italian guidelines in case of vit d deficiency

[stef2011]

this is very useful since i haven t seen guidelines around with proof of fast results and no sides.these are guidelines since 2011 and with predose of 300.000-1.000.000iu of d3 maintenace dose should be ok at 4000iu but this is not obvious one has to check and see because we are not healthy people with d deficinecy so it is very probable higher doses than 4000iu are needed especially on obese

http://www.reumatismo.org/index.php/reuma/article/viewFile/reumatismo.2011.129/510

Guidelines on prevention and treatment
of vitamin D deficiency
S. Adami1
, E. Romagnoli 2, V. Carnevale2
, A. Scillitani3
, A. Giusti4
, M. Rossini1
,
D. Gatti1
, R. Nuti5
, S. Minisola2
1
Unità di Reumatologia, Dipartimento di Medicina, Università di Verona; 2
Dipartimento di Medicina,
Università La Sapienza, Roma; 3
Unità di Endocrinologia, Ospedale S. Giovanni Rotondo, Foggia; 4
Ospedale Galliera, Genova, Italia; 5
Dipartimento di Medicina, Università degli Studi di Siena

The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has elaborated
the following guidelines about the definition, prevention and treatment of inadequate vitamin D status. The
highlights are presented here.
• Daily vitamin D allowance ranges from 1,500 IU (healthy adults) to 2,300 IU (elderly with low calcium
intake). Since the average Italian diet includes around 300 IU/day, subjects with no effective sun exposure
should be supplemented with 1,200-2,000 IU vitamin D per day.
• The serum 25-hydroxy-vitamin D [25(OH)D] levels represents the most accurate way to assess vitamin D
repletion, even though there are still no standardized assay methods.
• Conditions of “deficiency” and “insufficiency” are defined by the following ranges of 25(OH)D levels: less
than 20 ng/ml and 20-30 ng/ml, respectively.
• In Italy, approximately 50% of young healthy subjects have vitamin D insufficiency during the winter month
The prevalence of deficiency increases with ageing, affecting almost all elderly subjects not on vitamin D
supplements.
• When a condition of deficiency has been identified, a cumulative dose of 300,000-1,000,000 IU, over 1-4
weeks is recommended.
• In subjects recently treated for deficiency-insufficiency, a maintenance dose of 800-2,000 IU/day (or weekly
equivalent) is recommended. In patients on daily doses over 1,000 IU, 25(OH)D levels should be checked
regularly (e.g. once every two years).
• The highest tolerated daily dose has been identified as 4,000 IU/day.
• Vitamin D supplementation should be carefully monitored in patients at higher risk of vitamin D intoxication
(granulomatosis) or with primary hyperparathyroidism

[stef2011]

entecavir may be, not tenofovir.

as to HCC risk reduction we should look at 5-10years studies to know if that can be true and keep in mind drug makers can make fake studies published on fakes scientific journals, so which journal is also important

my guess is that the immune suppression in the liver, especially nagalase which acts in the whole body not only the liver, is what can promote liver cancer and the other cancers we are exposed too as hbsag carriers (pancreas, lymphomas and others i dont remember)

[stef2011]

wonderful updated article about vitamin d published april 2014, it covers many questions

https://drive.google.com/file/d/0B8E77QizhkLQRlVWT181SnlHVnM/edit?usp=sharing

most interesting paragraphs:
VITAMIN D STATUS AND IMMUNE FUNCTION
IMMUNE DISEASE AND THE DYSREGULATION OF VITAMIN D
VITAMIN D AND ADAPTIVE IMMUNITY

[melcul]

"entecavir may be, not tenofovir
Are you saying that entecavir may reduce the risk more then tenofovir or that entecavir is more carcigenic ? Thank you

[stef2011]

entecavir is under surveillance because it made lung cancer in mice, they were about to stop development but when they saw monkeys not developing lung cancer they decided to go on and just keep strict srveillance

[stef2011]

the time to get improvement after stable pth around 11-20pg/ml and high vit d is about 6 months on MS so probably few months to see effect on immune system too

[luckyman316]

Stef, you talked about Vitamin D and Vitamin K-2 (MK-7) combo. Is there a certain amount that should be take in combonation. Example: If I take Vitamin D3 10,000iu daily then should I take Vitamin K-2 200mcg daily as well or is there another amount I should take?