Importance and role of vitamin D in pharmaceutical practise

Abstract

The first scientific approach to vitamin D was made in the first half of the 20th century. The discovery had an important impact on the prevention and treatment of rickets, as well as enabling the knowledge and documentation of its role in regulating the balance of calcium-phosphate metabolism. Further reports have also suggested other health-relevant properties of vitamin D, including effects on: muscular, nervous, immune, cardiovascular, carbohydrate metabolism, obesity, cancer risk, and (relevant today) the issue of effects on the course and incidence of COVID-19. Six forms of vitamin D differing in the structure of the side chains was identified. The vitamin D group includes: cholecalciferol (vitamin D3) of animal origin or occurring in fungi ergocalciferol (vitamin D2). Vitamin D deficiency leads to rickets, osteomalacia and osteoporosis. Vitamin D supplementation allows, among other things, to reverse muscular atrophy, due to the fact that expression of the gene encoding VDR decreases with age. Insufficient synthesis of vitamin D or its low supply from diet can influence the development of cognitive disorders. A positive effect of the vitamin has been observed in the treatment of psoriasis and in obstructive diseases (asthma, chronic obstructive pulmonary disease). A special risk group for vitamin D deficiency are obese people who, according to recommendations, require an increased dose of vitamin D relative to the dose recommended for people with normal body weight. Supplementation should be conducted with simultaneous control of 25(OH)D3 metabolite concentration in blood. In supplementation and treatment of vitamin D deficiency in Poland and Europe mainly cholecalciferol (D3) is used, on American market also ergocalciferol (D2) is popular. The aim of this manuscript is to introduce the role and importance of vitamin D in pharmaceutical practice. High popularity of preparations containing vitamin D does not go hand in hand with the state of knowledge of patients and medical personnel, therefore, in addition to the role and function, the article also focuses on the problem of vitamin D deficiency (and its causes), recommendations of supplementation, and discusses toxicological issues.