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Land of the sun, but not unrelated to vitamin D deficiency, which affects in winter about half of Italians. The need to clarify this hormone and the controversy over the threshold values that define a real deficit prompted a panel of experts from the AME Association of Endocrinologists to issue guidelines on the management of vitamin D deficiency. vitamin D, which also provide answers to questions – explains Vincenzo Toscano, president of the AME – "vitamin D is it really a panacea? Protects against diabetes and cancer? Physicians must they focus their attention on levels circulating in the population? Are all vitamin D preparations the same?
OSTEOPOROSIS AND RACHITISM IN AGGUATO
Vitamin D is a strategic hormone that performs important functions for bone health by helping the body absorb calcium, one of the main constituents of our skeleton and preventing the occurrence of bone diseases, such as osteoporosis or rach The possible deficiency of vitamin D determines the reduced bone mineralization and is evaluated by a dosage in the blood. Its interpretation, which varies according to the different laboratories and especially the diktats of the various medical societies, is the following one: deficiency <10 ng/mL; insufficienza: 10 – 30 ng/mL; sufficienza: 30 – 100 ng/mL; tossicità: > 100 ng / mL.
NEW THRESHOLD FOR DEPARTURE
Levels to be reviewed because, as Roberto Cesareo, endocrinologist and first signatory of the book, explains, their adoption "is one of the reasons we let's end up declaring "vitamin D deficient" to many subjects who probably are not.) In the consensus, we found it more appropriate to define reduced values of vitamin D when they are clearly below 20 ng / dl ".
With one exception: "Osteoporotic subjects or patients who are already taking medications to treat osteoporosis or other categories of subjects significantly more at risk for vitamin D deficiency are right, to our Notice, that they have Vitamin D values exceed the limit of 30 ng / dl and therefore need to be treated.
SCIENTIFIC EVIDENCE: VITAMIN D IS NOT A LONG LIFE ELISITION
In the consensus, then, endocrinologists point to the lack of scientific evidence regarding the exact doses of vitamin D effective to reduce the risk of cancer. incidence of diseases badociated with its impairment, such as diabetes mellitus, some neurological syndromes, some types of tumors, in addition to osteomalacia and osteoporosis.
"We think it's fair to report this data – continues the expert – as conveying the message that vitamin D is the elixir of long life, as well as incorrect because it lack of solid scientific evidence, risks of being subjected to excessive prescribing and the risk of taking this molecule without real benefits. "
NEWS FROM THE PISA SUMMIT
Another document concerning vitamin D was recently published in the British Journal of Clinical Pharmacology, the result of the summit that gathered last year more than 25 experts from around the world in a scientific day devoted to this hormone Pisa
The experts hear that values below 12 ng / ml reflect an unfavorable condition for bone health, reduced calcium absorption, poor bone mineralization and are badociated with an increased risk of rickets and / or osteomalacia: Only doses greater than 20 ng / mL are considered safe and sufficient for bone health.
"This consensus is historic in its own way because for the first time ideal thresholds have been identified and shared by the greatest experts expressed by the scientific community to define vitamin D deficiency or deficiency
. does not mean that all the problems in this field are solved: in fact, while we have not yet reached a global standardization of measurement techniques, on the other hand, sometimes contradictory results often come from other sources. clinical studies, specifically related to intervention thresholds – explains Andrea Giustina, professor of endocrinology at San Raffaele in Milan and president GIOSEG – These two aspects are both sides of the same coin indeed the effects of vitamin D administration vary considerably depending on the condition more or less point of departure.
Supplementation on deficient subjects shows, in fact, These effects are significant, whereas in moderately poor people, equally valid results can not be expected. The definition of hypovitaminosis D to which the experts arrived represents an important step forward for clinical management based on internationally shared criteria. "
ATTENTION TO THE ELDERLY
A separate chapter deserves the elderly, who are at greater risk of osteoporosis, falls and fractures and who may have difficulty spending time in the evening. outside the sun. It is estimated that more than 90% of elderly people living in retirement homes suffer from vitamin D deficiency
In these subjects, vitamin D supplementation should be considered. What to do to get out of the shortage? During the summer, expose yourself to sunlight (even the arms and legs are enough), without sunscreens (which reduce the penetration of sunlight).
The seasonal variability of vitamin D values in the blood is normal: they tend to be larger in the fall, at the end of the summer months when exposure is more common then tend to decrease in winter. But if the values are low in the fall, it may mean that the "stocks" have not been filled and that the values will fall below the safe limits in the following months.
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