Pandemide D vitamini zehirlenmesine dikkat

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Koronavirüs pandemisi döneminde, artan D vitamini kullanımına dikkat çeken Doç. Dr. Mahmut Muzaffer İlhan, "D vitamini zehirlenmesi esas olarak uzun süre veya aşırı dozda kullanılan D vitamini ampulüyle gelişir. Yüksek dozda D vitamini K2 vitamini aktivitesini bozarak kemik kaybına yol açabilir. Aşırı doz D vitaminine bağlı gelişen kalsiyum yüksekliği ise böbrek ve kalp hastalıklarına neden olabilir" diyerek konu hakkında bilgi verdi.

Bağışıklık sistemi aynı kara, hava ve deniz kuvvetleri gibi çeşit çeşit sınıflarda hizmet eden devasa bir ordu görevi görür. Bu ordunun ciltten tutun bağırsaklara, kandan tutun dalağa kadar her doku için özelleşmiş farklı asker, tabur ve alayları vardır. Bu taburlar ve alaylar her daim tetikte bekleyip karşılaştıkları her hücreyi an be an taramadan geçirirler. Ancak vücuda bir bakteri veya virüs girdiği zaman saldırıya geçerler, savaş ilanı verip ordunun diğer taburlarını da o bölgeye çağırırlar. O bölgeye lojistik destek sağlayıp kan akımını arttırırlar. İltihaplanma dediğimiz savaş bölgesindeki bu reaksiyondur. İltihap bölgesinin şişmesi ve kızarması da o bölgedeki kanlanmanın ve lojistik desteğin bir sonucudur. Bağışıklık sisteminden beklentimiz kendi hücresine dokunmayıp, yabancı hücreye de aşırıya kaçmadan dengeli bir reaksiyon göstermesidir.
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Bağışıklık sisteminin kendi vücut hücresine saldırma hali örneğin tiroide karşı olursa haşimato, cilde karşı olursa vitiligo (ala hastalığı), pankreasa karşı olursa tip 1 diyabet, ince bağırsağa karşı olursa çölyak hastalığı, ekleme karşı olursa romatoid artrit, beyine karşı olursa multiple skleroz gibi hastalıklar gelişir. D vitamini şu ana kadar otoimmün hastalıklar ve enfeksiyonlara yatkınlık açısından 2 alanda incelendi. D vitamini bağışıklık hücrelerini düzenleyerek aşırı reaksiyon vermelerini engeller. Bu yüzden otoimmün hastalıklara etkisi birçok araştırmada incelenmiştir. Multipl skleroz ile D vitamini eksikliği için net kanıtlar mevcuttur. D vitamini düzeyi 20 ng/ml altında olduğunda multipl skleroz riski 2 kat artar.
D vitamini bağışıklık üstündeki düzenleyici etkilerinden dolayı pandemi sürecinde özel ilgi görüyor. Bazı çalışmalarda yoğun bakım hastalarında D vitamini seviyesinin daha düşük olduğu gösterildi. Bununla beraber yapılan daha geniş araştırmalarda Covid-19 riskini veya şiddetini azalttığına dair kesin bir bulgu saptanamadı. Daha büyük araştırmalar ile desteklenene kadar kanda D vitamini seviyesi maksimum 30 ng/ml olacak şekilde, günde 800-1000 IU D vitamini kullanımı mantıklı görünüyor.
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Bunun sebebi ciltte D vitamini yeterli seviyeye geldiğinde fren mekanizmalarının devreye girmesidir. D vitamini zehirlenmesi esas olarak çok uzun süre veya aşırı dozda D vitamini kullanmaya bağlı olarak gelişir. Ülkemizde D vitamini zehirlenmesinin en sık sebebi yüksek doz (300.000 IU gibi) D vitamini içeren ampullerin fazla miktarda ağız yoluyla alınmasıdır. D vitaminin fazla ve aşırı yüksek alımı kalsiyumda yükselme, idrarda aşırı kalsiyum ve kanda yüksek D vitamini düzeylerine sebep olur.
Kalsiyum yüksekliği bulantı, kusma, karın ağrısı, kabızlık, halsizlik, bilinç değişiklikleri, kaslarda zayıflık, yüksek tansiyon, sık idrara çıkma ve susamaya sebep olur. Ayrıca yüksek dozda D vitamini K2 vitamini aktivitesini bozarak kemik kaybına yol açabilir. Aşırı doz D vitaminine bağlı gelişen kalsiyum yüksekliğinin sebep olduğu en önemli sorunlardan biri ise böbrek yetmezliğidir. Kanda kalsiyum fosforla birleşerek böbrekte kristaller şeklinde böbrekte birikir. Bu şekilde gelişen böbrek yetmezliği bazı hastalarda düzelebilse de birçok hastada kalıcı böbrek hasarına ve kronik böbrek yetmezliğine sebep olabilir. Kalsiyumun aşırı yükselmesinden olumsuz etkilenebilecek diğer bir organ kalptir. Kalpte düzensiz atımlar, göğüs ağrısı ve kalp damarlarında kalsiyum birikimi oluşabilir.
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