25 Vitamin D- Tests Orthopedic Surgeons Should Think About

25 Vitamin D, Tests Ortho Surgeons Think About-Everything You Need To Know

Vitamin D 25 is the most appropriate study to assess and monitor vitamin D status in the body. Vitamin D is important for proper maturation and development of bone. Vitamin D is also important in immunity and plays a role in other conditions. The main function of Vitamin D is absorption of the calcium and phosphate from the intestine. Vitamin D comes from diet, supplements, and exposure to the sun. Vitamin D is naturally found in fish. Exposure to the sun for 15 minutes will give a person about 10,000 units of Vitamin D. The average daily requirement of Vitamin D is approximately 400-800 International Units (IUs). Vitamin D gets activated metabolically in the liver and in the kidney. The activation occurs by hydroxylation. Hydroxylation to 25 Vitamin D₃ occurs in the liver. The big organ takes the big number- 25, so 25(OH)-Vitamin D₃. Another hydroxylation occurs in the kidneys. ₂- Vitamin D₃. This is the active form of Vitamin D and works mainly on the intestines and bones. The activation of Vitamin D to 1, 25 hydroxyvitamin D is controlled by the parathyroid hormone. Any deficiency or any problem in the process of activating Vitamin D₃ to its active form will lead to deficiency of Vitamin D in the body. Vitamin D deficiency is very common and the majority of people are not aware of it. In fact, Vitamin D deficiency symptoms are subtle and nonspecific. 25-hydroxyvitamin D has a long half-life and a higher concentration. This is probably easier to measure and obtain 25 hydroxyvitamin D than the active form, which is 1,25-dihydroxyvitamin D. The half-life of 25-hydroxyvitamin D is 2-3 weeks. The half-life of 1,25-dihidroxyvitamin D is only 4-6 hours. The circulating levels of 25- hydroxyvitamin D is 1000x more than 1,25 dihydroxyvitamin D. therefore, 25-hydroxyvitamin D test is the best study to determine the Vitamin D deficiency in the body. A low level of 25- hydroxyvitamin D could mean that a person is not getting enough exposure to the sun, is not getting enough dietary Vitamin D, or there may be a problem with absorbing Vitamin D from the intestines. The patient may be taking Dilantin, which interferes with hydroxylation of Vitamin D in the liver. A low level of 1, 25-dihydroxyvitamin D usually indicates kidney disease. 40% of the United States population have Vitamin D deficiency.The small organ takes the small number-1. The result will be 1, 25 (OH)

Symptoms of Vitamin D deficiency may include:

·         Fatigue and tiredness

·         Not sleeping well

·         Muscle weakness

·         Bone pain

·         Osteoporosis/ Osteomalacia

·         Fractures

Elderly patients are vulnerable to Vitamin D deficiency because they usually live indoors or in nursing homes with no sun exposure or because these patients may not eat enough food containing Vitamin D or they may not receive enough supplements. Vitamin D deficiency may impair or affect wound healing. Vitamin D deficiency may cause bone loss and places the elderly patient at risk of fractures. Deficiency may cause slow healing of fractures or nonunion of the fractures. If you find a patient with fractures that are not healing well, or a patient with fractures due to low energy trauma where you find the bone mass is inadequate (osteoporosis), this is the time to get a 25- hydroxyvitamin D blood test. The Endocrine Society defines Vitamin D deficiency as 25 Vitamin D level below 20 ng/mL, and insufficiency as the level between 21-29 ng/mL. In general, a 25 Vitamin D level greater than 30 ng/mL is probably adequate, but these numbers are controversial.