martes, 17 de mayo de 2011

Which Form of Vitamin D is Better, D2 or D3? By Shereen Jegtvig, Guide

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What's best, D2 or D3?
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Question: Which Form of Vitamin D is Better, D2 or D3?
I want to take vitamin D supplements, but some people tell me I should only take D3 vitamin D supplements and not D2. What's the difference?Rusty - User
Answer: That's a great question, but I'm not convinced that it really makes much difference, at least for most of us who just want to increase our intake of vitamin D. If I were to pick out a vitamin D supplement, I would lean toward one with D3, but it may not matter that much - after all, D2 has been used for many years.

What's D2 and D3 Anyway?

Vitamin D is a substance your body synthesizes after your skin is exposed to sunlight, however it is also available in fish oil and in foods that have been fortified with vitamin D. In your body, vitamin D acts like a hormone to help your body absorb and use calcium and regulate the amount of calcium in your blood. If you don't get enough vitamin D, you'll increase your risk of osteoporosis, or other bone-weakening diseases such as osteomalacia and osteopenia. Vitamin D is also important for a healthy immune system and normal nerve and muscle function.Now for a little bit of vitamin D biochemistry (very little, I promise). Cholecalciferol (that's D3) is the form of vitamin D found in animals. When your skin is exposed to the UVB rays of sunlight , your body converts something called 7-Dehydrocholesterol (related to cholesterol) through a series of biochemical steps to cholecalciferol. Then through another step, the cholecalciferol is converted to calcifediol, which is also called 25-hydroxyvitamin D3 and is the form that the laboratory measures when your doctor orders a vitamin D test. Finally your body turns calcifediol into the active form of vitamin D (the one that does the work) called calcitriol.
Plants go through a similar process, but instead of cholecalciferol, plants have ergocalciferol (D2). Cholecalciferol and ergocalciferol are very similar chemically and in late 1920s it was discovered that ergocalciferol was effective for treating rickets in children. For decades, ergocalciferol has been accepted as a supplementary form of vitamin D.
In the 1980 and 90s, scientists suggested that the animal form, D3, was more effective for raising blood levels of vitamin D3 (25-hydroxyvitamin D3). Since then two more studies found no difference between the two forms and a third detected more effective increases with D3, but the researchers weren't clear if it really made much therapeutic difference.
Why such different results? Lots of factors can affect research studies of this type. One study was done in the summer so sun exposure could have messed up the results. And maybe diet and use of dietary supplements can change things. Plus who is the best group of people to study? People with osteoporosis? Kidney disease? Healthy people who may just be a little low in vitamin D? Old people? Young people? Men? Women? Research can be difficult because the findings for one group of people be the same for another.
I'm sure more research will be done on the differences between D2 and D3, but in the meantime if you're concerned about your vitamin D levels, the best thing to do is go to a health care provider to have your blood levels of vitamin D checked. If they're low, you can take either form of vitamin D and after a few weeks, have your blood checked again to see if the supplements are working. Always follow the label directions for taking vitamin D supplements unless your health care provider tells you differently.
A Comparison of Ergocalciferol and Cholecalciferol Therapy in Hemodialysis Patients and Effect on Parathyroid Hormone. Poster Session: Mineral Metabolism: Bone Disease (10:00 AM-12:00 PM) Poster Board Number: SA-PO2820. Accessed February 4, 2010.
Armas LA, Hollis BW, Heaney RP. "Vitamin D2 is much less effective than vitamin D3 in humans." J Clin Endocrinol Metab. 2004 Nov;89(11):5387-91.
Glendenning P, Chew GT, Seymour HM, Gillett MJ, Goldswain PR, Inderjeeth CA, Vasikaran SD, Taranto M, Musk AA, Fraser WD. "Serum 25-hydroxyvitamin D levels in vitamin D-insufficient hip fracture patients after supplementation with ergocalciferol and cholecalciferol." Bone. 2009 Nov;45(5):870-5.
Holick MF, Biancuzzo RM, Chen TC, Klein EK, Young A, Bibuld D, Reitz R, Salameh W, Ameri A, Tannenbaum AD. "Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D." J Clin Endocrinol Metab. 2008 Mar;93(3):677-81.
Houghton LA, Vieth R. "The case against ergocalciferol (vitamin D2) as a vitamin supplement." Am J Clin Nutr. 2006 Oct;84(4):694-7.
NIH Office of Dietary Supplements. "Dietary Supplement Fact Sheet: Vitamin D." Accessed February 4, 2010.

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