vitamin d treatment options in physician‘s everday practice
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Vitamin D treatment options in physician‘s everday practice. Author : Höck Anna Dorothea MD Internal Medicine and Psychotherapy. Sunlight is the natural source of vitamin D. Which functions and systems are supposed to be influenced by vitamin D? . - PowerPoint PPT PresentationTRANSCRIPT
Vitamin D treatment options in physician‘s
everday practice
Author: Höck Anna Dorothea MDInternal Medicine and Psychotherapy
Sunlight is the natural source of vitamin D
2Speech Dr. Hoeck. September 18th, 2011
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Vitamin D is activated to 1,25(OH)2D3
by CYP27B1
4Speech Dr. Hoeck. September 18th, 2011
My first experiences in 1993:
5Speech Dr. Hoeck. September 18th, 2011
Therapy with 10,000 IU (250 mcg)/d 25-hydroxycholecalciferol
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Why did I avoid calcium supplementation?
7Speech Dr. Hoeck. September 18th, 2011
However: the follow up of case histories tought me some lessons
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Fatigue and functional symptoms were combined and graded.
Treatment results dependent on grade.
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This introduced me into the calcium problem
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The calcium replete and deplete state hypothesis
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The controversy about calcium
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However: There is a daily calcium loss
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What I learned as well:
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The essentials of disease progression
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My fibromyalgia hypothesis
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My hypothesis about MCS
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My hypothesis about chronic fatigue syndrome
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Why opportunistic infections?
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These patients need vitamin D
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Of interest: Horizontal and vertical disease history
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The three columns of disease
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Treatment options
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The optimal 25OHD3 levels (1)
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The optimal vitamin D dose (2)
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However, there seem to exist pitfalls in therapy effectiveness:
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Possible way out: ultra-high dose cholecalciferol may overcome treatment resistance
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Which compound?
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Calcium Yes or No?
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The safe range of calcium/creatinine ratio 25OHD3 level
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Two possible causes of hypercalciuria:
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Possible solutions against aquired forms of hypercalciuria?
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An important absolute contraindication!
Mutations in CYP24A1 leading to idiopathic infantile Hypercalcemia
Schlingmann KP, et al. N Engl J Med 2011;365(5):410-21.
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Why basic powders:
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Contraindications
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Your take-home messages (1)
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