It’s no secret that vitamin D is critical to balancing many areas of health. But from pediatric broken bones to cluster headaches, physicians and scientists at The University of Texas Health Science Center at Houston (休斯顿乌西卫生）仍在学习所谓的“阳光维生素”有多么强大。

维生素D缺乏症已经非常普遍，约有42％的美国人口beplay苹果手机能用吗published in the National Institutes of Health database. Because of this, some researchers across the globe have referred to vitamin D deficiency as an “invisible epidemic.”

从整形外科医生到家庭医学从业者的医生正在看到维生素D缺乏症的患者有所增加。更多的测试是，由于皮肤癌的风险或最近，在COVID-19大流行期间的安全预防措施而在室内停留的人是增加的因素。

“我们看到一个上升趋势的原因是cause we’re checking for it,” said family physicianDeepa Iyengar，医学博士，家庭与社区医学教授以及医学博士Stanley G. Schultz，与休斯顿Uthealth Heston的McGovern医学院授予全球健康教授。“识别维生素D缺乏症是家庭医学类型的重要组成部分，因为各个年龄段都看到了缺乏症。”Iyengar在McGovern医学院的临床实践UT医生中看到患者。

尽管大多数人没有症状，但严重的维生素D缺乏病例会导致薄，脆弱或畸形的骨骼。幸运的是，赤字是可以治疗的，医生经常处方非处方维生素D的补充。

How vitamin D affects the body

维生素D以促进健康的骨骼和牙齿而闻名。当存在维生素D时，人体只能吸收钙的主要成分。

Accordingly, there is a well-documented relationship between vitamin D and orthopedic health, said pediatric orthopedic surgeonAlfred Mansour III, MD，麦戈文医学院的骨科手术临床副教授。他在UT医师的团队最近进行了一个质量改进项目，研究了小儿纪念馆赫尔曼医院急诊室的小儿患者之间的联系水平低和骨头骨折之间的联系。

“每个人都注意到骨折或手臂骨折，但是现在我们看起来更加深入，并揭示了背后的'为什么'。为什么这样做这个与这成千上万的其他孩子相比，孩子摔断了手臂？为什么这样做这个孩子的脚压力骨折吗？”曼苏尔说。“我有很多患者努力从这些伤害中改善，我们的小组发现，维生素D缺乏症在其中发挥了作用。”

Of the pediatric patients studied by Mansour’s group who needed surgical treatment for their fracture or broken bone, 85% were found to be vitamin D deficient. The discovery has led his team to implement new protocols, including partnering with the pediatric emergency room at Children’s Memorial Hermann Hospital to test for the condition in admitted patients.

正如Iyengar所指出的那样，一个人可以在任何年龄的年龄体验，从出生到以后的生活。但是，某些因素使某些人面临比其他人更大的风险。

据UT医生说，正在母乳喂养的婴儿是高风险群体之一肯尼亚公园，医学博士, clinical associate professor of pediatrics with McGovern Medical School.

帕克斯说：“我们绝对想促进母乳喂养，而母乳是婴儿最好的牛奶，但维生素D的牛奶非常低。”“母乳喂养的妈妈们希望确保他们的婴儿尽早得到补充。”

The American Academy of Pediatrics recommends breastfed and partially breastfed infants be supplemented with 400 international units (IU) of vitamin D per day, beginning in the first few days of life. Some doctors advise breastfeeding mothers to purchase vitamin D drops, which are available at nearly any pharmacy or grocery store and should be given to breastfed babies on a daily basis. Babies can also get vitamin D through 10 to 15 minutes of sunlight exposure each day.

Parks said other patients who are vitamin D deficient include children and teens who are obese – a phenomenon at least partially attributed to distribution into a greater amount of body tissue – and children and teens who are on certain anti-convulsant and anti-fungal medications, which interfere with their body’s ability to absorb or convert vitamin D.

在儿童中，维生素D缺乏症的极端病例表现为RICKET，这种疾病会导致软骨头和骨骼畸形。帕克斯说，瑞克斯还可能导致发育延迟，癫痫发作，肌肉痉挛和其他异常。

“Vitamin D is both a vitamin and a hormone,” Parks said. “Kids have growing bones, so if they don’t get enough vitamin D, their bones aren’t fortified.”

Beyond children with these medical issues, however, vitamin D deficiency is high among Black individuals, whose darker skin has more melanin than lighter-skinned individuals, reducing their ability to synthesize vitamin D from the sun and resulting in lower vitamin D levels.

The deficiency is最高among people who are elderly, institutionalized, or hospitalized. In the U.S., according to a study published in药物治疗, 60% of nursing home residents were low in vitamin D, while according to research published in新英格兰医学杂志，发现57％的住院患者缺乏维生素D。

Iyengar说：“随着年龄的增长，骨吸收会增加，骨骼形成减少，因此，如果您不能用足够的钙代替这种损失，则会导致骨质缺乏。”“您的身体认为您缺乏维生素D，因此它将维生素从骨骼中吸收并赋予血液，这使人们面临骨质疏松症的主要风险。”

随着年龄的增长，阳光暴露中皮肤中的维生素D产生也会下降，使老年人群体更依赖饮食补充剂。Iyengar说，由于维生素D缺乏症也与甲状旁腺代谢有关，因此妇女在更年期并失去雌激素时变得特别容易发生。

A woman’s ability to build bone peaks in her mid to late 20s, according toPamela Berens, MD, the Dr. John T. Armstrong Professor in Obstetrics and Gynecology with McGovern Medical School and an OB/GYN with UT Physicians. Therefore, as women enter their 30s, Berens advises her patients to simply work on maintaining their bone health.

“For post-menopausal women, it’s really important to know your bone density and vitamin D level. Having that knowledge gives you the power to fix it,” Berens said. “Younger women just need to think about what they can do to build healthy bones.”

维生素D还调节许多其他细胞功能，其抗炎，抗氧化剂和神经保护特性支持免疫健康，肌肉功能和脑细胞活性。

Mark Burish, MD, PhD，维维安·L·史密斯（Vivian L. Smith）神经外科助理教授与麦戈文医学院（McGovern医学院对于那些针对多发性硬化症和其他疾病的患者开处方的人来说，可能有效地治疗了群集头痛。

埋葬理论化了增加维生素D摄入量可能能够治疗聚类头痛的一些可能原因。一个是，维生素D似乎会阻止键盘头痛期间通常被激活的关键疼痛信号分子。另一个理论是，头痛可能与昼夜节律有关，这是一种自然的内部过程，可调节睡眠效果周期，每24小时重复一次。

“Normally, people receive vitamin D through direct sunlight, and the most common time for a cluster headache attack, no matter where you live, is 2 a.m., when it’s still very dark outside,” said Burish, who is also with The University of Texas MD Anderson Cancer Center Graduate School of Biomedical Sciences. “Vitamin D may be able to help regulate the light-dark pattern that seems to be tied to these headaches.”

如何获得足够的

一个人可以通过三种方式获得维生素D：通过皮肤，饮食和医学处方补充剂。

建议在阳光下进行一段时间，但是鉴于太多的阳光暴露会导致皮肤癌，因此食物可能是更好的来源。一些食物，包括脂肪鱼，牛肉肝脏，奶酪，蘑菇和蛋黄，自然会携带营养。它也可以在强化食品和饮料中找到，例如牛奶，早餐谷物，橙汁，酸奶和大豆饮料。

人们还从多种维生素和补充剂中获取维生素D，这些维生素是婴儿的药丸和液体形式。

According to the National Institutes of Health, the daily recommended amount of vitamin D is 400 IU for infants up to 12 months old, 600 IU for children and adults up to 70 years old as well as breastfeeding women, and 800 IU for adults who are at least 71 years old.

维生素D缺乏的标准治疗涉及补充。根据个人的状况，他们的医疗保健提供者会建议他们需要多少，需要多久服用多久以及需要多长时间才能服用。

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