Vitamin D

Vitamin D is a group of structurally related, fat-soluble compounds responsible for increasing intestinal absorption of calcium, along with numerous other biological functions. In humans, the most important compounds within this group are vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol). Unlike the other twelve vitamins, vitamin D is only conditionally essential in the diet, as with adequate skin exposure to the ultraviolet B (UVB) radiation component of sunlight there is synthesis of cholecalciferol in the deeper layers of the skin's epidermis. Vitamin D can also be obtained through diet, food fortification and dietary supplements. For most people, skin synthesis contributes more than dietary sources. Accordingly, the name "vitamin D" is arguably a misnomer, as rather than being an essential part of the diet, it acts more like a fat-soluble secosteroid hormone precursor. Nevertheless, US and other dietary guidelines generally assume that all of a person's vitamin D is taken orally, given the potential for insufficient sunlight exposure due to urban living, cultural choices for the amount of clothing worn when outdoors, and use of sunscreen because of concerns about safe sunlight exposure. In many countries, milk and plant-based milk substitutes are fortified with vitamin D3, as are breakfast cereals. Cholecalciferol is converted in the liver to calcifediol (also known as calcidiol or 25-hydroxycholecalciferol), while ergocalciferol is converted to ercalcidiol (25-hydroxyergocalciferol). These two vitamin D metabolites, collectively referred to as 25-hydroxyvitamin D or 25(OH)D, are measured in serum to assess a person's vitamin D status. Calcifediol is further hydroxylated by the kidneys and certain immune cells to form calcitriol (1,25-dihydroxycholecalciferol; 1,25(OH)2D), the biologically active form of vitamin D. Calcitriol attaches to vitamin D receptors, which are nuclear receptors found in various tissues throughout the body. Analogous reactions occur for other vitamin D forms as well as various vitamin D analogues. The...