviezen gelden hiervoor?
- Welke rol speelt voeding en welke adviezen gelden hiervoor?
- Hoe ga je na of de klant tot een risicogroep voor vitamine D-tekort behoort?
- Welke adviezen gelden er bij welke risicogroepen?
- Wat is de rol van calcium voor een goede botkwaliteit?
- Wanneer verwijs je naar de huisarts?
- Wanneer schrijft de huisarts vitamine D op recept voor?

‘Apothekers kunnen met het team in gesprek over advisering van vitamine D, bijvoorbeeld tijdens het werkoverleg. De kernpunten aan het begin van de richtlijn vormen hier input voor’, aldus Luinenburg en Dost. ‘De KNMP Kennistest over vitamine D die nog in ontwikkeling is, draagt hier later ook aan bij.’

Voor inhoudelijke vragen over de Zelfzorgrichtlijn vitamine D: gic@knmp.nl of (070) 373 73 77.

https://www.knmp.nl/nieuws/de-nieuwe-ze ... e-d-is-uit


NB
Zelfzorgrichtlijn is alleen te zien voor leden van KNMP




.

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laura
Berichten: 3071
Lid geworden op: 11 sep 2013, 22:42
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Re: Discussie over vitamine D

Bericht door laura » 13 apr 2017, 14:08

Why Are So Many People Popping Vitamin D?
By GINA KOLATA APRIL 10, 2017

There was no reason for the patients to receive vitamin D tests. They did not have osteoporosis; their bones were not cracking from a lack of the vitamin. They did not have diseases that interfere with vitamin D absorption.

Yet in a recent sample of 800,000 patients in Maine, nearly one in five had had at least one test for blood levels of the vitamin over a three-year period. More than a third got two or more tests, often to evaluate such ill-defined complaints as malaise or fatigue.

The researchers who gathered the data, Dr. Kathleen Fairfield and Kim Murray of the Maine Medical Center, were surprised. Perhaps they shouldn’t have been.

Millions of people are popping supplements in the belief that vitamin D can help turn back depression, fatigue, muscle weakness, even heart disease or cancer. In fact, there has never been widely accepted evidence that vitamin D is helpful in preventing or treating any of those conditions.

But so firm is this belief that vitamin D has become popular even among people with no particular medical complaints or disease risks. And they are being tested for vitamin D “deficiency” in ever greater numbers.

The number of blood tests for vitamin D levels among Medicare beneficiaries, mostly people 65 and older, increased 83-fold from 2000 to 2010, according to the Centers for Disease Control and Prevention. Among patients with commercial insurance, testing rates rose 2.5-fold from 2009 to 2014.

Labs performing these tests are reporting perfectly normal levels of vitamin D — 20 to 30 nanograms per milliliter of blood — as “insufficient.” As a consequence, millions of healthy people think they have a deficiency, and some are taking supplemental doses so high they can be dangerous, causing poor appetite, nausea and vomiting.

Vitamin D overdoses also can lead to weakness, frequent urination and kidney problems.

“A lot of clinicians are acting like there is a pandemic” of vitamin D deficiency, said Dr. JoAnn E. Manson, a preventive medicine researcher at Brigham and Women’s Hospital in Boston who helped write an Institute of Medicine report on vitamin D.

“That gives them justification to screen everyone and get everyone well above what the Institute of Medicine recommends.”

In fact, the institute committee on which Dr. Manson served concluded in 2010 that very few people were vitamin D deficient and noted that randomized trials had found no particular benefit for healthy people to have blood levels above 20 nanograms per milliliter.

Medical organizations, too, have repeatedly found that there is no reason to assess vitamin D levels in healthy adults, and recently two rigorous studies failed to find that high doses of the vitamin protect against heart disease or cancer.

Still, vitamin D has become “a religion,” said Dr. Clifford J. Rosen, an osteoporosis researcher at the Maine Medical Center Research Institute and a member of the Institute of Medicine’s committee.

Made in Sunlight

Vitamin D is a fat-soluble nutrient needed to absorb calcium and phosphorus, and therefore to make bones strong. People do not make their own: We need sunlight to synthesize vitamin D. The vitamin also is found in oily fish and in a few other foods, including milk, which is fortified with the vitamin.

Because many people have little exposure to sunlight, especially those living in northern climates in winter, some investigators became concerned more than a decade ago that large swaths of the population were not getting enough vitamin D.

One is Dr. Michael F. Holick, a professor of medicine, physiology and biophysics at Boston University School of Medicine and a leading proponent of the idea that just about everyone needs a vitamin D supplement.

He points to studies that suggest an association between low vitamin D levels and higher rates of various diseases. While these observational reports do not prove cause and effect, he is persuaded by the fact that many point in the same direction, hinting that low blood levels of vitamin D are hazardous.

Doctors, he believes, must take action. The recommended daily allowance is 600 international units up to age 70, and 800 I.U. for people who are older, Dr. Holick said. Diet cannot provide that much of the vitamin, he notes. And it would require nearly constant exposure to sunlight to reach the levels he recommends.

Over the years, he acknowledged, studies in which people were randomly assigned to take a vitamin D pill or a placebo have failed to support claims for the vitamin’s benefits. But those studies tended to be too small to be definitive, he said.

Yet recent trials, larger and more rigorous, also have not produced the hoped-for results.

One study with 5,108 participants, published this month in JAMA Cardiology, found that vitamin D did not prevent heart attacks.

Another study, published at the end of March, included 2,303 healthy postmenopausal women randomly assigned to take vitamin D and calcium supplements or a placebo. The supplements did not protect the women against cancer, the researchers concluded.
Well

Other, more ambitious studies are underway, including a five-year randomized study of almost 26,000 healthy men and women directed by Dr. Manson and Julie Buring, who hope to answer once and for all whether taking vitamin D can prevent cancer, heart disease and strokes.

A Parade of Papers

The frenzy for vitamin D began not in natural food stores but in medical journals. Beginning around 2000, a series of research papers linked vitamin D levels that are lower, but considered normal, to multiple sclerosis and mental illness, then to cancer risk and bone health.

Blood testing for the vitamin took off. “Patients began asking for it,” said Dr. Fairfield, the researcher in Maine. “A lot of people thought that if they were fatigued or sad or they did not feel well, they might be vitamin D deficient.”

In 2007, Dr. Holick published a paper in The New England Journal of Medicine asserting that vitamin D levels now considered normal — 21 to 29 nanograms per milliliter of blood — were linked to an increased risk of cancer, autoimmune disease, diabetes, schizophrenia, depression, poor lung capacity and wheezing.

He also published books promoting the idea that vitamin D levels in that range were insufficient to promote good health.

In 2011, a committee of the Endocrine Society, headed by Dr. Holick, came out with a recommendation that vitamin D levels be at least 30 nanograms per milliliter, which meant that most people were vitamin D deficient.

The group recommended the taking of supplements but not widespread testing, on the grounds that this would not be cost-effective.

The new guideline had an immediate effect: Commercial labs began describing levels of 20 to 30 nanograms per milliliter as insufficient. Many continue to do so today.

“There was a vitamin D bandwagon,” said Dr. Sundeep Khosla, an osteoporosis expert at the Mayo Clinic. Vitamin D tests “became incorporated into the general evaluation of patients,” he added.

Ravinder J. Singh, who runs a testing lab at the Mayo Clinic, was taken aback by the sudden deluge. “Demand for vitamin D testing went through the sky,” he said. “It was almost as though there was nothing else serious in clinical practice.”

Dr. Fairfield, like many other general practitioners, began testing patients, trying to make sure they raised their vitamin D levels above 29 and became concerned that she and other doctors had been too cavalier about the vitamin. “We were worried that there was a lot we were missing,” she said.

But when the Institute of Medicine report proved critical of the vitamin D craze, she started telling healthy patients there was no reason for them to be tested. Many did not want to hear that advice.

“People were used to vitamin D monitoring, like with cholesterol,” Dr. Fairfield said. “They wanted to know what their number is.”

Although Dr. Fairfield stopped routine vitamin D testing, many others have not.

Becky Rosen, 64, a nurse who is director of clinical services at a home health agency in Brunswick, Me., had a physical exam four years ago and was told she needed a vitamin D test. She declined.

Her next physical exam was in February, with a different doctor. Once again, the doctor wanted to test her vitamin D level.

“I said, ‘I don’t think I need it,’” Ms. Rosen said. The doctor persisted, explaining that Maine is so far north that people may not be exposed to much sunlight. Once again, Ms. Rosen politely but firmly declined.

But she is a special patient: Her husband, Dr. Rosen, helped write the Institute of Medicine report that was critical of vitamin D supplements.

“I can see other people getting persuaded,” Ms. Rosen said.

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A version of this article appears in print on April 11, 2017, on Page D1 of the New York edition with the headline: D Is for Dilemma. Order Reprints| Today's Paper|Subscribe
laura

Kijk voor meer informatie ook eens op Schildkliertje.

Raadpleeg altijd een arts als je twijfelt over je gezondheid.
Het Schildklierforum kan niet worden beschouwd als vervanging van een consult of een behandeling.

Amethist
Berichten: 17
Lid geworden op: 02 dec 2017, 12:10

Re: Discussie over vitamine D

Bericht door Amethist » 03 dec 2017, 11:16

Het klopt inderdaad dat vit D het gevolg is van bepaalde aandoeningen.
Enkele jaren geleden bloed geprikt, bleek mijn vit D waarde - 9 te zijn, ver onder het normale dus. Wekelijkse kuur gevolgd en kwam met moeite aan een waarde van 30 a 35. Aan de schildklier kon het niet liggen aangezien ik medicatie nam en deze weer normaal functioneerde.

Nu enkele maanden geleden bleek dat ik coeliakie had. Uiteindelijk is het zo dat bij coeliakie de darmen de nodige vitamines niet meer opnemen waardoor er een chronisch tekort komt. Ben blij dat ik eindelijk weet wat het tekort aan foliumzuur, vit B enz...teweegbracht.

Focus dus niet altijd op 1 aandoening maar zoek verder uit wat de oorzaak van tekorten kan zijn. ;)

Gebruikersavatar
BB1100XX
Berichten: 548
Lid geworden op: 18 jul 2017, 19:06

Re: Discussie over vitamine D

Bericht door BB1100XX » 03 dec 2017, 22:16

Amethist schreef:
03 dec 2017, 11:16
Aan de schildklier kon het niet liggen aangezien ik medicatie nam en deze weer normaal functioneerde.
Je schildklier geneest met het nemen van medicatie?

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