![]() This forced us to look for alternatives to maintain patient care. In 2006, the commercially available cholecalciferol tablets (Devaron 400 IU) were suddenly withdrawn from the market in The Netherlands. Usually, this is done with daily supplementation using tablets. ![]() In Europe, cholecalciferol (vitamin D 3) is mainly used to treat vitamin D deficiency. In the USA, ergocalciferol (vitamin D 2) is recommended at a dose of 50 000 IU/week for 8 weeks, irrespective of the degree of vitamin D deficiency or body weight (1). However, there is no consensus on how to achieve this target rapidly. There is an emerging consensus that serum 25-OHD 3 levels of about 75 nmol/l are optimal for bone health and extraskeletal effects ( 6, 7). Consequently, improvements in the detection and treatment of vitamin D deficiency may have a major health impact. ![]() A rapidly growing body of evidence indicates that vitamin D deficiency may play a role in the development of common cancers, autoimmune diseases, infectious diseases, and cardiovascular diseases ( 1, 3, 5). However, vitamin D receptors are also present on a large variety of extraskeletal cell types, including cardiomyocytes, vascular endothelial cells, neurons, immune cells, and pancreatic β-cells. ![]() Vitamin D deficiency is well known for its musculoskeletal complications in children and adults ( 1, 3, 4). In Germany, for example, 57% of the 18–79-year-old residents are vitamin D deficient, and this is mainly explained by the lack of sufficient sunlight exposure and low dietary vitamin D (2). As a result, vitamin D deficiency, defined as a serum 25-hydroxyvitamin D 3 (25-OHD 3) level <50 nmol/l, is very common in Northern Europe. Research shows that vitamin D3 (cholecalciferol) is approximately 87% more potent than vitamin D2 for raising and maintaining vitamin D blood levels.Vitamin D status is related to sunlight exposure and therefore depends on latitude (1). Supplementation with vitamin D may be necessary to meet daily needs, since obtaining sufficient vitamin D from natural food sources and sun exposure alone can be difficult. ![]()
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