View source for Talk:Vitamin D

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== Preparation for nominating for GA ==

Reviewing all references for compliance with [[WP:MEDRS]], old versus new editions, old and potentially replacable by more recent, duplications, etc. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 09:11, 21 November 2024 (UTC)
:There quite a lot of times the articles fails to [[WP:MEDSAY]]. [[User:Bon courage|Bon courage]] ([[User talk:Bon courage|talk]]) 09:16, 21 November 2024 (UTC)
::I agree, and will attempt to address that as part of my review process. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 09:38, 21 November 2024 (UTC)
:::The closer I look, the worse it looks (including that there were two bone health sections, now consolidated). [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 03:41, 22 November 2024 (UTC)
::::Either copying or moving sections to my Sandbox to edit there, and then return to article. Example: History. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 12:05, 23 November 2024 (UTC)
:::::Moved COVID-19 to Health effects and removed [[WP:MEDSAY]] text. Need to check for new lit on government or non-gov organizations issuing statements on D and COVID. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 14:26, 23 November 2024 (UTC)
::::::Completely rewrote Excess section and moved to after Deficiency. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 14:16, 27 November 2024 (UTC)
You're doing a great job reviewing this for the GA nomination.  Thanks.  However do you think the section of Excess should be longer than the one on Deficiency?  The magnitudes of these problems is very different.  I think the current version has lost the problem of incorrect measurement/contamination as a cause.[[User:Jrfw51|Jrfw51]] ([[User talk:Jrfw51|talk]]) 18:07, 27 November 2024 (UTC)
:{{u|Jrfw51}} I addressed Excess first because I thought the quality was worse that Deficiency, but D definitely needs work!!! I expect [[Vitamin D deficiency]] will provide useful content and references.  [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 23:38, 27 November 2024 (UTC)

Working on the Evolution section and last paragraph of Lead. The entire Lead will likely need work after all the other content is revised. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 13:18, 4 December 2024 (UTC)
:Added paragraph to History on cod liver oil as treatment for rickets predating identification of vitamin D as the active by 100 years. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 09:28, 6 December 2024 (UTC)
::Addod three images and removed a global map image. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 03:56, 8 December 2024 (UTC)
:::{{u|Jrfw51}} Almost ready to replace the Deficiency section, with some references removed and others added. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 06:28, 17 December 2024 (UTC)

Replaced Deficiency and Fortification sections [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 19:58, 20 December 2024 (UTC)
:Added Infant deficiency subsection. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 20:27, 28 December 2024 (UTC)
::Added Dark skin deficiency subsection. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 17:23, 30 December 2024 (UTC)
:::Purging more of the pre-2000 refs and will install newer when those sections are revised.[[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 19:43, 1 January 2025 (UTC)
::::Added Treatment subsection to Deficiency [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 12:05, 2 January 2025 (UTC)
:::::Replaced Sources subsection. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 13:54, 3 January 2025 (UTC)
::::::Started to revise Biosynthesis. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 05:24, 12 January 2025 (UTC)
:::::::Biology, Biosynthesis, Mechanism of action somewhat overhauled, but Intracellular mechanisms stll needs work. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 08:34, 20 January 2025 (UTC)

===Nomination timing===
The GA guidelines recommend that an article content be relatively stable before the nomination. For this reason, after I have completed what I see as the changes needed prior to the nomination, I intend to wait several months to see if there are major reverts, revisions or additions by other editors. May request a peer review before the GA nomination. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 20:13, 22 December 2024 (UTC)
:Nominated 9 February 2025. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 14:27, 9 February 2025 (UTC)

== Value of the Biology section? ==

The Biology section has four refs unique to it (one for the figure). Does the section - with the figure - add significant benefit to the article, or can it be removed, with any useful content and refs moved to other sections? Is the figure itself useful? [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 16:08, 13 January 2025 (UTC)

:The lede is well-organized and introduces the biology section in a way that impresses as concise and educational for the common user about how vitamin D is formed and works. Could the biology and biosynthesis sections (and its figures) be combined with the calcium figure (yes, useful) to better introduce the physiological roles for vitamin D early in the article? [[User:Zefr|Zefr]] ([[User talk:Zefr|talk]]) 16:57, 13 January 2025 (UTC)
::I will consider that before submitting to GA. The major part I still intend to revise/re-reference is Mechanism of action (and somewhere cover pharmacokinetics). All contributions welcome. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 19:28, 13 January 2025 (UTC)

== A puzzle ==

For several diseases and health conditions, there are observations of vitamin D deficiency being more prevalent than in healthy populations. For a few, there is additional evidence that supplementation at the amounts tested did not improve the diseases. Is low D a risk factor for these diseases and conditions, or is it something as simple that having these diseases or conditions cause people to have less exposure to UVB from sunlight? Clearly for age, and likely for obesity, these conditions can lead to less skin sun exposure. Without supplements or food fortification, sun exposure is much more of a contributor than diet. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 18:29, 17 January 2025 (UTC)

:For 20+ years, [[Michael F. Holick|Holick]] has made the case of increased disease risk due to vitamin D deficiency. A 2019 update [https://pmc.ncbi.nlm.nih.gov/articles/PMC6834997/ here] and one [https://pmc.ncbi.nlm.nih.gov/articles/PMC9919777/ from 2023] (unfortunately in an [[MDPI]] journal, [[predatory publishing|likely predatory]]). But is there a [[WP:MEDASSESS]] review or clinical guideline to support it? [[User:Zefr|Zefr]] ([[User talk:Zefr|talk]]) 23:19, 17 January 2025 (UTC)
::There are literally thousands of [[nuclear receptor]]s for vitamin D, and therefore thousands of genes either being turned on or off. '''All this makes vitamin D the Swiss Army Knife of vitamins.''' Clearly, calcium metabolism is directly affected in ways that have clinical consequences, and I am of the opinion that any involvement of immune and autoimmune conditions is also probably directly related to vitamin D actions. The question remains in my mind as to whether non-calcium, non-immune disease observations are linked to vitamin D deficiency due to direct action, or do these myriad disease states have the indirect commonality of causing less exposure to sunlight, i.e., [[Occam's Razor]]. The true test would be whether vitamin D supplementation reverses the diseases. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 14:37, 18 January 2025 (UTC)
::: Slight clarification. There is one and only one [[vitamin D receptor]], but this single receptor binds to thousands of [[response element]]s, and hence regulates the expression of thousands of genes.  Here are two [[WP:MEDASSESS]] sources that support that vitamin D deficiency results in increased disease risk:
:::* {{cite journal | vauthors = Demay MB, Pittas AG, Bikle DD, Diab DL, Kiely ME, Lazaretti-Castro M, Lips P, Mitchell DM, Murad MH, Powers S, Rao SD, Scragg R, Tayek JA, Valent AM, Walsh JM, McCartney CR | title = Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 109 | issue = 8 | pages = 1907–1947 | date = July 2024 | pmid = 38828931 | doi = 10.1210/clinem/dgae290 }}
:::* {{cite book | vauthors = Sizar O, Khare S, Goyal A, Givler A | chapter = Vitamin D Deficiency. | title = StatPearls [Internet] | date = July 2023 | location = Treasure Island (FL) | publisher = StatPearls Publishing. | chapter-url = https://www.ncbi.nlm.nih.gov/books/NBK532266/ }}
::: [[User:Boghog|Boghog]] ([[User talk:Boghog|talk]]) 20:25, 19 January 2025 (UTC)
::::Although a preventive effect for vitamin D on rickets is established, the Endocrine Society guideline states that the "certainty of evidence" for ''prevention'' is low-moderate for a) preeclampsia, b) intra-uterine mortality, c) preterm birth, d) small-for-gestational-age birth, and e) neonatal mortality. Other potential effects or associations with lower disease risk remain uncertain due to the evidence that "a causal link between serum 25(OH)D concentrations and many disorders has not been clearly established." The guideline doesn't specify a dose-effect relationship that would justify using this source to say anything about ''prevention'' in the article.
::::The StatPearls short review doesn't give any up-to-date evidence of causality between vitamin D supplementation and disease prevention. All references under ''Pertinent studies'' are out-of-date, [[WP:MEDDATE]].
::::Both reviews state that monitoring vitamin D levels in the general population is not justified, except in high-risk people. Further stated in the Endocrine Society report: "the optimal vitamin D intake and the role of testing for 25(OH)D for disease prevention remain uncertain."
::::This would suggest we are a long way from using vitamin D to prevent most diseases. [[User:Zefr|Zefr]] ([[User talk:Zefr|talk]]) 21:13, 19 January 2025 (UTC)
::::: Straw man argument. No one is claiming that vitamin D prevents most diseases. That is an absurd assertion. However, there are strong associations between low vitamin D levels and certain diseases. Additionally, vitamin D plays a well-established role in regulating gene expression related to calcium uptake, metabolism, as well as the cardiovascular and immune systems. A plausible mechanism helps demonstrate that the observed association is not coincidental. Moreover, when vitamin D levels are low, supplementation is generally recommended to maintain overall health.  [[User:Boghog|Boghog]] ([[User talk:Boghog|talk]]) 07:11, 20 January 2025 (UTC)

Once I am done revising section by section I intend to pause for several months before nominating for Good Article review. During that time I ask all interested editors to amend the article for completeness, gaps, contradictions, neutral point of view, references, etc. I then intend to look at everything with refreshed eyes and proceed. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 08:28, 20 January 2025 (UTC)

== Vitamin D and COVID-19 ==
All of the refs need to be checked. Some are no longer active, or perhaps newer versions have been published. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 14:52, 18 January 2025 (UTC)
:Update completed. Most recent (2024) meta-analyses of supplement trials (large dose oral on hospital admission) concluded significant reductions in ICU admissions and mortality. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 13:16, 19 January 2025 (UTC)

== Nominated for Good Article ==

Nominating for Good Article. Everyone welcome to review/improve the article while waiting for and during review. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 14:26, 9 February 2025 (UTC)
:Looking at [[Vitamin C]] as a model, this article could benefit from an animal synthesis section/subsection within Evolution. It appears that most but not all amphibians, reptiles, birds and mammals have the capacity for skin synthesis, but not dogs, cats, others (?). For example, nocturnal but not diurnal fruit-consuming bats have very low serum D but maintain plasma calcium and bone mineralization. PMID 20804612 has been incorporated into the History section, as it describes lion cubs in London zoo in 1889 being vitamin D deficient and dying from a diet fed to their nursing mothers and the weaned cubs of lean horse meat, treated by changing to goat - including bones - supplemented with cod liver oil, the latter based on observations that CLO treated rickets in human children. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 15:04, 9 February 2025 (UTC)
::Here is [https://link.springer.com/article/10.1007/s00360-017-1117-2 an article] that describes dermal synthesis of vitamin D in the North Island brown kiwi (''[[Apteryx mantelli]]''), tuatara (''[[Sphenodon punctatus]]''), and New Zealand sea lion (''[[Phocarctos hookeri]]''), and [https://www.nature.com/articles/s41598-018-29232-w another article] describing it in some insects. [[User:Reconrabbit|<span style="color:#6BAD2D">Recon</span>]][[User talk:Reconrabbit|<span style="color:#2F3833">rabbit</span>]] 16:10, 10 February 2025 (UTC)
:::In my Sandbox I am drafting a subsection to cover in general amphibians, reptiles, birds, mammals and fish, plus a few exceptions that do not skin-synthesize (dogs, cats, horses, other?). I doubt that there is merit in this being species-exhaustive (!!!!), but I will look at those links. I do not intend to delve into non-vertebrates, but other editors may choose to go there. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 17:09, 10 February 2025 (UTC)
::::Subsection added. [[User:David notMD|David notMD]] ([[User talk:David notMD|talk]]) 04:51, 11 February 2025 (UTC)
{{Talk:Vitamin D/GA1}}