Vitamin D is a name given to two fat-soluble compounds; calciferol (vitamin D2) and cholecalciferol (vitamin D3). They are now known to be hormones, but continue to be grouped with vitamins because of historical misclassification. Vitamin D3 plays an essential role in the metabolism of calcium and phosphorus in the body and prevents rickets in children. A plentiful supply of 7-dehydrocholesterol, the precursor of vitamin D3, exists in human skin and needs only to be activated by a moderate amount of ultraviolet light (less than a half hour of sunlight) to become fully potent. Rickets is usually caused by a lack of exposure to sunlight rather than a dietary deficiency, although dietary deficiencies can result from malabsorption in the small intestine caused by conditions such as sprue or colitis. Rickets can be prevented and its course halted by the intake of vitamin D2 (found in irradiated yeast and used in some commercial preparations of the vitamin) or vitamin D3 (found in fish liver oils and in fortified milk). Symptoms of vitamin D deficiency in children include bowlegs, knock knees, and more severe (often crippling) deformations of the bones. In adults deficiency results in osteomalacia, characterized by a softening of the bones. Excessive vitamin D consumption can result in toxicity. Symptoms include nausea, loss of appetite, kidney damage, and deposits of insoluble calcium salts in certain tissues. The recommended daily dietary allowance for cholecalciferol is 15 to 20 micrograms (600 to 800 IU) depending upon age and the availability of sunlight. Fortified cow's milk supplies 400 IU per quart (422 IU per liter).
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