Talk:Cholecalciferol

not a hormone

The second sentence is incorrect according to Reinhold Vieth's article "Why Vitamin D is not a hormone" Journal of Steroid Biochemistry and Molecular Biology 89-80 (2004): 571-573.

SMILES Notation

The SMILES Notation that is on the page now does not match the picture, so I'm going to change it to match (the picture is right, I checked on the EPA website).

Here is what it is now:

CC(C)CCC[C@@H](C)[C@H]1CC[C@H]2/C(CCC[C@]12C)=C/C=C3/C[C@@H](O)CCC3=C

And here's what it actually is:

CC(C)CCC[C@@H](C)[C@H]1CCC2C(\CCCC12C)=C\C=C3\C[C@@H](O)CCC3=C

Sbrools ^{(talk . contribs)} 17:29, 6 May 2007 (UTC)

Clinical relevance

I haven't the time now, but this article desperately needs some clinical relevance. Cholecalciferol's clinical implications are very significant, with relation to Calcium absorption in the gut and renal osteodystrophy. 81.179.117.49 10:50, 17 June 2007 (UTC)

On a similar note, I thought that the following would be relevant;

The ratio of total 25OHD3 and 1,25(OH)2D3 to plasma DBP, rather than total circulating vitamin D metabolites, may provide a more useful index of biological activity. Further studies are required to substantiate this hypothesis. http://www.ncbi.nlm.nih.gov/pubmed/16339300?ordinalpos=33&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

I haven't been able to find any controlled studies that shows D3 supplementation counteracts bone loss in 25 D3 deficient individuals superior to calcium alone. Likewise, it's anti-cancer effects only appear in short term trials and are consistant with other immunosuppressives such as prednisone in this regard.

CONCLUSIONS: Kidney-transplant recipients receiving modern immunosuppressive regimens with low doses of corticosteroids experience only minimal loss of BMD during the first posttransplant year. Cholecalciferol supplementation did not prevent posttransplant bone loss http://www.ncbi.nlm.nih.gov/pubmed/15714177?ordinalpos=45&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

CONCLUSIONS: In this carefully controlled study calcium plus vitamin D3 supplements only had minor influences of uncertain significance on the calcium balance in healthy, calcium and vitamin D sufficient early postmenopausal women.

http://www.ncbi.nlm.nih.gov/pubmed/15114377?ordinalpos=60&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

More succinctly, http://bacteriality.com/2007/09/15/vitamind/ http://trevormarshall.com/BioEssays-Feb08-Marshall-Preprint.pdf —Preceding unsigned comment added by 63.166.226.83 (talk) 18:39, 4 June 2008 (UTC)

—Preceding unsigned comment added by Wiserd911 (talk • contribs) 04:28, 2 June 2008 (UTC)

--Ryan Wise (talk) 04:09, 2 June 2008 (UTC)

Overdose

While the main Vitamin D article notes the potential for oversupplementation, a single sentence in this article is probably merited as well, just to be on the safe side. (24.147.80.106 15:07, 26 June 2007 (UTC))

|---

Hi. I like to point that in the "Dose" subsection the same sentence is repeated twice with different information. See around citation 4 and 5 about current suggested value too low & max acceptable limit, Thanks. —Preceding unsigned comment added by 173.179.42.153 (talk) 16:59, 17 January 2011 (UTC)

So, what's it do?

Yes, what is it good for?
TIA,
--Jerome Potts 08:01, 23 September 2007 (UTC)

Supplementation doesn't seem to increase bone density

In healthy individuals it activates the Vitamin D receptor, which serves an immune function. It is also immunosuppressive. (presumably, after you're out in the sun, your body needs some time to repair itself.)

For more info; http://bacteriality.com/2007/09/15/vitamind/

http://trevormarshall.com/BioEssays-Feb08-Marshall-Preprint.pdf --Ryan Wise (talk) 18:42, 4 June 2008 (UTC)

You're right, supplementation doesn't increase bone density, calcium does. But you need vitamin D with your calcium for proper absorption. Vitamin D only maintains blood calcium and prevents PTH from leeching it from your bones in lack of oral calcium. Bare in mind that, immunosupressive in this context is not a bad thing. It numbs what needs to be numbed and activates what needs to be activated. Mo79 (talk) 20:32, 26 July 2008 (UTC)

Slightly more specifically, blood calcium + Vitamin K is required to increase bone mineral density. Without Vit. K, more calcium in the blood leads easily to soft tissue calcification. This is why commonly used blood thinners such as the salycilates (Aspirin or Warfarin for instance) which work by inhibiting vit. K1 have recently been found to increase heart attacks in the long term. I should have said 'immunomodulatory' rather than immunosuppressive ( I was thoughtlessly echoing bacteriality here.) Calcitriol, which activates the VDR, downregulates cell mediated immunity and upregulates the production of cathelidicin. Bacteriality's assertion that +cholecalciferol leads to VDR blockage seems to be based primarily on proprietary computer models and in vivo corroboration is shaky. --Ryan Wise (talk) 09:42, 27 December 2008 (UTC)--76.166.24.76 (talk) 09:35, 27 December 2008 (UTC)

There are two forms of Vitamin-K. The K1 form often administered to babies at birth has clotting benefits to prevent rare bleeds. The K2 form has implications in reducing soft tissue calcification and is promoted as a cofactor with Vitamin-D3 supplementation often with magnesium. It would be prudent to indicate the form of Vitamin-K that is under discussion.

85.131.100.60 (talk) 16:12, 19 February 2024 (UTC)

Patientslikeme.com suggests that D3 supplementation reduces MS relapse rate and intensity. Speaking from personal experience, it has helped me a lot. —Preceding unsigned comment added by 193.1.223.254 (talk) 12:13, 4 March 2011 (UTC)

There is some research to back up the connection and benefit of Vitamin-D3 in MS management. It has been used in a treatment protocol in some countries for decades, successfully.

Vitamin D and multiple sclerosis—from epidemiology to prevention DOI: 10.1111/ane.12432

Vitamin D Resistance as a Possible Cause of Autoimmune Diseases: A Hypothesis Confirmed by a Therapeutic High-Dose Vitamin D Protocol DOI: 10.3389/fimmu.2021.655739

Idyllic press (talk) 21:21, 18 February 2023 (UTC)

Vegan D3

VEGAN D3...Hi there. If my comments are not appropriate please forgive. I've never posted on Widipedia until now.

I've been searching for D3 that does NOT come from fish oil. While not technically vegan, I have found D3 made from lanolin. The vitamin shelves are VERY confusing because most all products say their D3 comes from cholecalciferol. Vitamin consultants say all D3 is from fish oil. However, I contacted the maker of the D3 I'm taking and they assure me the cholecalciferolin their product comes from lanolin.

That's quite plausible. You can actually extract D3 from the fat from sheep wool: D3 is formed when sunlight irradiates certain types of fat, including lanolin. As for saying the D3 "comes from" cholecalciferol: that's actually a form of D3, and doesn't give you any information on the source. It could be from fish liver or irradiated cholesterol (the kind that your body makes naturally). --Slashme (talk) 05:20, 21 January 2008 (UTC)

As far as I know, supplemental D3 either comes from fish oil or lanolin (more from lanolin). The only truly vegan option is D2, however this of course is a pain with D2 being much less effective. Mo79 (talk) 20:32, 26 July 2008 (UTC)

if they can verified that claim on paper and that the product is purely made from it, but i doubt they can guarantee it (as company's cut corners to reduce costs, and are allowed to say whatever they want as long as it's not presented as fact ) Markthemac (talk) 04:53, 25 January 2009 (UTC)

Vegan D3 (from lichens) is now being commercially produced for use in vitamin supplements. I've added it to the article, see here. -kotra (talk) 03:30, 16 March 2013 (UTC)

There is also a recent new form of Vitamin-D3 that has been produced from precursor from an east coast Australian seaweed. It has reached the market and is also sold as a vegan Vitamin=D3 because it is 'special' it will be indicated on the bottle and reflected in the higher price.

85.131.100.60 (talk) 16:17, 19 February 2024 (UTC)

pig brains?

Does any one know about D3 coming from pig brains? Is lanolin the only source? 24.152.217.54 (talk) 14:54, 6 February 2008 (UTC)

using brain/spine for food supplement is not allowed in most of the western world after the BSE scare, not from any animal. Markthemac (talk) 04:47, 25 January 2009 (UTC)

and lanolin is mostly acquired from sheep's wool Markthemac (talk) 13:17, 27 April 2012 (UTC)

Colecalciferol

Has anyone else noticed that cholecalciferol is mentioned more often without the h as colecalciferol, and what could the reason for this be? I know it sounds a very trivial question, but I'm intrigued if an interesting answer exists. Perhaps it's a way to differentiate supplements from skin produced D3? But why change now? Mo79 (talk) 20:32, 26 July 2008 (UTC)

There is a move to internationalise drug names. As part of this the new name for cholecalciferol is colecalciferol. However I am only aware this is the case for its use as a drug/ medication/ supplement. This may not have any bearing on scientific nomenclature and it seems reasonable to continue to use cholecalciferol outside any mention as a medication, such as in this article. —Preceding unsigned comment added by 202.154.155.67 (talk) 09:51, 21 October 2008 (UTC)

This article is almost wholy about its manufacture and dosing as a medication. As such WP:MEDMOS indicates that the International Nonproprietary Name (INN) be used rather what might still be United States Adopted Name (USAN) or the former British Approved Name (BAN) which changed years ago to the INN. David Ruben ^Talk 23:02, 13 March 2011 (UTC)

It is probably spelt with an "h" in it as vitamin D is a (7-dehydro)cholesterol derivative, denoting its relation to bile (greek: bile = chole). --85.218.152.255 (talk) 15:57, 7 June 2012 (UTC)

Trevor Marshall (Marshall Protocol)

Trevor Marshall is an electrical engineer. He should not be featured on this information page. His "approach" is considered quack science by EVERY REAL scientist in the field. Any reference to him should be taken off this site. Wikipedia is a place for information that is accepted by the medical community and he is NOT a member of the medical community at large. Many real doctors have a profound dislike of this dangerous suggestions. Furthermore the only thing Trevor Marshall has ever had published was not peer reviewed, and was not an actual study but merely a stated theory. Judderwocky (talk) 18:14, 24 September 2009 (UTC)

While most of what you've said is true (Marshall's PhD is in electrical Engineering, for instance and he's certainly not mainstream), some of Trevor Marshall's criticisms (and those associated with him) are valid and well supported by published research. Vitamin K + calcium puts calcium into bones. There aren't any studies showing that D3 + calcium increases bone mineral density over calcium alone. Upregulated TLR-4, which is associated with infection leads to upregulated CYP271B which leads to increased conversion from calcidiol to calcitriol (thus creating an apparently low level of calcidiol which is what tests rely on.) Care to post any studies which address low calcidiol due to increased conversion to calcitriol as compared to insufficient levels of cholecalciferol? It's a genuine black hole in published research.

And lack of vitamin D3 along with decreased Vitamin K does lead to calcification of soft tissue. This suggests that increased conversion of calcidiol, rather than insufficient cholecalciferol, is the actual source of problems in at least a few cases (those diseases where low calcidiol is associated with calcification of soft tissue.)

Now granted, the whole "Marshal Protocol" is entirely unsupported by peer reviewed research (nor is the protocol mentioned anywhere on this page that I can see. Has it been removed already?) Marshall seems to go astray with the unwarranted assumption that most chronic infections act like sarcoidosis. Some chronic infections could involve significantly different bacteria, viruses or fungi, which is not something that the Marshall protocol seems to take into account at all. However that doesn't invalidate idea that chronic inflammation is capable of causing lowered calcidiol, nor does it invalidate the popularity of his ideas among a significant minority.--97.115.253.90 (talk) 06:36, 12 October 2009 (UTC)

Poison?

I think it is a bit unclear as to whether or not cholecalciferol is poisonous, or if it simply used as part of the bait. Could someone please clarify? Also, what purpose does it serve in the bait? Why are possums attracted to it? —Preceding unsigned comment added by 64.73.12.253 (talk) 05:35, 6 June 2010 (UTC)

Cholecalciferol as poison

Cholecalciferol in and of itself is an active product of the body, and not harmless in doses proportional to what a vertebrate organism can create in natural sunlight. It is a prohormone which regulates multiple functions in the cells of vertebrates, and it is used as a poison because of it's effects on calcium absorption in the small intestine. It is used as the active part of the bait to create the desired effect of hypercalcemia in the soft-tissue organs of the target animal's body.

The factor which defines a toxic level of vitamin D3 (cholecalciferol) is the level of calcidiol (25-hydroxyvitamin D or 25(OH)D3) in the blood of an organisim. Humans reach the toxicity level when their 25-hydroxyvitamin D levels are at 200-250 ng/mL (500-750 nmol/L) or higher, but it is the effect of vitamin D3 on the absorption of calcium that results in organ damage and death. The absorption of calcium is proportional to the level of 25-hydroxyvitamin D in the blood; thus when an animal consumes a high level of vitamin D3 they overabsorb calcium. When levels of calcium in the blood are too high the animal enters a state of hypercalcemia, which causes arrhythmia of the heart and a subsequent death by heart attack.

Unsigned, possums would be attracted to the bait by the cholecalciferol and calcium being hidden in a food that the possum likes to eat. The vitamin is more or less taste-free and odorless, and it'd be a pretty easy way to knock off the animal. I hope this clarifies things a bit! My source for most of this information is the vitamin D council page on toxicity. Sources on toxicity levels and studies are cited (four of them) at the bottom of the linked page. --JHansen (talk) 21:50, 2 June 2011 (UTC)

Suggestion - vitamin D co-factors?

I think that it'd be relevant to address the newest information on cholecalciferol from the vitamin D3 website in this article, in order to address the new fad of heavy vitamin D supplementation - at least to name them in linkages, alongside what roles they play in cooperation with cholecalciferol in the body.

Thoughts and feedback? Thanks, --JHansen (talk) 21:50, 2 June 2011 (UTC)

Material that is added to Wikipedia needs to be supported by reliable sources. Furthermore Wikipedia has very high standards for sources to support medical claims (see WP:RSMED). The Vitamin D Council documents things much better than most web sites (see for example the reference section at the bottom of "Magnesium". Vitamin D cofactors. Vitamin D Council. {{cite web}}: Cite has empty unknown parameter: |coauthors= (help)). At the same time, I think they present a lot of circumstantial evidence that magnesium deficiency contributes to vitamin D insufficiency but they do not provide any direct evidence for this claim. This PMID 16596461 primary source comes a lot closer. Ideally we would like a secondary source (i.e., a review article or meta clinical study) to support this claim. At the same time, the introduction of this article that reviews the evidence for this linkage can be considered a secondary source. Hence I think it would be OK to mention magnesium deficiency as a contributing factor to vitamin D insufficiency and cite PMID 16596461. The claims for vitamin K, boron, and zinc would have to be looked at in a similar way. Boghog (talk) 09:45, 3 June 2011 (UTC)

Therapeutic vs D3 deficiency during CRC, chemotherapy

I found these links interesting: ASCO 2009and Chemotherapy is linked to severe vitamin D deficiency in patients with colorectal cancer--Stageivsupporter (talk) 08:06, 3 June 2011 (UTC)

Industrial production techniques

I found it very hard to find a description of Vitamin D3 industrial production technques. Today, I found a good description which I think can be used as a reference and quoted or paraphrased:

 http://www.agdnutrition.com/d3-story.html

This is in the sub-section previously "As a food fortification", now renamed "Industrial production".

This description seems to match that given via email from another manufacturer, which I think is not a primary reference and can't be quoted:

 http://blogs.vancouversun.com/2011/02/08/what-do-sheep-have-to-do-with-vitamin-d-supplements-quite-a-bit-actually-mates/

This second description is from DSM Nutritional Products, but the best information they I can find on their websites is much less detailed:

 http://www.vitamin-basics.com/index.php?id=3

Robin Whittle (talk) 13:03, 8 April 2012 (UTC)

Photosynthesis

Can it be said that we photosynthesize Cholecalciferol? — Preceding unsigned comment added by 72.130.93.49 (talk) 20:03, 26 May 2012 (UTC)

Linguistically that seems correct, the ultraviolet irradiation of the precursor forms an intermediate metabolite that thermally isomerises to the vitamin form Cholecalciferol. Some might complain that Chlorophyll is not involved so it does not count and because it turns into a hormone and not food it might also not convince others.

• precursor/7-dehydrocholesterol/7-DHC + UVB =
• pre-Vitamin-D3/pre-cholecalciferol + heat (spontaneous isomerisation) =
• Vitamin-D3/VD3/cholecalciferol + 25-hydroxylase enzyme mostly in liver =
• storage form/calcifediol/calcidiol/25(OH)D3 + 1-alpha-hydroxylase enzyme mostly in the kidneys =
• hormone/active form/calcitriol/1,25(OH)2D3

There is a diagram that shows the process on another wikipedia page. The preview window already shows some of the relevant bits.

https://en.wikipedia.org/wiki/Cholecalciferol#Biosynthesis 85.131.100.60 (talk) 16:36, 19 February 2024 (UTC)

D3 as an hormone

I found this :

• THE MIRACULOUS RESULTS OF EXTREMELY HIGH DOSES OF THE SUNSHINE HORMONE VITAMIN D3 MY EXPERIMENT WITH HUGE DOSES OF D3 FROM 25,000 to 50,000 to 100,000 IU A Day OVER A 1 YEAR PERIOD

Is there any study backing that ? Yug (talk) 17:01, 12 August 2012 (UTC)

These were mentioned in the talk section above and relate to high dose protocol/s but doctors using these protocols generally say medical supervision is essential over 30'000IU=750ug dosing and serum testing already before that.

• Vitamin D and multiple sclerosis—from epidemiology to prevention DOI: 10.1111/ane.12432
• Vitamin D Resistance as a Possible Cause of Autoimmune Diseases: A Hypothesis Confirmed by a Therapeutic High-Dose Vitamin D Protocol DOI: 10.3389/fimmu.2021.655739

85.131.100.60 (talk) 16:44, 19 February 2024 (UTC)

Opposition to vitamin D supplements

This section is badly written and I'm going to try to make sense of it. Nicmart (talk) 22:06, 22 February 2013 (UTC)

Now that I've rewritten it I find that the reference provides no support at all (that I can deduce) for what is claimed about allergies and immune disorder. If there is no disagreement then this should be wiped: "Medical experts who oppose supplementing with vitamin D hypothesize that doing so might cause new allergies to emerge or exacerbate existing allergies and autoimmune disorders.[10]" Nicmart (talk) 23:50, 22 February 2013 (UTC)

Dietary sources

It's very odd that the article doesn't touch on dietary sources! Someone really ought to fix that. --92.28.98.184 (talk) 18:25, 4 November 2013 (UTC)

Shearing sheep doesn't kill them!

"Cholecalciferol is also produced industrially for use in vitamin supplements from lichens, which is suitable for vegetarians and vegans."

Why would sheep's wool objectionable to vegetarians? I've seen many sheep shorn, and in the hands of an experienced shearer, the sheep is usually relaxed during the process. I also know many vegetarians who are not offended by the use of wool or the process of shearing, and are happy to use wool and wool by-products.

http://en.wikipedia.org/wiki/Vegetarianism "Vegetarianism is the practice of abstaining from the consumption of meat – red meat, poultry, seafood and the flesh of any other animal; it may also include abstention from by-products of animal slaughter."

http://en.wikipedia.org/wiki/Veganism "Veganism /ˈviːɡənɪzəm/ is the practice of abstaining from the use of animal products, particularly in diet, as well as following an associated philosophy that rejects the commodity status of sentient animals. A follower of veganism is known as a vegan."

So I will change this to: "Cholecalciferol is also produced industrially for use in vitamin supplements from lichens, which is suitable for vegans." — Preceding unsigned comment added by 193.128.105.36 (talk) 17:18, 22 April 2014 (UTC)

D2 vs D3

This article currently says "There are conflicting reports concerning the absorption of cholecalciferol (D3) versus ergocalciferol (D2), with some studies suggesting less efficacy of D2,[12] and others showing no difference.[13]"

There is nothing conflicting about the two studies cited. The first study shows less efficacy in D2 vs D3 when administered in a large monthly dose. This study showed similar serum 25OHD levels between D2 and D3 immediately after the dosage but that these levels dropped off dramatically over the course of the month with D2 but stayed strong with D3.

The second study showed D2 and D3 to be equally effective with a daily dose. The first study's authors also suggested this would be case.

--Ericjs (talk) 22:01, 24 July 2016 (UTC)

The growing evidence over a long period has confirmed that the use of D2 in humans and most livestock (especially fowl) is to be avoided the effects are not identical and one is the form we produce ourselves. Those two studies do illustrate a conflict in how studies can give different results when measuring differently.

I have collected a list of studies that investigate the topic if you want to try and find better consensus.

DOI: 10.1093/ajcn/68.4.854 Evidence that vitamin D3 increases serum 25-hydroxyvitamin D more efficiently than does vitamin D2

DOI: 10.1210/jc.2004-0360 Vitamin D2 is much less effective than vitamin D3 in humans

DOI: 10.1093/ajcn/84.4.694 The case against ergocalciferol (vitamin D2) as a vitamin supplement

DOI: 10.1210/jc.2008-0350 Short and long-term variations in serum calciotropic hormones after a single very large dose of ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) in the elderly

DOI: 10.1210/jc.2010-2230 Vitamin D(3) is more potent than vitamin D(2) in humans

DOI: 10.1016/B978-0-12-381978-9.10057-5 Chapter 57 - The Pharmacology of Vitamin D

DOI: 10.1111/nbu.12293 Vitamin D2 vs. vitamin D3: They are not one and the same

DOI: 10.4158/EP-2018-0415 IT'S TIME TO STOP PRESCRIBING ERGOCALCIFEROL

DOI: 10.1007/s11154-019-09532-w Consensus statement from 2nd International Conference on Controversies in Vitamin D

17:03, 19 February 2024 (UTC) 85.131.100.60 (talk) 17:03, 19 February 2024 (UTC)

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Injection

This ref specifically says not by injection.[1] It is a different vitamin D given by injection. Doc James (talk · contribs · email) 16:19, 3 September 2017 (UTC)

OK wrong reference, but it is "sometimes given by injection" - see PMID 28114352, PMID 26852398, PMID 26913455, PMID 26186566, PMID 26151421, etc. and [2] (Canada!), [3]. I can't find good secondary MEDRS reviews -- this might do to show it exists PMID 23418806. Jrfw51 (talk) 17:33, 3 September 2017 (UTC)

I think we can say it use by IM injection has been studied. Not notable for the lead IMO. Doc James (talk · contribs · email) 17:36, 3 September 2017 (UTC)

Cost in lead summary?

This is specific to my edits which have been reverted by @Doc James:, but I thought I'd explain my position here in case anybody else wants to chip in.

Whilst price is indeed important, which is why I included a subsection titled 'Cost' on the page, the 2015 cost of vitamin D3 treatment in the US doesn't seem notable enough to include in the lead summary. Imagine if the summary included the cost of treatment or wholesale procurement in every nation? That would seems excessively detailed for an opening summary to me. So better not to have country-specific price points in the summary, and save it for the subsection.

Furthermore, the reference to the cost in the developing world is misleading, as the source cited as far as I can ascertain provides one single supplier price-point specific to Costa Rica. The price point in Costa Rica is not equivalent to the price point across other economically equivalent nations, so it's false to interpret it so. Think of it this way: you wouldn't use a reference specific only to one German supplier to state the price in the developing world as a whole, would you? Developing world is itself a questionably broad term, anyway.

My proposals are: Keep country-specific prices in the Cost subsection, and remove the reference to cost in the "developing world" as the citation only pertains to Costa Rica. Thoughts? 80.192.27.175 (talk) 23:00, 28 September 2017 (UTC)

For medications there are generally three main price groupings globally. Least expensive in the developing world. Most expensive in the USA. Middle expensive in the rest of the developed world. Thus US and developing world generally gets the range. Doc James (talk · contribs · email) 05:18, 29 September 2017 (UTC)

Thanks for the response @Doc James:, but that raises the same questions.

Firstly, the Costa Rican price is the wholesale cost, not cost of treatment. The US price is the cost of treatment, not the wholesale cost. Apples and oranges, and for that reason not a useful range to include in the summary.

Secondly, the Costa Rican supplier is the only price in the reference cited, and described within the article as "the wholesale cost in the developing world". One supplier in one country is not the wholesale cost in the developing world, nor "the least expensive in the developing world" which is one of your three groupings.

Thirdly, the US price of treatment is not the average price in the developing world, nor is it framed as such here. So it's no more or less important than the cost of treatment anywhere else, in which case it should be kept out of the lead summary lest we mention every average cost in every country in the lead. I'm trying to minimise American-centricity on Wikipedia.

My thinking is: useful ranges to include in the lead summary would be the average wholesale cost in developed world vs. average wholesale cost in the developed world, and the average cost of treatment in the developing world vs. the average cost of treatment in the developed world.

What we have currently is the wholesale cost in Costa Rica and the cost of treatment in US, both of which aren't really important enough to keep in the lead. They don't provide a range as per your three groupings. So shall I remove them from the summary (I moved them to the Cost subsection already)? If not, why not? 80.192.27.175 (talk) 21:33, 30 September 2017 (UTC)

Whole say cost in the developing world is generally the lowest well cost to the consumer is generally the highest.

The wholesale cost generally relates to the consumer cost (not apples and oranges.

The cost in the developing world is generally the least, yes sometimes we only have a few countries and in this example one country. I have stated the exact country.

Not sure what is wrong with "In the United States treatment costs less than 25 USD per month"? Doc James (talk · contribs · email) 03:21, 4 October 2017 (UTC)

I appreciate that it now says Costa Rica instead of "developing world" in the summary, since it's more accurate, so thanks for that.

But if you're saying the Costa Rican wholesale cost and the US monthly treatment cost provide a useful range, perhaps it should be framed as "In 2015, the cost of a 30ml bottle ranged from around X to Z worldwide" or something similar instead? That way it clearly and concisely indicates a range. At the moment, it reads like two incomparable costs from two random countries on two separate lines, which is why I thought it inappropriate for a summary. What do you think? 80.192.27.175 (talk) 08:34, 5 October 2017 (UTC)

We would need a ref that says the range. It is presented separately as that is what the sources support. Price transparency around medicines is a significant global issue.[4] Doc James (talk · contribs · email) 18:08, 5 October 2017 (UTC)

So you're saying it doesn't constitute a range without a specific reference stating the range. In which case, again @Doc James:, why have the Costa Rican wholesale price and then the US treatment price in the lead section of the article? If it doesn't provide a useful range, then it is just two price points in two unconnected countries. The lead section is meant to provide a useful overview of the article, with more specific details in subsections below, as per Wikipedia's summary style guidelines. If the price in Costa Rica and the US aren't any more notable than the price in, say, Zimbabwe or New Zealand etc., how about removing them from the summary but keeping them in the subsection? This was my original point, and the reason for my edit which you reverted. 80.192.27.175 (talk) 14:09, 9 October 2017 (UTC)

The price in the US is notable as it is the largest EN speaking country. The price in Costa Rica is representative of the cost in much of the developing world. Doc James (talk · contribs · email) 23:45, 9 October 2017 (UTC)

INN

Apparently, the INN is 'Colecalciferol', not 'Cholecalciferol' (-h-). Per WP:PHARM then, shouldn't the article content be in Colecalciferol? That's a move over redirect, so nothing will be broken. -DePiep (talk) 21:59, 11 October 2017 (UTC)

The INN is indeed without the 'h'. This is meant to be the spelling for the therapeutic agent (in most of the world). But it is also the natural compound, which is with the 'h'. This is overwhelmingly the spelling used in Pubmed. Jrfw51 (talk) 08:16, 12 October 2017 (UTC)

Sure both names are correct. For medicines, we apply the general rule Pharmacology, Style guise that the article title takes the INN. This would simply be a name swap (current name will be a Redirect, will work just as well). Do this? Jrfw51 -DePiep (talk) 08:10, 13 October 2017 (UTC)

No, leave with a redirect and clear posting to the INN. My point is that this is a natural compound made in skin, as well as being given as a pharmaceutical. The article, like so much here on vitamin D, focuses on its use as a drug/suppplement, and the biochemical/physiological aspects are not developed. Pubmed has 53 citations using 'colecalciferol' and over 7000 using 'cholecalciferol'. Jrfw51 (talk) 08:28, 13 October 2017 (UTC)

Both names are correct, no problem in there. It clearly is a medicine, and so must be guided by the style guide I linked. External hit count has no meaning in this (this is not about disambiguation). -DePiep (talk) 11:00, 14 October 2017 (UTC)

ping Jrfw51 -DePiep (talk) 00:08, 15 October 2017 (UTC)

WP:MEDMOS/WP:PHARMMOS

Mechanism of action, biosynthesis, and industrial production are not "physiologcial effects". Therefore reverted to how it was. Doc James (talk · contribs · email) 09:09, 14 October 2017 (UTC)

User:Jrfw51 this is the place to work out issues with the article's structure. Jytdog (talk) 21:19, 14 October 2017 (UTC)

Jytdog and talk: Please explain your reasoning for reverting these changes. I am trying to use the same structure that is used for other biological compounds which are also given as therapeutic agents. I have done this is three different ways, not always very well on the firsts attempt. Could you please review and edit, rather than reverting. Thank you. Jrfw51 (talk) 21:59, 14 October 2017 (UTC) ---- Amended to User:Doc James Jrfw51 (talk) 22:01, 14 October 2017 (UTC)

This is a hard issue all over. See WT:WikiProject_Medicine/Archive_91#Splitting_articles_about_endogenous_molecules_used_as_drugs and discussion linked from there. It is something better to discuss rather than probing ways to do it. Jytdog (talk) 22:13, 14 October 2017 (UTC)

Thanks for pointing out that discussion which I had missed when my attention was elsewhere. Not sure this needs splitting (yet) into Cholecalciferol and Colecalciferol (supplement) -- with different spellings -- but I would appreciate your review of my last edit, which you reverted, to state briefly and early in the article the biological function before moving on to therapeutic medical uses. Jrfw51 (talk) 22:23, 14 October 2017 (UTC)

• Biological function is what something does. This is more chemistry "It is a secosteroid, that is, a steroid molecule with one ring open." This is more mechanism of action "By itself it is inactive: it is converted to its active form by two hydroxylations: the first in the liver, the second in the kidney. These modifications form calcitriol, the active form of vitamin D, whose action is mediated by the vitamin D receptor, a nuclear receptor. This }}reflist-talk}}regulates the synthesis of hundreds of enzymes and is present in virtually every cell in the body." What does it do? Well it is important for maintaining calcium levels and thus promoting bone health and development.

References

--Doc James (talk · contribs · email) 05:26, 15 October 2017 (UTC)

This is a critique of the current version by Jytdog and your definitions are appropriate. My last version started "Cholecalciferol is a form of vitamin D which is naturally synthesised in skin and functions as a pro-hormone". My edits are an attempt to redress the balance and make this not just above a drug. Jrfw51 (talk) 07:47, 15 October 2017 (UTC)

• Our articles about vitamins are not consistent. Vitamin A, Vitamin C is more like this one; Vitamin E is more oriented toward the biochemical. Vitamin B and Vitamin D, being more "main articles" about several specific biochemicals are yet different, and specific B vitamin articles linked from the main one, are not consistent. It would be good if we standardized a sectioning for vitamins in particular, maybe. These are different from things like say adrenaline or insulin. Pinging User:David notMD just to pull him in, who just nominated the Vitamin C article for GA review.... Shall we work out a general structure somewhere? (where?) Jytdog (talk) 15:13, 15 October 2017 (UTC)

The inconsistencies of content and format and rating/importance across vitamins has been annoying me for a while. Most are rated in WikiProject Chemicals, but a few are not rated in WikiProject Medicine. Perhaps identify one vitamin as a model, discuss in Talk, and then address? Or is there a way of sandboxing this? Clearly a few vitamins are special cases that need allowance for unique sections, as size of articles currently ranges from 20K to 120K. The large (complicated or controversial) vitamins are C and D, followed by folate, B12, K and niacin. Please keep me in the conversation. David notMD (talk) 15:41, 15 October 2017 (UTC)

I would support a more consistent format for vitamins, and would prefer that for used at present for Vitamin E: Forms -- Function -- Supplements etc. This defines what they are, and what they do, before going into an analysis of the often controversial claims for benefits of supplements. But please note: Cholecalciferol is different in that it is a product of normal synthesis in the skin, making it a prohormone, where the active form is calcitriol. (You might want to review how we deal with this too). I will try adding the one sentence again about what I hope will be noncontroversial function, in keeping with some of the comments above. Jrfw51 (talk) 18:20, 15 October 2017 (UTC)

I suggest you self-revert. I will give you some time before I file the case. Jytdog (talk) 21:55, 15 October 2017 (UTC)

Some are single substances, others are groups of substances so unlikely to be able to have one outline for both. Doc James (talk · contribs · email) 07:56, 16 October 2017 (UTC)

Is there consensus that I should remove or keep the present statement re function? Or should we split the topic? What to other recent contributors think? Pinging User:David notMD, DePiep and User:Doc James. Jrfw51 (talk) 11:58, 16 October 2017 (UTC)

I am late to this party, but would prefer removing Function as a section for this article. As written, Function is very general, and to some degree repeats what is in the Lead. The information in it either is or can be covered in context in subsequent sections. If anything, Function may be more appropriate to vitamin D than to Cholecaciferol (and for vitamin A over retinol). To my and Doc James points, what is and what is not a section, and appropriate order, are not constant across the vitamins. The fact that for some, there is more than one compound being described in one article - with different effects - complicates the issue. David notMD (talk) 12:14, 16 October 2017 (UTC)

Yup I am with David on this one. Doc James (talk · contribs · email) 12:45, 16 October 2017 (UTC)

I think I have failed to make you understand my reasoning for this particular compound which is the precursor of calcitriol. This is a fundamental property of the compound and is of much greater importance to an encyclopedia then the current price of one formulation in one central American country for instance. But I asked for a consensus. I will move the information from there. Jrfw51 (talk) 12:58, 16 October 2017 (UTC)

Reference still relevant?

The wholesale cost in the Costa Rica is about 2.15 USD per 30 ml bottle of 10,000 IU/ml.[11] In the United States treatment costs less than 25 USD per month.[4]

This references a citation in which 2015 is the most current data. Since prices vary, and historical pricing information is of minimal value, should these statements be updated, amended, or withdrawn? Gprobins (talk) 01:11, 28 April 2018 (UTC)

I'm kind of wondering if the line should be there at all. Having a statement that pretty much randomly refers to the wholesale price in Costa Rica and the end-user price in the United States is...weird. Unless there's some reason why the price of this particular drug is particularly noteworthy or unusual, I can't see why it would be mentioned at all—let alone in the article lede. (Compare and contrast an example from the opposite extreme, Daraprim, where the price being jacked up to an unconscionable level by the smirking sleazeball Martin Shkreli received wide coverage.) TenOfAllTrades(talk) 01:25, 28 April 2018 (UTC)

Agreed. I'll remove based on dated information. If others consider it appropriate, they can restore with current data and provide a more relevant context. Gprobins (talk) 15:14, 2 May 2018 (UTC)

Some idea of the different costs worldwide seems relevant but I do not think this is needed in the lead. Added UK costs which are as acessible as the Tarascon book quoted for the US. Jrfw51 (talk) 08:49, 3 May 2018 (UTC)

There are generally three price ranges for medications globally (the US, the rest of the developed world, and LMIC). So yes having price info from the US/developed world and developing world is useful. Do prices randomly vary by large amounts? No they do not. Prices are typically stable for long periods of time. There may be a significant decrease when drugs go generic and there may be price variation is certain locations when companies manage to create a monopoly but others not. Doc James (talk · contribs · email) 02:51, 4 May 2018 (UTC)

Cholecalciferol as a rodenticide

The article seems to cover the big idea of how this human vitamin (in low doses) is also used as a rodenticide in high doses, with sources etc.

I did just run into another veterinary type source that seems to indicate the LD50 levels for toxicity might, in fact, be rather much lower than whatever is listed in the article from an existing source (~10 to 17 mg/kg), whereas this is talking lethal doses of 5x to 10x lower than that. Here is the link at vspn.org if anyone thinks it might be of use. I don't really know what sort of veridicality we might expect from this source--I generally try to use papers and journal articles--but perhaps others have an opinion. Cheers. N2e (talk) 13:13, 15 October 2019 (UTC)

The doses for an human if possum biology was the same would be 1g of the pure product (16.8mg/kg for a 62kg adult). That is about 10'000 of the strong 100ug (4000IU) capsules at a sitting. It is hard to swallow 25 big bottles of capsules to gain a LD50 dose of possum poison from retail vitamins. This should not need mention on this page as it is not going to happen from vitamins. It is already described on the Hypervitaminosis-D page and still needs work there.

Idyllic press (talk) 19:58, 12 May 2020 (UTC)

The lede/chances of toxicity

I've just learned quite a bit about D3 from several medical lectures available on youtube - from, e.g., the University of California or Boston College. One thing the speakers emphasized was that the dangers of D3 overdose/toxicity are greatly overblown. Doses of 50,000-1,000,000 IU seem to cause such toxicity. Most of the speakers recommend daily does of 3000-5000 IU a day, rather than the 600 IU presently recommended ("USDA"). With that, I noted that there is a substantial paragraph in the lede on the dangers of too much, and it strikes me as an undue weight to the issue. Examples of overdoses in the lectures I saw involve suppliers behaving very badly - shipping pure Cholecalciferol as a dietary supplement, or a dairy in the Boston area erroneously and grotesquely supplementing their milk with vastly too much vitamin D. (such examples may well be useful for the article). So tone down the warnings in the lede? Or perhaps cite values for toxicity as against "normal" values? Bdushaw (talk) 12:39, 4 March 2020 (UTC) I speak of lectures on youtube by Michael Holick of Boston University, for example.Bdushaw (talk) 13:14, 4 March 2020 (UTC)

I believe your idea of citing values for toxicity against "normal" values would be of some use.

Cholecalciferol is a bit complicated as it has a primary use (that is almost assumed as the main use in the article) of low-dose usage by humans. But as a chemical compound, it of course has adverse effects in high doses, and moreover, is explicitly used in high doses as a rodenticide, as is described in the article, and briefly mentioned in the lede. But sure, additional clarification on these topics in the prose would likely improve the article. N2e (talk) 12:39, 5 March 2020 (UTC)

Have adjusted this to "Doses greater than 40,000 IU (1,000 μg) per day are generally required before high blood calcium occurs." other side effects may occur at different doses of course. Doc James (talk · contribs · email) 21:29, 6 March 2020 (UTC)

I am also strongly in favour of toning down the irrational fear of toxicity. There is one recorded death from Vitamin-D toxicity in the last 14 years. Another paper said is it not possible to calculate statistics on toxicity because there are not enough data points. Basically Vitamin-D is less toxic in practice than almost any other orally administered stuff by healthcare or self medication. In treatment for Fibromyalgia (I think it was) it is given as a "Stoss" treatment in doses of 2500-15'000ug (100'000-600'000IU) bolus even to children. There are papers that mention a higher limit of 1250ug (50'000IU) long term dosing without detectable side effects or metabolic changes.

Basically this information has no business in the lede and rates a minor mention and direction to the hypervitaminosis-D page. In essence there are no cases of toxicity of a safe supplement that has one of the highest fear factors artificially maintained because of IoM over caution from a decade back still, it is time to follow the facts.

Idyllic press (talk) 09:23, 12 December 2020 (UTC)

tre 158.51.113.56 (talk) 03:03, 29 April 2023 (UTC)

Error in units

While pondering about an out of range value I confirmed an error in the Pesticide section and will make the correction, I will leave this explanation here to try and avoid hasty reverts.

   Toxicity has been reported across a wide range of cholecalciferol dosages, with LD50 as high as 88 mg/kg or as low as 2 mcg/kg reported for dogs.    
   

This quote comes from the abstract of the paper which is wrong. Sadly the Science Direct and EuropePMC aggregators only show the incorrect abstract and the snippet visible of the main body cuts of right before it displays the correct value.

The 2 microgram (mcg, ug, µg) dose is very close to a physiological dose while a 2 milligram (mg) dose is an overdose.  When compared to the 88mg/kg LD50 the ratio to LDLo of 2mg/kg is 44:1 which is high but when compared to the LDLo of 2ug/kg it is 44'000:1 and this is clearly too high.

From the Abstract
Although the reported lethal dose 50% for cholecalciferol is 88mg/kg, deaths have been seen with an individual exposure of 2mcg/kg in dogs.

From the second section Toxic Dose
The oral lethal dose 50% has been reported to be 88 mg/kg in dogs, however lethal outcomes have occurred at exposures as low as 2 mg/kg.^1,4,5

Michael E.Peterson & Kerstin Fluegeman, Cholecalciferol (Topic Review), Topics in Companion Animal Medicine, Volume 28, Issue 1, February 2013, Pages 24-27. DOI: 10.1053/j.tcam.2013.03.006 , PMID: 23796485

Elsevier ScienceDirect   [5]https://www.sciencedirect.com/science/article/abs/pii/S1938973613000287

ELIXIR EuropePMC [6]https://europepmc.org/article/med/23796485
85.131.100.60 (talk) 15:10, 20 February 2024 (UTC)