Drug and hormone effects on vitamin D metabolism

Barrie M. Weinstein, Sol Epstein

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

1 Scopus citations


This chapter discusses the effects that drugs and hormones have on vitamin D metabolism. The level of active vitamin D metabolite and the activity of the renal hydroxylase enzymes that are responsible for regulating its production are governed by a variety of hormones and cations. Along with the endogenous regulators of the levels of the vitamin D metabolites, some exogenous drugs and hormones are also capable of exerting an effect on the vitamin D endocrine system. Drugs are being increasingly recognized in this regard and those that have received the most attention are the anticonvulsants, ethanol, and corticosteroids. The effects of various endogenous and exogenous hormones and drugs on the metabolism of vitamin D are complex. Parathyroid hormone (PTH) and parathyroid hormone receptor protein (PTHrP) are potent stimulators of 1,25(OH)2D3 production. Past and current literature suggest that growth hormone, via IGF-1, and estrogen increase production of 1,25(OH)2D3. Long-term use of most anticonvulsants leads to increased 25(OH)D catabolism which is likely the main cause of the low bone mass observed in these patients. A strong association exists between the use of corticosteroids and immunosuppressants and the development of significant bone loss. The evidence on the effect of ethanol and commonly used agents such as heparin, lithium, theophylline, and cimetidine on vitamin D metabolism is inconclusive. More careful screening of susceptible individuals, such as those with poor nutritional status or who lack exposure to ultraviolet light, is called for.

Original languageEnglish
Title of host publicationVitamin D
PublisherElsevier Inc.
Number of pages46
ISBN (Print)9780123819789
StatePublished - 2011


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