Витамин Д взрослому нужен ли?
 

Добрый день!
Подскажите, пожалуйста, нужен ли взрослому человеку (30 лет) дополнительный прием витамина Д?
Невролог рекомендовала принимать пожизненно в зимний период. Я спросила зачем, она сказала что у меня остеохондроз и слабая хрящевая ткань, поэтому это типа такая поддержка.
То, что витамин Д необходим детям до 3-х лет, я видела, но вот про взрослых информации не нашла.

В северных странах в осенне-зимний период витамин D вообще не синтезируется, поэтому необходим его дополнительный приём. Рекомендованные дозы витамина D для ежедневного приёма составляют: подросткам, беременным и кормящим 400 МЕ/сут, взрослым 200МЕ/сут

Ежедневный прием с целью укрепления костной ткани и профилактики переломов добавок, содержащих витамин D и кальций, не только не имеет никакого практического смысла, но может нести негативные последствия.
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А затем читаем оригиналы и перекрестные ссылки,в т.ч.
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...
The Task Force's recommendations must be interpreted in the light of ongoing disputes about the most effective method for assessing vitamin D deficiency, whether calcium and vitamin D supplements are needed by a large portion of the population, and what level of supplementation might best maximize benefits and minimize risks.

In 2011, after reviewing more than 1000 studies, the Institute of Medicine (IOM) concluded that vitamin D and calcium are indeed critical to bone health but their role in other diseases—cancer, heart disease, diabetes, immune function, and reproductive health, for example—remains uncertain. The IOM did not consider deficiencies of either calcium or vitamin D to be serious problems in the United States, except among certain population groups. Instead, because of widespread fortification and supplementation, the IOM was concerned about the possibility of adverse consequences from oversupplementation (6).

With risks as well as benefits in mind, the IOM established the average adult daily requirement for calcium at 800 to 1000 mg depending on age, the Recommended Dietary Allowance (the amount needed to meet the needs of about 97% of the population) at 1000 to 1200 mg, and the safe upper level of intake at 2000 to 2500 mg. Its corresponding recommendations for vitamin D were 400 IU, 600 IU (800 IU for older adults), and 4000 IU, respectively. The IOM viewed these levels as sufficient to maintain blood levels of 25-hydroxyvitamin D at or above 20 ng/mL, a level it considered adequate to meet population-based needs regardless of amounts synthesized as a result of sun exposure.

Vitamin D, of course, is not a vitamin in the usual sense. It is a hormone produced in response to the action of sunlight on skin. Like other hormones, vitamin D has multiple roles in the body, not all of them well-understood. Vitamin D supplementation, therefore, must be considered a form of hormone replacement therapy. As such, it raises all of the questions about efficacy, dose, and side effects currently asked of such therapies.

In that light, the 2011 recommendations of the Endocrine Society deserve special scrutiny (7). The Society approaches questions about vitamin D from a standpoint quite different from that of the IOM. It appointed its own task force to make recommendations based on the premise that vitamin D deficiencies are common among all age groups. The Society prefers 30 ng/mL of 25-hydroxyvitamin D as the target level for maximum benefits. By that criterion, virtually all U.S., Canadian, and European adults are deficient in hormone vitamin D and require daily supplements of 1500 to 2000 IU. For adults with demonstrated deficiency, the Society recommends treatment with 50 000 IU of the hormone once a week or daily supplementation of 6000 IU for 8 weeks, followed by 1500 to 2000 IU for maintenance.
...
The USPSTF's recommendations can be understood as an attempt to clarify the present situation with respect to one specific outcome of supplementation. In doing so, its recommendations have a substantial advantage. They depend on hard end points—fractures—rather than on blood levels of 25-hydroxyvitamin D, at best an indirect measure of vitamin D adequacy. The USPSTF uses the same precautionary approach as did the IOM. In the absence of compelling evidence for benefit, taking supplements is not worth any risk, however small.

Набрать 1000 гр кальция и 2000 МЕ витамина Д из еды просто нереально. Получается выход один - потреблять добавки?
Вот только не совсем понятно, какую дозу авторы статьи рекомендуют: 600 МЕ или же 2000 МЕ?

BMJ |16 FEBRUARY 2013 | VOLUME 346

Long term calcium intake and rates of all cause and cardiovascular
mortality: community based prospective longitudinal cohort study

Department of Surgical Sciences,
Section of Orthopedics, Uppsala
University, SE-751 85 Uppsala,
Sweden

Department of Medical Sciences,
Section of Clinical Pharmacology,
Uppsala University, Uppsala,
Sweden

Division of Nutritional
Epidemiology, Institute of
Environmental Medicine, Karolinska
Institutet, Stockholm, Sweden


STUDY QUESTION
What is the association of long term intake of dietary and
supplemental calcium with mortality from all causes and
cardiovascular disease?

SUMMARY ANSWER
High intakes of calcium (>1400 mg/day) are associated with
higher mortality from all causes and cardiovascular disease.
WHAT IS KNOWN AND WHAT THIS PAPER ADDS
A low calcium intake is associated with a higher risk of
fracture, stroke, and fatal ischaemic heart disease. Metaanalyses of randomised studies have, however, shown a
higher risk of ischaemic heart disease and stroke with use
of calcium supplements. In our Swedish cohort study of
women, high intakes of calcium were associated with higher
mortality from all causes, cardiovascular disease, and
ischaemic heart disease but not from stroke.

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Generalisability to other populations

Our results might not apply to people of other ethnic origins or to men