Vitamin D

Last Updated: November 30, 2023

Vitamin D is a fat-soluble vitamin that our skin synthesizes when exposed to the sun. It benefits us in many ways, from bone health to mood.

dosageDosage
examine-databaseExamine Database
research-feedResearch feed

Vitamin D is most often used for

What is vitamin D?

Vitamin D is a fat-soluble nutrient. It is one of the 24 micronutrients critical for human survival. The sun is the major natural source, through eliciting vitamin D production in the skin, but vitamin D is also found naturally in oily fish and eggs and is often added to milk and milk alternatives.

Is there a difference between Vitamin D2 and Vitamin D3?

What are some dietary sources of vitamin D3?

What are vitamin D’s main benefits?

Supplemental vitamin D is associated with a range of benefits, including improved immune health, bone health, and well-being. Supplementation may also reduce the risk of cancer mortality, diabetes, and multiple sclerosis. Vitamin D is often taken for depression and similar mental health issues, but the evidence is mixed as to whether supplementation improves these outcomes.

The effects of vitamin D likely depend on a person’s circulating levels of 25-hydroxyvitamin D (25(OH)D; a form of vitamin D that is measured in blood samples to determine vitamin D status), and many of the benefits of supplementation will only be seen when a deficiency is reversed.

Can vitamin D cure depression?

Can vitamin D supplementation help with symptoms of depression?

Can vitamin D status affect testosterone levels?

Is there a link between vitamin D levels and all-cause mortality?

Can vitamin D supplementation improve symptoms of multiple sclerosis?

Can vitamin D supplementation help with treatment or prevention of Alzheimer’s disease?

Can vitamin D supplementation help with the treatment or prevention of other neurodegenerative diseases?

What are vitamin D’s main drawbacks?

Extremely high doses of vitamin D can lead to vitamin D toxicity, which causes hypercalcemia (excess calcium in the blood), leading to and array of health problems[1]

Vitamin D supplementation may also have risks independent of vitamin D toxicity. A few trials on older adults have found that vitamin D increased the risk of falls,[2][3] and one study observed a decrease in bone mineral density among women taking high doses of vitamin D.[4]

Do vitamin D supplements interact with any medications?

How does vitamin D work?

image

Vitamin D exerts its effects by binding to and activating the vitamin D receptor (VDR). Upon binding vitamin D, the VDR functions as a transcription factor, regulating the activity of over 1,000 different genes.[5] This ‘genomic’ action of vitamin D tends to be slower-acting, requiring the synthesis of new mRNA and proteins to take effect.

Vitamin D also works through ‘non-genomic’ mechanisms, causing rapid activation of various signaling pathways within the cell. Although VDRs have been identified on cell membranes, it isn’t currently known whether the more rapid, non-genomic action of vitamin D occurs through membrane-associated vitamin D receptors, or a different cellular receptor.[6]

Although the most commonly associated effects of vitamin D on the body are associated with bone metabolism, the almost ubiquitous presence of VDRs in cells and tissues throughout the body indicates that vitamin D can affect a wide range of physiological processes.[7] The additional effects of vitamin D on the body include, but aren’t limited to, the following:[8]

  • Anticancer effects (promotion of cell death or suppressing proliferation in cancer cells)
  • Brain development[9]
  • Cell differentiation[10][11]
  • Anti-inflammatory effects[12]
  • Antioxidant effects[13]
  • Antibacterial effects (through vitamin D’s effects on immune cells, and its promotion of the expression of genes encoding antimicrobial peptides)[14]
  • Blood vessel protection[15]
  • Nervous system health
  • Calcium regulation

How much fat do I need to absorb vitamin D?

Does sunscreen decrease vitamin D?

How much sun do I need for vitamin D production?

Who needs to supplement vitamin D?

What are some of the factors that can increase the risk of having a vitamin D deficiency?

Can I get enough vitamin D3 from diet and sun exposure alone, or do I need to take supplements?

How much vitamin D should I take?

Can I get too much vitamin D?

Should vitamin D supplements be given to infants and children?

What else is Vitamin D known as?
Note that Vitamin D is also known as:
  • Cholecalciferol (Vitamin D3)
  • Ergocalciferol (Vitamin D2)
Vitamin D should not be confused with:
  • Calcitriol or 1
  • 25-Dihydroxyvitamin D (Hormonally active yet not directly supplemented form)
Update History
References
  1. ^Asif A, Farooq NVitamin D ToxicityStatPearls.(2023-01)
  2. ^Bischoff-Ferrari HA, Dawson-Hughes B, Orav EJ, Staehelin HB, Meyer OW, Theiler R, Dick W, Willett WC, Egli AMonthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline: A Randomized Clinical TrialJAMA Intern Med.(2016 Feb)
  3. ^Lawrence J Appel, Erin D Michos, Christine M Mitchell, Amanda L Blackford, Alice L Sternberg, Edgar R Miller 3rd, Stephen P Juraschek, Jennifer A Schrack, Sarah L Szanton, Jeanne Charleston, Melissa Minotti, Sheriza N Baksh, Robert H Christenson, Josef Coresh, Lea T Drye, Jack M Guralnik, Rita R Kalyani, Timothy B Plante, David M Shade, David L Roth, James Tonascia, STURDY Collaborative Research GroupThe Effects of Four Doses of Vitamin D Supplements on Falls in Older Adults : A Response-Adaptive, Randomized Clinical TrialAnn Intern Med.(2021 Feb)
  4. ^Lauren A Burt, Emma O Billington, Marianne S Rose, Richard Kremer, David A Hanley, Steven K BoydAdverse Effects of High-Dose Vitamin D Supplementation on Volumetric Bone Density Are Greater in Females than MalesJ Bone Miner Res.(2020 Dec)
  5. ^Maestro MA, Molnár F, Mouriño A, Carlberg CVitamin D receptor 2016: novel ligands and structural insights.Expert Opin Ther Pat.(2016-Nov)
  6. ^Zmijewski MA, Carlberg CVitamin D receptor(s): In the nucleus but also at membranes?Exp Dermatol.(2020-Sep)
  7. ^Carlberg CVitamin D and Its Target Genes.Nutrients.(2022-Mar-24)
  8. ^Wang W, Li Y, Meng XVitamin D and neurodegenerative diseases.Heliyon.(2023-Jan)
  9. ^Eyles DW, Burne TH, McGrath JJVitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease.Front Neuroendocrinol.(2013-Jan)
  10. ^Fernandes de Abreu DA, Eyles D, Féron FVitamin D, a neuro-immunomodulator: implications for neurodegenerative and autoimmune diseases.Psychoneuroendocrinology.(2009-Dec)
  11. ^Chen S, Sims GP, Chen XX, Gu YY, Chen S, Lipsky PEModulatory effects of 1,25-dihydroxyvitamin D3 on human B cell differentiation.J Immunol.(2007-Aug-01)
  12. ^Ma Y, Johnson CS, Trump DLMechanistic Insights of Vitamin D Anticancer Effects.Vitam Horm.(2016)
  13. ^Chen L, Yang R, Qiao W, Zhang W, Chen J, Mao L, Goltzman D, Miao D1,25-Dihydroxyvitamin D exerts an antiaging role by activation of Nrf2-antioxidant signaling and inactivation of p16/p53-senescence signaling.Aging Cell.(2019-Jun)
  14. ^Prietl B, Treiber G, Pieber TR, Amrein KVitamin D and immune functionNutrients.(2013 Jul 5)
  15. ^Enkhjargal B, Malaguit J, Ho WM, Jiang W, Wan W, Wang G, Tang J, Zhang JHVitamin D attenuates cerebral artery remodeling through VDR/AMPK/eNOS dimer phosphorylation pathway after subarachnoid hemorrhage in rats.J Cereb Blood Flow Metab.(2019-Feb)
  16. ^Nair R, Maseeh AVitamin D: The "sunshine" vitaminJ Pharmacol Pharmacother.(2012 Apr)
  17. ^Parker GB, Brotchie H, Graham RKVitamin D and depressionJ Affect Disord.(2017 Jan 15)
  18. ^Allan GM, Cranston L, Lindblad A, McCormack J, Kolber MR, Garrison S, Korownyk CVitamin D: A Narrative Review Examining the Evidence for Ten BeliefsJ Gen Intern Med.(2016 Jul)
  19. ^Gowda U, Mutowo MP, Smith BJ, Wluka AE, Renzaho AMVitamin D supplementation to reduce depression in adults: meta-analysis of randomized controlled trialsNutrition.(2015 Mar)
  20. ^Spedding SVitamin D and depression: a systematic review and meta-analysis comparing studies with and without biological flawsNutrients.(2014 Apr 11)
  21. ^F Vellekkatt, V MenonEfficacy of vitamin D supplementation in major depression: A meta-analysis of randomized controlled trialsJ Postgrad Med.(Apr-Jun 2019)
  22. ^Vaziri F, Nasiri S, Tavana Z, Dabbaghmanesh MH, Sharif F, Jafari PA randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothersBMC Pregnancy Childbirth.(2016 Aug 20)
  23. ^Laurent MR, Gielen E, Pauwels S, Vanderschueren D, Bouillon RHypervitaminosis D Associated With Tanning Bed Use: A Case ReportAnn Intern Med.(2017 Jan 17)
  24. ^Pilz S, Frisch S, Koertke H, Kuhn J, Dreier J, Obermayer-Pietsch B, Wehr E, Zittermann AEffect of vitamin D supplementation on testosterone levels in menHorm Metab Res.(2011 Mar)
  25. ^Wehr E, Pilz S, Boehm BO, März W, Obermayer-Pietsch BAssociation of vitamin D status with serum androgen levels in menClin Endocrinol (Oxf).(2010 Aug)
  26. ^Rodgers S, Grosse Holtforth M, Hengartner MP, Müller M, Aleksandrowicz AA, Rössler W, Ajdacic-Gross VSerum testosterone levels and symptom-based depression subtypes in menFront Psychiatry.(2015 May 4)
  27. ^Johnson JM, Nachtigall LB, Stern TAThe effect of testosterone levels on mood in men: a reviewPsychosomatics.(2013 Nov-Dec)
  28. ^Bassil N, Alkaade S, Morley JEThe benefits and risks of testosterone replacement therapy: a reviewTher Clin Risk Manag.(2009 Jun)
  29. ^Zarrouf FA, Artz S, Griffith J, Sirbu C, Kommor MTestosterone and depression: systematic review and meta-analysisJ Psychiatr Pract.(2009 Jul)
  30. ^Davis SR, Wahlin-Jacobsen STestosterone in women--the clinical significanceLancet Diabetes Endocrinol.(2015 Dec)
  31. ^Sharma A, Madaan V, Petty FDExercise for mental healthPrim Care Companion J Clin Psychiatry.(2006)
  32. ^Melrose SSeasonal Affective Disorder: An Overview of Assessment and Treatment ApproachesDepress Res Treat.(2015)
  33. ^O'Hare C, O'Sullivan V, Flood S, Kenny RASeasonal and meteorological associations with depressive symptoms in older adults: A geo-epidemiological studyJ Affect Disord.(2016 Feb)
  34. ^Golden RN, Gaynes BN, Ekstrom RD, Hamer RM, Jacobsen FM, Suppes T, Wisner KL, Nemeroff CBThe efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidenceAm J Psychiatry.(2005 Apr)
  35. ^Lam RW, Levitt AJ, Levitan RD, Enns MW, Morehouse R, Michalak EE, Tam EMThe Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorderAm J Psychiatry.(2006 May)
  36. ^Kerr DC, Zava DT, Piper WT, Saturn SR, Frei B, Gombart AFAssociations between vitamin D levels and depressive symptoms in healthy young adult womenPsychiatry Res.(2015 May 30)
  37. ^Frandsen TB, Pareek M, Hansen JP, Nielsen CTVitamin D supplementation for treatment of seasonal affective symptoms in healthcare professionals: a double-blind randomised placebo-controlled trialBMC Res Notes.(2014 Aug 14)
  38. ^Holick MFVitamin D deficiencyN Engl J Med.(2007 Jul 19)
  39. ^Forrest KY, Stuhldreher WLPrevalence and correlates of vitamin D deficiency in US adultsNutr Res.(2011 Jan)
  40. ^Haq A, Svobodová J, Imran S, Stanford C, Razzaque MSVitamin D deficiency: A single centre analysis of patients from 136 countriesJ Steroid Biochem Mol Biol.(2016 Nov)
  41. ^Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, A Catharine Ross, Christine L Taylor, Ann L Yaktine, Heather B Del ValleDietary Reference Intakes for Calcium and Vitamin D
  42. ^Heaney R, Garland C, Baggerly C, French C, Gorham ELetter to Veugelers, P.J. and Ekwaru, J.P., A statistical error in the estimation of the recommended dietary allowance for vitamin D. Nutrients 2014, 6, 4472-4475; doi:10.3390/nu6104472Nutrients.(2015 Mar 10)
  43. ^Veugelers PJ, Ekwaru JPA statistical error in the estimation of the recommended dietary allowance for vitamin DNutrients.(2014 Oct 20)
  44. ^Bikle DDVitamin D metabolism and function in the skinMol Cell Endocrinol.(2011 Dec 5)
  45. ^Antony R Young, Joël Claveau, Ana Beatris RossiUltraviolet radiation and the skin: Photobiology and sunscreen photoprotectionJ Am Acad Dermatol.(2017 Mar)
  46. ^A Faurschou, D M Beyer, A Schmedes, M K Bogh, P A Philipsen, H C WulfThe relation between sunscreen layer thickness and vitamin D production after ultraviolet B exposure: a randomized clinical trialBr J Dermatol.(2012 Aug)
  47. ^Mantas Grigalavicius, Vladimir Iani, Asta JuzenieneLayer Thickness of SPF 30 Sunscreen and Formation of Pre-vitamin DAnticancer Res.(2016 Mar)
  48. ^Libon F, Courtois J, Le Goff C, Lukas P, Fabregat-Cabello N, Seidel L, Cavalier E, Nikkels AFSunscreens block cutaneous vitamin D production with only a minimal effect on circulating 25-hydroxyvitamin DArch Osteoporos.(2017 Dec)
  49. ^Bibi Petersen, Hans Christian WulfApplication of sunscreen--theory and realityPhotodermatol Photoimmunol Photomed.(Apr-Jun 2014)
  50. ^R E Neale, S R Khan, R M Lucas, M Waterhouse, D C Whiteman, C M OlsenThe effect of sunscreen on vitamin D: a reviewBr J Dermatol.(2019 Nov)
  51. ^T Passeron, R Bouillon, V Callender, T Cestari, T L Diepgen, A C Green, J C van der Pols, B A Bernard, F Ly, F Bernerd, L Marrot, M Nielsen, M Verschoore, N G Jablonski, A R YoungSunscreen photoprotection and vitamin D statusBr J Dermatol.(2019 Nov)
  52. ^Barbara B Shih, Mark D Farrar, Marcus S Cooke, Joanne Osman, Abigail K Langton, Richard Kift, Ann R Webb, Jacqueline L Berry, Rachel E B Watson, Andy Vail, Frank R de Gruijl, Lesley E RhodesFractional Sunburn Threshold UVR Doses Generate Equivalent Vitamin D and DNA Damage in Skin Types I-VI but with Epidermal DNA Damage Gradient Correlated to Skin DarknessJ Invest Dermatol.(2018 Oct)
  53. ^Ann R Webb, Andreas Kazantzidis, Richard C Kift, Mark D Farrar, Jack Wilkinson, Lesley E RhodesColour Counts: Sunlight and Skin Type as Drivers of Vitamin D Deficiency at UK LatitudesNutrients.(2018 Apr 7)
  54. ^Ann R Webb, Andreas Kazantzidis, Richard C Kift, Mark D Farrar, Jack Wilkinson, Lesley E RhodesMeeting Vitamin D Requirements in White Caucasians at UK Latitudes: Providing a ChoiceNutrients.(2018 Apr 17)
  55. ^A R Webb, B R DeCosta, M F HolickSunlight regulates the cutaneous production of vitamin D3 by causing its photodegradationJ Clin Endocrinol Metab.(1989 May)
  56. ^Engelsen O, Kylling AFast simulation tool for ultraviolet radiation at the earth's surfaceOpt Eng.(2005 Apr)
  57. ^John C Dowdy, Robert M Sayre, Michael F HolickHolick's rule and vitamin D from sunlightJ Steroid Biochem Mol Biol.(2010 Jul)
  58. ^Vitaly Terushkin, Anna Bender, Estee L Psaty, Ola Engelsen, Steven Q Wang, Allan C HalpernEstimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supplementation across seasons at two US latitudesJ Am Acad Dermatol.(2010 Jun)
  59. ^Ann R Webb, Ola EngelsenCalculated ultraviolet exposure levels for a healthy vitamin D statusPhotochem Photobiol.(Nov-Dec 2006)
  60. ^Whiting SJ, Green TJ, Calvo MSVitamin D intakes in North America and Asia-Pacific countries are not sufficient to prevent vitamin D insufficiency.J Steroid Biochem Mol Biol.(2007-Mar)
  61. ^Sepehrmanesh Z, Kolahdooz F, Abedi F, Mazroii N, Assarian A, Asemi Z, Esmaillzadeh AVitamin D Supplementation Affects the Beck Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stress in Patients with Major Depressive Disorder: A Randomized, Controlled Clinical TrialJ Nutr.(2016 Feb)
  62. ^Retraction of Vitamin D Supplementation Affects the Beck Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stress in Patients with Major Depressive Disorder: A Randomized, Controlled Clinical Trial. J Nutr 2016;146(2):243-8.J Nutr.(2021-May-11)
  63. ^Wilczyński KM, Chęcińska K, Kulczyk K, Janas-Kozik MVitamin D deficiency and depressive symptoms: meta-analysis of studies .Psychiatr Pol.(2022-Dec-31)
  64. ^Shipowick CD, Moore CB, Corbett C, Bindler RVitamin D and depressive symptoms in women during the winter: a pilot studyAppl Nurs Res.(2009 Aug)
  65. ^Dean AJ, Bellgrove MA, Hall T, Phan WM, Eyles DW, Kvaskoff D, McGrath JJEffects of vitamin D supplementation on cognitive and emotional functioning in young adults--a randomised controlled trialPLoS One.(2011)
  66. ^Yalamanchili V, Gallagher JCTreatment with hormone therapy and calcitriol did not affect depression in older postmenopausal women: no interaction with estrogen and vitamin D receptor genotype polymorphismsMenopause.(2012 Jun)
  67. ^ A. Catharine Ross, Christine L. Taylor, Ann L. Yaktine, and Heather B. Del Valle. The National Academies Press; Washington, D.C. Dietary Reference Intakes for Calcium and Vitamin D (2011). The National Academies Press; Washington, D.C..(2011)
  68. ^Kimlin MGGeographic location and vitamin D synthesis.Mol Aspects Med.(2008-Dec)
  69. ^Engelsen O, Brustad M, Aksnes L, Lund EDaily duration of vitamin D synthesis in human skin with relation to latitude, total ozone, altitude, ground cover, aerosols and cloud thickness.Photochem Photobiol.(2005)
  70. ^Wagner CL, Greer FR, ,Prevention of rickets and vitamin D deficiency in infants, children, and adolescents.Pediatrics.(2008-Nov)
  71. ^Pappa HM, Bern E, Kamin D, Grand RJVitamin D status in gastrointestinal and liver disease.Curr Opin Gastroenterol.(2008-Mar)
  72. ^Chakhtoura M, Rahme M, El-Hajj Fuleihan GVitamin D Metabolism in Bariatric Surgery.Endocrinol Metab Clin North Am.(2017-Dec)
  73. ^Peterson LA, Zeng X, Caufield-Noll CP, Schweitzer MA, Magnuson TH, Steele KEVitamin D status and supplementation before and after bariatric surgery: a comprehensive literature review.Surg Obes Relat Dis.(2016)
  74. ^Jenna R Chalcraft, Linda M Cardinal, Perry J Wechsler, Bruce W Hollis, Kenneth G Gerow, Brenda M Alexander, Jill F Keith, D Enette Larson-MeyerVitamin D Synthesis Following a Single Bout of Sun Exposure in Older and Younger Men and WomenNutrients.(2020 Jul 27)
  75. ^Healthline: The Best Vegan Sources of Vitamin D(Jan 2020)
  76. ^Vitamin D Fact sheet for consumers. National Institutes of Health (NIH) Office of Dietary Supplements (ODS), updated 2022 Nov 8; cited 2023 May 24
  77. ^Feldman, D., Pike, J.W., Bouillion, R., Giovannucci, E. Vitamin D in foods: an evolution of knowledge. In: Vitamin D (4th Edition). New York, NY: Elsevier. p. 41-77
  78. ^Taylor CL, Patterson KY, Roseland JM, Wise SA, Merkel JM, Pehrsson PR, Yetley EAIncluding food 25-hydroxyvitamin D in intake estimates may reduce the discrepancy between dietary and serum measures of vitamin D status.J Nutr.(2014-May)
  79. ^Webb AR, Kline L, Holick MFInfluence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skinJ Clin Endocrinol Metab.(1988 Aug)
  80. ^Coney P, Demers LM, Dodson WC, Kunselman AR, Ladson G, Legro RSDetermination of vitamin D in relation to body mass index and race in a defined population of black and white women.Int J Gynaecol Obstet.(2012-Oct)
  81. ^Heike A Bischoff-Ferrari, Edward Giovannucci, Walter C Willett, Thomas Dietrich, Bess Dawson-HughesEstimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomesAm J Clin Nutr.(2006 Jul)
  82. ^Vieth R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP, Holick MF, Hollis BW, Lamberg-Allardt C, McGrath JJ, Norman AW, Scragg R, Whiting SJ, Willett WC, Zittermann AThe urgent need to recommend an intake of vitamin D that is effective.Am J Clin Nutr.(2007-Mar)
  83. ^Galior K, Grebe S, Singh RDevelopment of Vitamin D Toxicity from Overcorrection of Vitamin D Deficiency: A Review of Case Reports.Nutrients.(2018-Jul-24)
  84. ^Michael J GladeA 21st century evaluation of the safety of oral vitamin DNutrition.(2012 Apr)
  85. ^Vitamin D Fact sheet for health professionals. MedlinePlus. National Institutes of Health (NIH) Office of Dietary Supplements (ODS). Updated 2022 Aug 12; cited 2023 May 22
  86. ^McDuffie JR, Calis KA, Booth SL, Uwaifo GI, Yanovski JAEffects of orlistat on fat-soluble vitamins in obese adolescents.Pharmacotherapy.(2002-Jul)
  87. ^Kim Robien, Sarah J Oppeneer, Julia A Kelly, Jill M Hamilton-ReevesDrug-vitamin D interactions: a systematic review of the literatureNutr Clin Pract.(2013 Apr)
  88. ^Skversky AL, Kumar J, Abramowitz MK, Kaskel FJ, Melamed MLAssociation of glucocorticoid use and low 25-hydroxyvitamin D levels: results from the National Health and Nutrition Examination Survey (NHANES): 2001-2006.J Clin Endocrinol Metab.(2011-Dec)
  89. ^Crowe M, Wollner L, Griffiths RAHypercalcaemia following vitamin D and thiazide therapy in the elderly.Practitioner.(1984-Mar)
  90. ^P J Drinka, W E NoltenHazards of treating osteoporosis and hypertension concurrently with calcium, vitamin D, and distal diureticsJ Am Geriatr Soc.(1984 May)
  91. ^Smit E, Crespo CJ, Michael Y, Ramirez-Marrero FA, Brodowicz GR, Bartlett S, Andersen REThe effect of vitamin D and frailty on mortality among non-institutionalized US older adults.Eur J Clin Nutr.(2012-Sep)
  92. ^Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud CVitamin D supplementation for prevention of mortality in adultsCochrane Database Syst Rev.(2014 Jan 10)
  93. ^Zhang Y, Fang F, Tang J, Jia L, Feng Y, Xu P, Faramand AAssociation between vitamin D supplementation and mortality: systematic review and meta-analysisBMJ.(2019 Aug 12)
  94. ^Simpson S, Blizzard L, Otahal P, Van der Mei I, Taylor BLatitude is significantly associated with the prevalence of multiple sclerosis: a meta-analysis.J Neurol Neurosurg Psychiatry.(2011-Oct)
  95. ^Islam T, Gauderman WJ, Cozen W, Mack TMChildhood sun exposure influences risk of multiple sclerosis in monozygotic twins.Neurology.(2007-Jul-24)
  96. ^Boltjes R, Knippenberg S, Gerlach O, Hupperts R, Damoiseaux JVitamin D supplementation in multiple sclerosis: an expert opinion based on the review of current evidence.Expert Rev Neurother.(2021-Jun)
  97. ^Julia Feige, Tobias Moser, Lara Bieler, Kerstin Schwenker, Larissa Hauer, Johann SellnerVitamin D Supplementation in Multiple Sclerosis: A Critical Analysis of Potentials and ThreatsNutrients.(2020 Mar 16)
  98. ^Lu'o'ng KV, Nguyên LTThe beneficial role of vitamin D in Alzheimer's disease.Am J Alzheimers Dis Other Demen.(2011-Nov)
  99. ^Mizwicki MT, Liu G, Fiala M, Magpantay L, Sayre J, Siani A, Mahanian M, Weitzman R, Hayden EY, Rosenthal MJ, Nemere I, Ringman J, Teplow DB1α,25-dihydroxyvitamin D3 and resolvin D1 retune the balance between amyloid-β phagocytosis and inflammation in Alzheimer's disease patients.J Alzheimers Dis.(2013)
  100. ^Jingya Jia, Jing Hu, Xiaoxu Huo, Rujuan Miao, Yanping Zhang, Fei MaEffects of vitamin D supplementation on cognitive function and blood Aβ-related biomarkers in older adults with Alzheimer's disease: a randomised, double-blind, placebo-controlled trialJ Neurol Neurosurg Psychiatry.(2019 Dec)
  101. ^Chakkera M, Ravi N, Ramaraju R, Vats A, Nair AR, Bandhu AK, Koirala D, Pallapothu MR, Quintana Mariñez MG, Khan SThe Efficacy of Vitamin D Supplementation in Patients With Alzheimer's Disease in Preventing Cognitive Decline: A Systematic Review.Cureus.(2022-Nov)
  102. ^Corsello A, Milani GP, Giannì ML, Dipasquale V, Romano C, Agostoni CDifferent Vitamin D Supplementation Strategies in the First Years of Life: A Systematic Review.Healthcare (Basel).(2022-Jun-01)
  103. ^Kara C, Gunindi F, Ustyol A, Aydin MVitamin D intoxication due to an erroneously manufactured dietary supplement in seven children.Pediatrics.(2014-Jan)
  104. ^Travison TG, Morley JE, Araujo AB, O'Donnell AB, McKinlay JBThe relationship between libido and testosterone levels in aging menJ Clin Endocrinol Metab.(2006 Jul)
  105. ^Chrysohoou C, Panagiotakos D, Pitsavos C, Siasos G, Oikonomou E, Varlas J, Patialiakas A, Lazaros G, Psaltopoulou T, Zaromitidou M, Kourkouti P, Tousoulis D, Stefanadis CLow total testosterone levels are associated with the metabolic syndrome in elderly men: the role of body weight, lipids, insulin resistance, and inflammation; the Ikaria studyRev Diabet Stud.(2013 Spring)
  106. ^Westley CJ, Amdur RL, Irwig MSHigh Rates of Depression and Depressive Symptoms among Men Referred for Borderline Testosterone LevelsJ Sex Med.(2015 Aug)
  107. ^Giltay EJ, Enter D, Zitman FG, Penninx BW, van Pelt J, Spinhoven P, Roelofs KSalivary testosterone: associations with depression, anxiety disorders, and antidepressant use in a large cohort studyJ Psychosom Res.(2012 Mar)
  108. ^Feldman HA, Longcope C, Derby CA, Johannes CB, Araujo AB, Coviello AD, Bremner WJ, McKinlay JBAge trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging studyJ Clin Endocrinol Metab.(2002 Feb)
  109. ^Wu FC, Tajar A, Pye SR, Silman AJ, Finn JD, O'Neill TW, Bartfai G, Casanueva F, Forti G, Giwercman A, Huhtaniemi IT, Kula K, Punab M, Boonen S, Vanderschueren D, European Male Aging Study GroupHypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging StudyJ Clin Endocrinol Metab.(2008 Jul)
  110. ^Handelsman DJ, Yeap B, Flicker L, Martin S, Wittert GA, Ly LPAge-specific population centiles for androgen status in menEur J Endocrinol.(2015 Dec)
  111. ^Cote KA, McCormick CM, Geniole SN, Renn RP, MacAulay SDSleep deprivation lowers reactive aggression and testosterone in menBiol Psychol.(2013 Feb)
  112. ^Leproult R, Van Cauter EEffect of 1 week of sleep restriction on testosterone levels in young healthy menJAMA.(2011 Jun 1)
  113. ^Penev PDAssociation between sleep and morning testosterone levels in older menSleep.(2007 Apr)
  114. ^González-Santos MR, Gajá-Rodríguez OV, Alonso-Uriarte R, Sojo-Aranda I, Cortés-Gallegos VSleep deprivation and adaptive hormonal responses of healthy menArch Androl.(1989)
  115. ^Cortés-Gallegos V, Castañeda G, Alonso R, Sojo I, Carranco A, Cervantes C, Parra ASleep deprivation reduces circulating androgens in healthy menArch Androl.(1983 Mar)
  116. ^Nedeltcheva AV, Kilkus JM, Imperial J, Schoeller DA, Penev PDInsufficient sleep undermines dietary efforts to reduce adiposityAnn Intern Med.(2010 Oct 5)
  117. ^O'Leary CB, Hackney ACAcute and chronic effects of resistance exercise on the testosterone and cortisol responses in obese males: a systematic reviewPhysiol Res.(2014)
  118. ^Kraemer WJ, Ratamess NAHormonal responses and adaptations to resistance exercise and trainingSports Med.(2005)
  119. ^Daly W, Seegers CA, Rubin DA, Dobridge JD, Hackney ACRelationship between stress hormones and testosterone with prolonged endurance exerciseEur J Appl Physiol.(2005 Jan)
  120. ^Hackney AC, Aggon EChronic Low Testosterone Levels in Endurance Trained Men: The Exercise- Hypogonadal Male ConditionJ Biochem Physiol.(2018)
  121. ^Grossmann MLow testosterone in men with type 2 diabetes: significance and treatmentJ Clin Endocrinol Metab.(2011 Aug)
  122. ^Tajar A, Forti G, O'Neill TW, Lee DM, Silman AJ, Finn JD, Bartfai G, Boonen S, Casanueva FF, Giwercman A, Han TS, Kula K, Labrie F, Lean ME, Pendleton N, Punab M, Vanderschueren D, Huhtaniemi IT, Wu FC, EMAS GroupCharacteristics of secondary, primary, and compensated hypogonadism in aging men: evidence from the European Male Ageing StudyJ Clin Endocrinol Metab.(2010 Apr)
  123. ^Hall SA, Esche GR, Araujo AB, Travison TG, Clark RV, Williams RE, McKinlay JBCorrelates of low testosterone and symptomatic androgen deficiency in a population-based sampleJ Clin Endocrinol Metab.(2008 Oct)
  124. ^Grossmann M, Matsumoto AMA Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic ManagementJ Clin Endocrinol Metab.(2017 Mar 1)
  125. ^Corona G, Rastrelli G, Monami M, Saad F, Luconi M, Lucchese M, Facchiano E, Sforza A, Forti G, Mannucci E, Maggi MBody weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysisEur J Endocrinol.(2013 May 2)
  126. ^Camacho EM, Huhtaniemi IT, O'Neill TW, Finn JD, Pye SR, Lee DM, Tajar A, Bartfai G, Boonen S, Casanueva FF, Forti G, Giwercman A, Han TS, Kula K, Keevil B, Lean ME, Pendleton N, Punab M, Vanderschueren D, Wu FC, EMAS GroupAge-associated changes in hypothalamic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing StudyEur J Endocrinol.(2013 Feb 20)
  127. ^Netter A, Hartoma R, Nahoul KEffect of zinc administration on plasma testosterone, dihydrotestosterone, and sperm countArch Androl.(1981 Aug)
  128. ^Chang CS, Choi JB, Kim HJ, Park SBCorrelation between serum testosterone level and concentrations of copper and zinc in hair tissueBiol Trace Elem Res.(2011 Dec)
  129. ^Tang YM, Wang DG, Li J, Li XH, Wang Q, Liu N, Liu WT, Li YXRelationships between micronutrient losses in sweat and blood pressure among heat-exposed steelworkersInd Health.(2016 Jun 10)
  130. ^Institute of Medicine (US) Panel on MicronutrientsDietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc
  131. ^Singh M, Das RRZinc for the common coldCochrane Database Syst Rev.(2011 Feb 16)
  132. ^Valentiner-Branth P, Shrestha PS, Chandyo RK, Mathisen M, Basnet S, Bhandari N, Adhikari RK, Sommerfelt H, Strand TAA randomized controlled trial of the effect of zinc as adjuvant therapy in children 2-35 mo of age with severe or nonsevere pneumonia in Bhaktapur, NepalAm J Clin Nutr.(2010 Jun)
  133. ^Willis MS, Monaghan SA, Miller ML, McKenna RW, Perkins WD, Levinson BS, Bhushan V, Kroft SHZinc-induced copper deficiency: a report of three cases initially recognized on bone marrow examinationAm J Clin Pathol.(2005 Jan)
  134. ^Afrin LBFatal copper deficiency from excessive use of zinc-based denture adhesiveAm J Med Sci.(2010 Aug)
  135. ^Maggio M, De Vita F, Lauretani F, Nouvenne A, Meschi T, Ticinesi A, Dominguez LJ, Barbagallo M, Dall'aglio E, Ceda GPThe Interplay between Magnesium and Testosterone in Modulating Physical Function in MenInt J Endocrinol.(2014)
  136. ^Uwitonze AM, Razzaque MSRole of Magnesium in Vitamin D Activation and FunctionJ Am Osteopath Assoc.(2018 Mar 1)
  137. ^Costello RB, Moser-Veillon PBA review of magnesium intake in the elderly. A cause for concern?Magnes Res.(1992 Mar)
  138. ^Nielsen FH, Lukaski HCUpdate on the relationship between magnesium and exerciseMagnes Res.(2006 Sep)
  139. ^Institute of Medicine (US) Committee on Military Nutrition Research; Marriott BM, editor. Washington (DC)Nutritional Needs in Hot Environments, “Influence of Exercise and Heat on Magnesium Metabolism”National Academies Press (US).(1993)
  140. ^Consolazio CF, Matoush LO, Nelson RA, Harding RS, Canham JEExcretion of sodium, potassium, magnesium and iron in human sweat and the relation of each to balance and requirementsJ Nutr.(1963 Apr)
  141. ^Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference IntakesDietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride
  142. ^Yoshimura Y, Fujisaki K, Yamamoto T, Shinohara YPharmacokinetic Studies of Orally Administered Magnesium Oxide in RatsYakugaku Zasshi.(2017 May 1)
  143. ^Firoz M, Graber MBioavailability of US commercial magnesium preparationsMagnes Res.(2001 Dec)
  144. ^Gonzales-Arimborgo C, Yupanqui I, Montero E, Alarcón-Yaquetto DE, Zevallos-Concha A, Caballero L, Gasco M, Zhao J, Khan IA, Gonzales GFAcceptability, Safety, and Efficacy of Oral Administration of Extracts of Black or Red Maca (Lepidium meyenii) in Adult Human Subjects: A Randomized, Double-Blind, Placebo-Controlled StudyPharmaceuticals (Basel).(2016 Aug 18)
  145. ^Zenico T, Cicero AF, Valmorri L, Mercuriali M, Bercovich ESubjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trialAndrologia.(2009 Apr)
  146. ^Gonzales GF, Córdova A, Vega K, Chung A, Villena A, Góñez C, Castillo SEffect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy menAndrologia.(2002 Dec)
  147. ^Dording CM, Schettler PJ, Dalton ED, Parkin SR, Walker RS, Fehling KB, Fava M, Mischoulon DA double-blind placebo-controlled trial of maca root as treatment for antidepressant-induced sexual dysfunction in womenEvid Based Complement Alternat Med.(2015)
  148. ^G. D’Aniello, S. Ronsini, T. Notari, N. Grieco, V. Infante, N. D’Angel, F. Mascia, M. Fiore, G. Fisher and A. D’AnielloD-asparate, a key element for the improvement of sperm qualityAdvances in Sexual Medicine.(2012 Oct)
  149. ^Topo E, Soricelli A, D'Aniello A, Ronsini S, D'Aniello GThe role and molecular mechanism of D-aspartic acid in the release and synthesis of LH and testosterone in humans and ratsReprod Biol Endocrinol.(2009 Oct 27)
  150. ^Melville GW, Siegler JC, Marshall PWThree and six grams supplementation of d-aspartic acid in resistance trained menJ Int Soc Sports Nutr.(2015 Apr 1)
  151. ^Willoughby DS, Leutholtz BD-aspartic acid supplementation combined with 28 days of heavy resistance training has no effect on body composition, muscle strength, and serum hormones associated with the hypothalamo-pituitary-gonadal axis in resistance-trained menNutr Res.(2013 Oct)