{"id":884,"date":"2019-05-24T07:00:15","date_gmt":"2019-05-24T04:00:15","guid":{"rendered":"http:\/\/acilbulten.net\/?p=884"},"modified":"2021-11-10T22:38:16","modified_gmt":"2021-11-10T19:38:16","slug":"d-vitamini-siradan-bir-besin-maddesi-degildir","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/aciltipbulteni\/2019\/05\/24\/d-vitamini-siradan-bir-besin-maddesi-degildir\/","title":{"rendered":"D vitamini s\u0131radan bir besin maddesi de\u011fildir!"},"content":{"rendered":"\n

Yazar: <\/em><\/strong>Serkan \u015eener<\/strong><\/em><\/p>\n\n\n\n

D vitamini di\u011fer vitaminlerin aksine, v\u00fccutta al\u0131\u015f\u0131lmad\u0131k derecede etkileri olan bir hormon gibi davran\u0131r. Bir\u00e7ok \u00e7al\u0131\u015fmada imm\u00fcn ve kardiyovask\u00fcler sistem ile kemik sa\u011fl\u0131\u011f\u0131 ve \u00e7ok daha fazlas\u0131 i\u00e7in \u00e7ok \u00f6nemli oldu\u011funu bildirilmektedir. Hatta diyabetin \u00f6nlenmesinde rol oynad\u0131\u011f\u0131n\u0131 bile baz\u0131 klinik ara\u015ft\u0131rmalar desteklemektedir.<\/p>\n\n\n\n

Ancak haliyle \u015f\u00fcpheler de devam etmektedir. D vitamininin kan \u015fekeri kontrol\u00fcne nas\u0131l destek oldu\u011funa tam a\u00e7\u0131kl\u0131k gelmemi\u015ftir. Bu gizem ve klinik kan\u0131tlar\u0131n yetersizli\u011fi g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda, iki yeni \u00e7al\u0131\u015fman\u0131n sonu\u00e7lar\u0131 olduk\u00e7a \u00f6nemli g\u00f6r\u00fcn\u00fcyor.<\/p>\n\n\n\n

Konuya biraz daha farkl\u0131 olsun diye diyabet \u00fczerinden giri\u015f yapt\u0131m. Ama yukar\u0131da da bahsetti\u011fim gibi asl\u0131nda Vitamin D bir\u00e7ok sistemi etkileyen bir hormon gibi etki ediyor. \u00d6rne\u011fin a\u015fa\u011f\u0131daki 25 OH Vitamin D3 d\u00fczeylerine kar\u015f\u0131l\u0131k gelen hastal\u0131klar\u0131n varl\u0131\u011f\u0131 direkt ya da indirekt yetersizli\u011fini sorgulamam\u0131z\u0131 gerektiriyor.<\/p>\n\n\n\n

< 10 ng\/ml  Ciddi Yetersizlik <\/strong>\u2013 Ra\u015fitizm riski<\/p>\n\n\n\n

< 20 ng\/ml  Ciddi Yetersizlik<\/strong> \u2013 Kolon kanser riskinde % 75 art\u0131\u015f<\/p>\n\n\n\n

< 30 mg\/ml Yetersizlik<\/strong> \u2013 Osteoporoz (kemiklerden kalsiyum kayb\u0131nda art\u0131\u015f), zay\u0131f yara iyile\u015fimi, artm\u0131\u015f kas a\u011fr\u0131s\u0131, artm\u0131\u015f eklem ve s\u0131rt a\u011fr\u0131s\u0131, artm\u0131\u015f depresyon diyabet, \u015fizofreni, migren, otoimm\u00fcn hastal\u0131k (lupus skleroderma), allerji, pre-eklampsi riski<\/p>\n\n\n\n

30 \u2013 50 ng\/ml Suboptimal Seviye<\/strong><\/p>\n\n\n\n

< 34 ng\/ml \u2013 Kalp krizi riskinde 2 kat art\u0131\u015f<\/p>\n\n\n\n

< 36 ng\/ml \u2013 Hipertansiyon insidans\u0131nda art\u0131\u015f<\/p>\n\n\n\n

< 40 ng\/ml \u2013 Multiple Skleroz riskinde 3 kat art\u0131\u015f<\/p>\n\n\n\n

50 \u2013 80 ng\/ml \u2013 Optimal Seviyeler<\/strong><\/p>\n\n\n\n

> 50 ng\/ml \u2013 Meme kanserinde % 50 azalma, solid t\u00fcm\u00f6r geli\u015fiminde azalma<\/p>\n\n\n\n

80 – 100 ng\/ml \u2013 Kanser hastalar\u0131nda kanser ilerlemesinde yava\u015flama<\/p>\n\n\n\n

> 100 ng\/ml \u2013 Artm\u0131\u015f toksisite riski <\/strong>(hiperkalsemi, hiperkalsi\u00fcri, \u00fcrolithiazis)<\/p>\n\n\n\n

Neden D vitamini yeterli de\u011fil<\/em><\/p>\n\n\n\n

Eski yani \u00e7ooook eski -onbinlerce y\u0131l \u00f6nceki- avc\u0131 toplay\u0131c\u0131 oldu\u011fumuz zamanlarda, tohumlarla ve g\u00fcne\u015f alt\u0131nda do\u011fadan beslenen hayvanlar\u0131 avlayarak beslenen insano\u011flu; D vitaminin bir \u00e7o\u011funu bunlardan kar\u015f\u0131lam\u0131\u015f oluyordu. Kald\u0131 ki, bir de \u00e7\u0131plak t\u00fcm g\u00fcn\u00fcn\u00fc g\u00fcne\u015f alt\u0131nda ge\u00e7irip, g\u00fcne\u015ften kendisini koruyacak gereksiz koruyucu kremler kullanmad\u0131\u011f\u0131 i\u00e7in cildinde yeterince D vitamini de sentezleyebiliyordu. Bulundu\u011funuz lokasyonda (enlem) \u00f6zellikle May\u0131s ile Ekim aylar\u0131 aras\u0131nda g\u00fcne\u015fin en dik oldu\u011fu saatte 15 dk ile ba\u015flayarak 30 dk’ ya kadar uzayabilen s\u00fcrelerle koruyucu kullanmadan m\u00fcmk\u00fcn olan en az k\u0131yafetle g\u00fcne\u015f alt\u0131nda kal\u0131nd\u0131\u011f\u0131nda ciltte yakla\u015f\u0131k 10-15 bin \u00fcnite D vitamini sentezlenebilir. Tabii ki teniniz ne kadar koyu ise o kadar daha fazla g\u00fcne\u015f \u0131\u015f\u0131\u011f\u0131na ihtiyac\u0131n\u0131z oldu\u011funu unutulmamal\u0131.<\/p>\n\n\n\n

Peki ya \u015fimdi? \u015eimdi ne kadar g\u00fcne\u015fi g\u00f6rd\u00fc\u011f\u00fcm\u00fcz\u00fc siz d\u00fc\u015f\u00fcn\u00fcn. Di\u011fer taraftan yedi\u011fimiz i\u015flenmi\u015f ve rafine edilerek raf \u00f6mr\u00fc uzat\u0131lm\u0131\u015f g\u0131dalarla, yine g\u00fcne\u015f g\u00f6rmeyen, binbir \u00e7e\u015fit antibiyotik, hormon ve kimyasal ile s\u00fcrekli pinekleyerek b\u00fcy\u00fcyen hayvanlar et, s\u00fct ve yumurtalar\u0131n\u0131 yemek zorunday\u0131z. En fazla D vitamini bulundu\u011funu bildi\u011fimiz bal\u0131klardan biri olan somon i\u00e7in ise \u00fcreticiler m\u00fc\u015fterilerinin iste\u011fine uygun renk tonunda eti \u00fcretebilmek i\u00e7in yapay \u00fcretim teknikleri geli\u015ftirmi\u015f bulunmaktalar. Bu besinlerle ne kadar D vitamini kazand\u0131\u011f\u0131m\u0131z ise me\u00e7hul!<\/p>\n\n\n\n

Gel g\u00f6r ki bizim genetik kodlar\u0131m\u0131z hala binlerce y\u0131l \u00f6ncesi \u015fartlara ayarl\u0131 ve de\u011fi\u015fmedi. Hal b\u00f6yle olunca metabolizman\u0131n gerekli makro ve mikro besinlerini yerine koy(a)mam\u0131z sonucu kronik inflamatuvar ve dejeneratif hastal\u0131klar\u0131n insidans\u0131nda ciddi art\u0131\u015flar fark ediliyor.<\/p>\n\n\n\n

Ne kadar D vitamini replase etmeli?<\/strong><\/p>\n\n\n\n

Plazma 25 OH Vitamin D3 seviyesine g\u00f6re tedavi \u015femas\u0131 belirlenmelidir. Tedavi ba\u015flad\u0131ktan sonra 1 ile 2 ay aralarla 25 OH Vitamin D3 seviyeleri takip edilmelidir. \u00d6zellikle yaz ve k\u0131\u015f aylar\u0131nda da yar\u0131 ayr\u0131 yak\u0131n takip edilerek doz bireyselle\u015ftirilmelidir. <\/p>\n\n\n\n

<10 ng\/mL \u2013 10,000 \u00fcnite\/g\u00fcn<\/p>\n\n\n\n

10\u201320 ng\/mL \u2013 10,000 \u00fcnite\/g\u00fcn<\/p>\n\n\n\n

20\u201330 ng\/mL \u2013 8,000 \u00fcnite\/g\u00fcn<\/p>\n\n\n\n

30\u201340 ng\/mL \u2013 5,000 \u00fcnite\/g\u00fcn<\/p>\n\n\n\n

40\u201350 ng\/mL \u2013 2,000 \u00fcnite\/g\u00fcn<\/p>\n\n\n\n

2009\u2019da yay\u0131nlanan bir makalede Vitamin D seviyelerinin 40-60 mg\/ml seviyelerine \u00e7\u0131kar\u0131lmas\u0131 sonucu 58.000\/y\u0131l yeni meme kanseri ve 49.000\/y\u0131l yeni kolorektal kanser ve bu hastal\u0131klardan \u00f6l\u00fcmlerin 3\/4\u2019\u00fcn\u00fcn engellenebilece\u011fi bildirilmi\u015ftir.<\/p>\n\n\n\n

2016\u2019da Nutrition dergisinde yay\u0131nlanan 90.757 kat\u0131l\u0131mc\u0131 ve 7 \u00e7al\u0131\u015fman\u0131n dahil edildi\u011fi bir meta analizde de Vitamin D seviyesinin 29,6 ng\/ml\u2019 nin \u00fczerine \u00e7\u0131kar\u0131lmas\u0131 durumunda mesane kanseri riskinin % 60 azalaca\u011f\u0131 g\u00f6sterilmi\u015f.<\/p>\n\n\n\n

Bu durumda Vitamin D i\u00e7eren besinleri de bir kenara not etmekte fayda var. Tabii ki serbest dola\u015fan, otlayan (beslenen) mutlu hayvanlar i\u00e7in ge\u00e7erli bunlar. Bunlarla s\u0131n\u0131rl\u0131 olmamakla beraber ya\u011fl\u0131 bal\u0131klar (somon, orkinos, uskumru, sardalya, vb), dana ci\u011feri, peynir, yumurta sar\u0131s\u0131 say\u0131labilir.<\/p>\n\n\n\n

Ama di\u011fer yandan \u00f6zellikle Sarkoidoz, T\u00fcberk\u00fcloz, Lyme Hastal\u0131\u011f\u0131, Lenfoma veya baz\u0131 renal hastal\u0131klarda artm\u0131\u015f serum kalsiyum seviyeleri nedeniyle dikkatle verilmeli ve seviyeleri yak\u0131ndan izlenmelidir.
<\/p>\n\n\n\n

REFERANSLAR<\/p>\n\n\n\n

  1. Dutta D. et al. Vitamin D supplementation in prediabetes reduced progression to type 2 diabetes and was associated with decreased insulin resistance and systemic inflammation: an open label randomized prospective study from Eastern India Diabetes Res Clin Pract. 2014 Mar;103(3):e18-23. doi: 10.1016\/j.diabres.2013.12.044)<\/em><\/li>
  2. Kimball SM, Emery JCH, Lewanczuk RZ Effect of a vitamin and mineral supplementation on glycemic status: Results from a community-based program. J Clin Transl Endocrinol. 2017 Nov 7;10:28-35. doi: 10.1016\/j.jcte.2017.11.002.<\/em><\/li>
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  17. Anderson L, Cotterchio M, Vieth R, Knight J. Vitamin D and calcium intakes and breast cancer risk in pre- and postmenopausal women. Am J Clin Nutr 2010; 91(6): 1699-1701. <\/em><\/li>
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    \"\"<\/figure><\/div>\n\n\n\n

    Serkan \u015eENER,<\/em> 1993-1999 y\u0131llar\u0131nda Akdeniz \u00dcTF’ de lisans e\u011fitimini tamamlay\u0131p, arkas\u0131ndan Dokuz Eyl\u00fcl \u00dcTF’ de Acil T\u0131p ihtisas\u0131 yapt\u0131. 2006 y\u0131l\u0131ndan bu yana Ac\u0131badem Sa\u011fl\u0131k Grubu’da Acil T\u0131p uzman\u0131 olarak ve 2010 y\u0131l\u0131ndan bu yana da Ac\u0131badem \u00dcniversitesi’nde \u00f6\u011fretim \u00fcyesi olarak g\u00f6rev yapmaktad\u0131r. Acil t\u0131p uzmanlar\u0131n\u0131n acil servisler d\u0131\u015f\u0131nda da (havada, spor sahalar\u0131nda, vb) g\u00f6rev yapabilece\u011fini tecr\u00fcbe etmi\u015ftir.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

    Yazar: Serkan \u015eener D vitamini di\u011fer vitaminlerin aksine, v\u00fccutta al\u0131\u015f\u0131lmad\u0131k derecede etkileri olan bir hormon gibi davran\u0131r. Bir\u00e7ok \u00e7al\u0131\u015fmada imm\u00fcn ve kardiyovask\u00fcler…<\/p>\n","protected":false},"author":1599,"featured_media":312,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10015],"tags":[72,158],"class_list":["post-884","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sosyal-blog-yazisi","tag-d-vitamini","tag-saglikli-yasam"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/884","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/users\/1599"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/comments?post=884"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/posts\/884\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media\/312"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/media?parent=884"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/categories?post=884"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/aciltipbulteni\/wp-json\/wp\/v2\/tags?post=884"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}