Pregnancy Use

Vitamin D supplements as either D2 or D3 are exempt from pregnancy classification by the TGA, which reflects their safety in pregnancy and lactation (Australian Drug Evaluation Committee 1999).

PRACTICE POINTS/PATIENT COUNSELLING

• Vitamin D has a critical role in bone growth and development but has also diverse roles throughout the body, including inhibiting abnormal proliferation of cells.

• Most vitamin D is endogenously produced through sun exposure and an activation process that involves both the liver and the kidneys; food sources represent a secondary and often unreliable source. Those groups in the community who have restricted sun exposure are at the greatest risk of a deficiency, including the elderly, newborns, institutionalised, adolescents and young children with marginal calcium intake during rapid growth periods, and those with dark skins.

• Vitamin D supplements are most commonly given in combination with other nutrients, such as calcium, in the prevention of falls and prevention or treatment of osteoporosis.

• Other uses for vitamin D include supplementation during pregnancy to increase fetal levels, correction of deficiencies that may result from medications or malabsorptive diseases such as coeliac disease, Crohn's disease and cystic fibrosis, as a protective agent against breast, prostate and colorectal cancer, and for a variety of metabolic bone disorders.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What will this vitamin do for me?

Vitamin D is essential for health and wellbeing. It plays a critical role in regulating calcium and phosphorus levels in the body, and is important for healthy bones and preventing abnormal cell changes, which may increase the risk of some cancers. When will it start to work?

This will depend on the condition being treated. In uncomplicated rickets, serum levels should begin to rise in 1-2 days and after 3 weeks signs of calcium and phosphorus mineralisation appear on X-ray. Are there any safety issues?

Vitamin D is considered a safe supplement when used in recommended doses; however, it may interact with some other medicines.

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