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(e.g., tetany) For more information see Vitamin D deficiency. Vitamin D toxicity Causes Oversupplementation Granulomatous disorders (e.g., sarcoidosis): due to increased 1-hydroxylase activation in epithelioid macrophages increased 1,25-dihydroxyvitamin D synthesis Clinical features Hypercalcemia, hypercalciuria (see also laboratory evaluation of bone disease) Loss of appetite Stupor Therapeutic uses Osteoporosis (prevention and treatment) Paget disease Prenatal supplementation for vegetarian mothers (400 IU per day) Characteristics Synonyms: : tocopherol, tocotrienol Substance class: tocopherols Chemical structure: chromane with isoprenoid side chain Inactive precursors (provitamins): none Active form: tocopherol Sources: meat, eggs, vegetable oils, leafy vegetables [8] Transport: alpha-tocopherol transfer protein (-TTP) Storage: adipose tissue, parenchymal cells of the liver Excretion: via bile Functions Antioxidant Prevents free radical damage, especially in RBCs and at cell membranes Interrupts free radical chains and oxidizes itself as a result Other functions Inhibition of platelet aggregation, cell proliferation, and monocyte adhesion Enzyme inhibition (e.g., protein kinase C, phospholipase A2) Inhibition of gene transcription (e.g., for -TTP, tropomyosin alpha-1 chain) Vitamin E deficiency Deficiency is very rare

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