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Vitamin D (Colecalciferol/Cholecalciferol/Vitamin D3)

Colecalciferol: A Fat-Soluble Nutrient with Health Benefits

Vitamin D3, also known as colecalciferol, is a vital fat-soluble nutrient that is essential for human health. It is produced in the skin when exposed to sunlight and can also be found in certain foods such as fatty fish and liver. Despite its nickname as "the sunshine vitamin," many people do not get enough vitamin D from sunlight alone and must obtain it from other sources such as nutritional supplements or certain foods. However, there are not many foods that contain high amounts of vitamin D, leading to widespread deficiency. This deficiency is especially prevalent in young adults, with 32% of those in Australia being deficient. Researchers worldwide have referred to vitamin D deficiency as an "invisible epidemic."

Vitamin D3 plays a crucial role in bone health by helping the body absorb calcium and phosphorus from the diet. It is also involved in immune system function and has been shown to have a protective effect against various health conditions. While the optimal daily amount of vitamin D and its potential to cure diseases remains a subject of debate, there is a strong link between vitamin D deficiency and poor health outcomes.

In order to become active, vitamin D must undergo two processes called hydroxylations in the body. These processes convert vitamin D, which is biologically inactive when obtained from sun exposure, food, or supplements, into its active forms. The first hydroxylation occurs in the liver and converts vitamin D into 25-hydroxyvitamin D, also known as "calcidiol." The second hydroxylation, which primarily occurs in the kidney, produces the active form of vitamin D called 1,25-dihydroxyvitamin D, also known as "calcitriol." When calcitriol binds to the vitamin D receptor (VDR) found in nearly every cell in the body, it can influence gene expression and alter cellular behavior, regulating various physiological processes in the body.

Natural dietary sources of vitamin D3

There are a few dietary sources of vitamin D3, including:

  • Fatty fish: Fatty fish such as salmon, mackerel, and sardines are excellent sources of vitamin D3. A 100-gram serving of cooked salmon provides about 447 IU of vitamin D3, while the same serving of mackerel provides around 388 IU.

  • Cold liver oil: Cod liver oil is a very rich source of vitamin D3, with a single tablespoon (15 ml) providing over 1,360 IU.

  • Egg yolks: Egg yolks contain small amounts of vitamin D3, with one large egg yolk providing about 41 IU.

  • Cheese: Cheese can be a good source of vitamin D3, with one ounce (28 grams) of cheddar cheese providing around 114 IU.

  • Mushrooms: Wild grown mushrooms that have been exposed to UV light can also be a source of vitamin D2, D4 and even some shiitake mushrooms contain D3. A 3.5-ounce (100-gram) serving of these mushrooms can provide around 2,000 IU of vitamin D.

It is important to note that the amount of vitamin D3 in an animal's tissues can be influenced by its diet and can vary depending on factors such as the specific type of food, whether it's farmed or wild, the way it is prepared, and the specific brand.

Exposure to sunlight

Vitamin D is a hormone (secosteroid) that is produced when skin is exposed to sunlight. When UVB radiation with a wavelength of around 290-320 nanometers hits uncovered skin, it converts a compound called 7-dehydrocholesterol into previtamin D3, which is then converted into vitamin D3. Many factors can affect the amount of vitamin D that is produced, including the season, time of day, length of day, cloud cover, smog, skin melanin content, and the use of sunscreen. Fair-skinned individuals and those who are younger are more efficient at converting sunshine into vitamin D than those who are darker-skinned and over 70 years old. Additionally, personal factors such as genetic predisposition, sex, age, and dietary habits also play a role in an individual's response to vitamin D. According to a 2017 study, vitamin D deficiency is common among shift workers, healthcare workers, and indoor workers, likely due to differences in lifestyle factors such as sunlight exposure.

It is difficult to give precise guidelines for how much sun exposure is needed to maintain adequate vitamin D levels, but some experts suggest that 5-30 minutes of sun exposure, especially between 10 a.m. and 4 p.m., either daily or at least twice a week, to the face, arms, hands, and legs without sunscreen, may be sufficient. However, it is important to protect the skin from UV radiation, as it is a carcinogen and the leading cause of skin cancer. Sunscreen with an SPF of 15 or higher should be used when people are exposed to the sun to reduce the risk of skin cancer, although it should be noted that sunscreens with an SPF of 8 or higher may block UV rays that produce vitamin D.

The role of colecalciferol in bone health

    Vitamin D is essential for maintaining healthy bones, as it helps to promote the absorption of calcium and phosphate from the intestine and regulate their metabolism. This is important because calcium and phosphate are essential for normal bone mineralisation. In cases of vitamin D deficiency, the body has been shown to absorb less than half the normal amount of calcium and crucially may compensate by activating the release of a hormone that mobilises calcium and phosphate from the bones, leading to decreased bone density and an increased risk of osteoporosis. This can result in thin, brittle, or misshapen bones, and can cause conditions such as rickets in children and osteomalacia in adults.

    Adequate vitamin D levels are also important for preventing conditions like hypocalcemic tetany (muscle spasms and cramps caused by low calcium levels) and promoting bone growth and remodeling by osteoblasts and osteoclasts. When combined with calcium, vitamin D can also help to protect older adults from osteoporosis, a condition characterized by weak and brittle bones. This is often caused by low calcium intake, but inadequate intake of vitamin D can also contribute to osteoporosis by reducing calcium absorption.

    A systematic review of 41 randomized controlled trials found that vitamin D3 supplementation improved bone mineral density and reduced the risk of fractures in older adults. Another study found that vitamin D3 supplementation improved bone density in postmenopausal women.

    The benefits of colecalciferol for cardiovascular health

    Vitamin D3 has been shown to have a protective effect on cardiovascular health. This is likely due to its role in regulating the renin-angiotensin-aldosterone system (which helps regulate blood pressure), vascular cell growth, and inflammatory and fibrotic pathways. Vitamin D deficiency has been associated with vascular dysfunction, arterial stiffening, left ventricular hypertrophy, and hyperlipidemia.

    Observational studies have shown that higher levels of vitamin D, as measured by serum 25(OH)D levels, are linked to a lower risk of cardiovascular disease (CVD) incidence and mortality. A meta-analysis of 34 studies involving 180,667 participants found that higher levels of serum 25(OH)D were associated with a lower risk of CVD events and mortality. There is also evidence that vitamin D supplementation may have a positive impact on cholesterol and blood pressure, two major CVD risk factors. Genetic studies have suggested that a low vitamin D status may increase the risk of hypertension and CVD.

    The role of vitamin D in depression

    Depression is a common and disabling mental illness that affects people of all ages, genders, and races worldwide. In 2015, it affected 4.4% of the global population. Depression is associated with increased morbidity and mortality, as it increases the risk for stroke, cardiovascular events, and suicide, as well as lifestyle-related disorders such as diabetes and hypertension.

    There is a well-established association between vitamin D deficiency and depressive disorders, as demonstrated by numerous studies. Vitamin D plays a role in various brain functions and its receptors are found on neurons and glia in certain areas of the brain that may be linked to the development of depression. Vitamin D may help regulate mood and reduce the risk of depression.

    A systematic review and meta-analysis of 14 observational studies involving a total of 31,424 adults (mean ages ranging from 27.5 to 77 years) found a link between low levels of 25(OH)D and depression. A review of 7,534 people found that those who received vitamin D supplements while experiencing negative emotions saw an improvement in their symptoms. Supplementation with vitamin D may be particularly helpful for individuals with depression who also have a deficiency in the vitamin. Another study found that low vitamin D levels are a risk factor for more severe symptoms of fibromyalgia, as well as anxiety and depression. A study from the Netherlands found that those living with depression had 14% lower circulating concentrations of vitamin D (25-hydroxyvitamin D, a form of vitamin D) than those not diagnosed with depression.

    The role of colecalciferol in immune system function

    It is important to avoid severe vitamin D deficiency in order to maintain immune health. Low levels of vitamin D may be associated with an increased risk of infections, particularly colds and flus, and autoimmune diseases such as rheumatoid arthritis, type 1 diabetes, and inflammatory bowel disease. Vitamin D3 has been shown to improve immune response in various conditions, and studies have found that vitamin D3 supplementation can reduce the incidence of respiratory tract infections in older adults.

    Vitamin D enhances the activity of antimicrobial peptides (AMPs), which are found in immune cells and on mucosal surfaces and play a key role in defending the body against bacterial and viral infections. Adequate vitamin D levels are necessary for optimal immune function, and deficiency in this nutrient has been linked to an increased risk of respiratory and other infections. In vitro evidence supports the role of vitamin D in immune regulation and the effects of vitamin D metabolites on immune cells. Both animal and human studies have also demonstrated a relationship between low vitamin D levels and negative immune outcomes.

    While clinical trials of vitamin D supplementation have had mixed results, the specific form, dose, and frequency of administration may be important factors to consider. Using vitamin D in a preventive setting may also be key to its effectiveness in improving immune health and reducing the risk of autoimmune diseases.

    The potential of colecalciferol in cancer prevention

    Vitamin D may have a variety of effects that could inhibit the development of cancer, such as promoting cell differentiation, inhibiting metastasis, and exhibiting anti-inflammatory, immunomodulatory, proapoptotic, and antiangiogenic effects. Observational studies have found that vitamin D is associated with a reduced risk of certain types of cancer.

    In a meta-analysis of 16 prospective cohort studies involving 137,567 participants, a 50 nmol/L increase in vitamin D levels was linked to an 11% decrease in overall cancer incidence and a 24% reduction in cancer mortality among women. Another meta-analysis of clinical trials found that vitamin D supplementation reduced cancer mortality rates by 12-13%. The largest clinical trial, called VITAL, which included 25,871 men and women with no history of cancer, found that vitamin D supplementation did not significantly affect the incidence of breast, prostate, or colorectal cancer, but did reduce the risk of cancer in normal-weight participants. Some studies have also linked vitamin D to a reduced risk of specific types of cancer, such as breast, colorectal, lung, pancreatic, and prostate cancer.

    Synergistic role of colecalciferol and vitamins A, K, K2 and magnesium

    Studies have shown that vitamin D works synergistically with other vitamins and minerals to support overall health. For example, magnesium, a mineral that is involved in over 300 enzymatic reactions in the body and is essential for the proper function of the immune system, muscles, and bones, helps activate vitamin D and may have a synergistic effect on bone health and immune function when taken with vitamin D. Magnesium is required for the binding of 25(OH)D to the vitamin D binding protein (VDP), which enables circulation throughout the bloodstream and delivery to various tissues throughout the body. Additionally, Magnesium is a vital component in the conversion of 25(OH)D to the active 1,25(OH)2D hormone form. Both of these mechanisms are crucial in determining an individual's vitamin D status.

    Vitamin K, a fat-soluble vitamin that is necessary for the synthesis of proteins involved in blood clotting and bone metabolism, has a synergistic effect on bone health when taken with vitamin D. Vitamin K2, a subtype of vitamin K found in fermented foods, has been shown to support cardiovascular and bone health. Vitamin D, specifically D3, plays a critical role in calcium homeostasis by increasing the intestinal absorption of calcium and phosphorus, and by promoting the renal reabsorption of calcium. Vitamin K1 and K2, on the other hand, are essential for the carboxylation of specific matrix Gla-proteins (MGP) and osteocalcin, proteins that are responsible for maintaining the structural integrity of the bones and preventing calcification in the soft tissues. The carboxylation process activated by vitamin K2, converts these proteins into their biologically active form. Together, vitamin D and K work in a synergistic manner to promote healthy bone mineralization and cardiovascular health.

    Vitamin D and vitamin A also have a synergistic relationship in the body. Vitamin D is essential for the proper functioning of the immune system and for maintaining healthy bones, while vitamin A plays a critical role in vision, immune function, and cell growth and differentiation. Vitamin D plays a role in the regulation of vitamin A levels by controlling the expression of genes involved in vitamin A metabolism. When vitamin D levels are low, the expression of certain genes that are responsible for the conversion of beta-carotene to retinol (the active form of vitamin A) are suppressed. This can lead to a deficiency in vitamin A, which can have negative effects on vision, immune function, and skin health.

    On the other hand, Vitamin A is also important for maintaining healthy levels of vitamin D. Retinoic acid, the active form of vitamin A, is essential for the proper functioning of the vitamin D receptor, which is responsible for the regulation of vitamin D metabolism. When retinoic acid levels are low, vitamin D metabolism is impaired, which can lead to a deficiency in vitamin D and the development of health problems such as osteoporosis and rickets.

    Nutrients work in synergy to promote optimal health and prevent deficiencies in other nutrients. When an individual becomes insufficient or deficient in one, it can have a cascading effect on overall health, potentially leading to temporary symptoms, developmental issues, permanent symptoms, accelerated aging, and even premature death. It is essential to ensure adequate intake of all essential nutrients to maintain optimal health and prevent these negative outcomes.

    What are the symptoms of vitamin D deficiency?

    Vitamin D plays a critical role in maintaining strong bones and teeth, as well as supporting a robust immune system. Testing for deficiency and insufficiency in vitamin D can be done through measuring total serum 25-hydroxyvitamin D (or 25(OH)D) levels. A deficiency in vitamin D can lead to various health issues, including symptoms such as:

    • Fatigue and tiredness: Vitamin D plays a role in energy metabolism, so a deficiency can cause feelings of fatigue and tiredness.

    • Muscle weakness: Vitamin D is necessary for muscle function, so a deficiency can cause muscle weakness and a general feeling of malaise.

    • Bone pain: Vitamin D is important for bone health, so a deficiency can cause bone pain and an increased risk of fractures.

    • Impaired wound healing: Vitamin D is necessary for the healing process, so a deficiency can cause wounds to heal slowly.

    • Depression: Some research suggests that low levels of vitamin D may be associated with an increased risk of depression.

    • Hair loss: A deficiency in vitamin D can cause hair loss.

    • Dry skin: Vitamin D plays a role in maintaining healthy skin, so a deficiency can cause dry, flaky skin.

    If you are experiencing symptoms associated with a deficiency in vitamin D, it is imperative to consult a health professional. They will be able to accurately diagnose the cause of your symptoms and recommend appropriate treatment options. It is worth noting that, according to clinical data, individuals who have more severe deficiencies or insufficiencies typically respond better to supplementation.

    What are the potential side effects of taking vitamin D3 supplements?

    Vitamin D3 supplements are generally well tolerated and have a low risk of side effects when taken in recommended amounts. However, taking excessive amounts of vitamin D3 can cause side effects, including:

    • Nausea and vomiting: Consuming large amounts of vitamin D3 can cause digestive symptoms, such as nausea and vomiting.

    • Constipation: Vitamin D3 supplements may cause constipation in some people.

    • Weakness: Large amounts of vitamin D3 may cause weakness and fatigue.

    • Loss of appetite: Some people may experience a loss of appetite after taking high doses of vitamin D3.

    • Weight loss: Consuming large amounts of vitamin D3 may cause weight loss.

    • Increased risk of kidney stones: Some research suggests that taking high doses of vitamin D3 may increase the risk of developing kidney stones. However, more research is needed to fully understand this relationship.

    • High blood calcium levels: Excessive amounts of vitamin D3 can cause high levels of calcium in the blood, which can lead to serious health problems, such as kidney damage and heart problems.

    It is important to note that these side effects are typically associated with taking large amounts of vitamin D3, well above the recommended daily intake. It is important to speak with a health professional before taking vitamin D3 supplements to ensure that you are taking the appropriate amount.

    Vitamin D3 supplements are generally safe when taken in recommended amounts. However, as with any supplement, it is important to speak with a health professional before starting to ensure that they are safe and appropriate for you.

    Can vitamin D3 supplements interact with other medications or supplements?

    Yes, vitamin D3 supplements can interact with certain medications and supplements. Some medications and supplements that may interact with vitamin D3 include:

    • Calcium supplements: Vitamin D3 helps the body absorb calcium. Taking vitamin D3 supplements along with calcium supplements may increase the risk of high levels of calcium in the blood.

    • Thiazide diuretics: These medications, which are used to treat high blood pressure, can reduce the absorption of vitamin D3. Taking vitamin D3 supplements along with thiazide diuretics may increase the risk of vitamin D3 deficiency.

    • Cholestyramine: This medication, which is used to lower cholesterol levels, can interfere with the absorption of vitamin D3. Taking vitamin D3 supplements along with cholestyramine may increase the risk of vitamin D3 deficiency.

    • Other supplements: Some supplements, such as large doses of iron, may interfere with the absorption of vitamin D3. It is important to speak with a health professional about potential interactions between vitamin D3 and any other supplements you are taking.

    It is important to speak with a health professional before taking vitamin D3 supplements to ensure that they are safe and appropriate for you. They can help you understand any potential interactions with other medications or supplements you are taking.

    Is it safe to take vitamin D3 supplements if I have a particular health condition?

    Vitamin D3 supplements are generally safe and well tolerated when taken in recommended amounts. However, if you have a particular health condition, it is important to speak with a health professional before taking vitamin D3 supplements to ensure that they are safe and appropriate for you. Some conditions that may be affected by vitamin D3 supplements include:

    • Kidney disease: If you have kidney disease, your body may have difficulty processing vitamin D3. This can lead to an accumulation of the nutrient in the body and potentially cause side effects. It is important to speak with a health professional about the appropriate amount of vitamin D3 to take if you have kidney disease.

    • High blood pressure: Some research suggests that high doses of vitamin D3 may increase the risk of high blood pressure. It is important to speak with a health professional about the appropriate amount of vitamin D3 to take if you have high blood pressure.

    • Diabetes: Vitamin D3 may affect blood sugar levels in people with diabetes. It is important to speak with a health professional about the appropriate amount of vitamin D3 to take if you have diabetes.

    • Medications: Vitamin D3 supplements may interact with certain medications, such as thiazide diuretics and cholestyramine. It is important to speak with a health professional about potential interactions between vitamin D3 and any medications you are taking.

    It is always important to speak with a health professional before starting any new supplement to ensure that it is safe and appropriate for you. They can help you understand any potential risks or interactions with your specific health condition and any medications or supplements you are taking.


    Colecalciferol, also known as vitamin D3, is a fat-soluble vitamin that is essential for human health. It plays a critical role in bone health and is involved in immune system function. It has also been shown to have a protective effect against cardiovascular disease and certain types of cancer. 

    While sun exposure for vitamin D3 is important for maintaining adequate levels in the body, it is possible to obtain this nutrient with vitamin supplements. However, the best way to get the essential nutrients your body needs is to eat a variety of whole, unprocessed, fruits, vegetables, nuts, seeds, and other plant-based foods. Along with sun exposure, these types of food ensure that you are getting a wide range of nutrients, and should not be replaced by vitamin and mineral supplements alone.

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