Vitamin D therapy and related metabolomics: is the calciferol dose and form the only requirements for successful clinical therapeutics?
A nutraceutical that has exploded onto the prescription pad in recent years is the fat soluble vitamin, vitamin D. This is due to an increasing medical interest in the utility of the vitamin in the treatment and prevention of an array of diseases and ailments. Despite the continued debate over the correct dose, form and serum levels, many clinicians fail to achieve intended therapeutic responses with their patients and deficiencies still exist. This may be due to medical professionals being less aware of the multitude of factors that can influence treatment when dosing a product. In this paper we explore the magnitude of interactions that exist between the host physiology and the vitamin and cite such points as a reason for confounding treatment end points. Aspects that are proposed to influence treatment success more critically than dose and molecular form prescribed are: organ pathology, intracellular states, the endocrine system, concomitant products, genetics, lifestyle, quality of product, and modern delivery systems.
University of the Witwatersrand, Faculty of Health Sciences, Department of Pharmacy and Pharmacology, 7 York Road, Parktown, 2193 Johannesburg, South Africa.
M C
MC
Braithwaite
P
P
Kumar
C
C
Tyagi
L K
LK
Tomar
Y E
YE
Choonara
V
V
Pillay
D004305:Dose-Response Relationship, Drug; D016503:Drug Delivery Systems; D004357:Drug Synergism; D004703:Endocrine System / Q000187:drug effects; D004872:Ergocalciferols / Q000737:chemistry / Q000494:pharmacology* / Q000627:therapeutic use*; D005246:Feedback / Q000187:drug effects; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D053858:Metabolic Networks and Pathways / Q000187:drug effects* / Q000235:genetics; D055432:Metabolomics; D008954:Models, Biological; D010818:Practice Patterns, Physicians' / Q000639:trends*
D004872:Ergocalciferols