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Ergocalciferol, also known as vitamin D2 and nonspecifically calciferol, is a type of
vitamin D Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects. In humans, the most important compounds in this group are vitamin D3 (c ...
found in food and used as a dietary supplement. As a supplement it is used to prevent and treat
vitamin D deficiency Vitamin D deficiency or hypovitaminosis D is a vitamin D level that is below normal. It most commonly occurs in people when they have inadequate exposure to sunlight, particularly sunlight with adequate ultraviolet B rays (UVB). Vitamin D defic ...
. This includes vitamin D deficiency due to poor absorption by the intestines or
liver disease Liver disease, or hepatic disease, is any of many diseases of the liver. If long-lasting it is termed chronic liver disease. Although the diseases differ in detail, liver diseases often have features in common. Signs and symptoms Some of the si ...
. It may also be used for low blood calcium due to
hypoparathyroidism Hypoparathyroidism is decreased function of the parathyroid glands with underproduction of parathyroid hormone (PTH). This can lead to low levels of calcium in the blood, often causing cramping and twitching of muscles or tetany (involuntary m ...
. It is used by mouth or
injection into a muscle Intramuscular injection, often abbreviated IM, is the injection of a substance into a muscle. In medicine, it is one of several methods for parenteral administration of medications. Intramuscular injection may be preferred because muscles ha ...
. Excessive doses can result in increased urine production, high blood pressure,
kidney stones Kidney stone disease, also known as nephrolithiasis or urolithiasis, is a crystallopathy where a calculus (medicine), solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the ...
,
kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
, weakness, and constipation. If high doses are taken for a long period of time,
tissue calcification Calcification is the accumulation of calcium salts in a body tissue. It normally occurs in the formation of bone, but calcium can be deposited abnormally in soft tissue,Miller, J. D. Cardiovascular calcification: Orbicular origins. ''Nature Mat ...
may occur. Normal doses are safe in
pregnancy Pregnancy is the time during which one or more offspring develops (gestation, gestates) inside a woman, woman's uterus (womb). A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occur ...
. It works by increasing the amount of
calcium Calcium is a chemical element with the symbol Ca and atomic number 20. As an alkaline earth metal, calcium is a reactive metal that forms a dark oxide-nitride layer when exposed to air. Its physical and chemical properties are most similar t ...
absorbed by the intestines and kidneys. Food in which it is found include some
mushrooms A mushroom or toadstool is the fleshy, spore-bearing fruiting body of a fungus, typically produced above ground, on soil, or on its food source. ''Toadstool'' generally denotes one poisonous to humans. The standard for the name "mushroom" is ...
. Ergocalciferol was first described in 1936. Ergocalciferol is available as a generic medication and
over the counter Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a requirement for a prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to consumers possessing a valid prescr ...
. In 2020, it was the 46th most commonly prescribed medication in the United States, with more than 14million prescriptions. Certain foods such as breakfast cereal and margarine have ergocalciferol added to them in some countries. It is on the
World Health Organization's List of Essential Medicines The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health s ...
.


Use

Ergocalciferol may be used as a vitamin D supplement, whereas
cholecalciferol Cholecalciferol, also known as vitamin D3 and colecalciferol, is a type of vitamin D that is made by the skin when exposed to sunlight; it is found in some foods and can be taken as a dietary supplement. Cholecalciferol is made in the skin fo ...
(vitamin D3) is produced naturally by the skin when exposed to ultraviolet light. Ergocalciferol (D2) and cholecalciferol (D3) are considered to be equivalent for vitamin D production, as both forms appear to have similar efficacy in ameliorating
rickets Rickets is a condition that results in weak or soft bones in children, and is caused by either dietary deficiency or genetic causes. Symptoms include bowed legs, stunted growth, bone pain, large forehead, and trouble sleeping. Complications ma ...
and reducing the incidence of falls in elderly patients. Conflicting reports exist, however, concerning the relative effectiveness, with some studies suggesting that ergocalciferol has less efficacy based on limitations in absorption, binding, and inactivation. A
meta-analysis A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
concluded that evidence usually favors cholecalciferol in raising vitamin D levels in blood, although it stated more research is needed.


Mechanism

Ergocalciferol is a
secosteroid A secosteroid () is a type of steroid with a "broken" ring. The word ''secosteroid ''derives from the Latin verb ''secare'' meaning "to cut", and 'steroid'. Secosteroids are alternatively described as a subclass of steroids; ; or derived from s ...
formed by a
photochemical Photochemistry is the branch of chemistry concerned with the chemical effects of light. Generally, this term is used to describe a chemical reaction caused by absorption of ultraviolet (wavelength from 100 to 400  nm), visible light (400–7 ...
bond breaking of a steroid, specifically, by the action of
ultraviolet light Ultraviolet (UV) is a form of electromagnetic radiation with wavelength from 10 nanometer, nm (with a corresponding frequency around 30 Hertz, PHz) to 400 nm (750 Hertz, THz), shorter than that of visible light, but longer than ...
(UV-B or UV-C) on ergosterol, a form of provitamin D2. Like
cholecalciferol Cholecalciferol, also known as vitamin D3 and colecalciferol, is a type of vitamin D that is made by the skin when exposed to sunlight; it is found in some foods and can be taken as a dietary supplement. Cholecalciferol is made in the skin fo ...
, ergocalciferol is inactive by itself. It requires two hydroxylations to become active: the first in the liver by
CYP2R1 CYP2R1 is cytochrome P450 2R1, an enzyme which is the principal vitamin D 25-hydroxylase. In humans it is encoded by the ''CYP2R1'' gene located on chromosome 11p15.2. It is expressed in the endoplasmic reticulum in liver, where it performs the fi ...
to form 25-hydroxyergocalciferol (ercalcidiol or 25-OH D2), and the second in the kidney by
CYP27B1 25-Hydroxyvitamin D 1-alpha-hydroxylase (VD 1A hydroxylase) also known as calcidiol 1-monooxygenase or cytochrome p450 27B1 (CYP27B1) or simply 1-alpha-hydroxylase is a cytochrome P450 enzyme that in humans is encoded by the ''CYP27B1'' gene. ...
, to form the active 1,25-dihydroxyergocalciferol (ercalcitriol or 1,25-(OH)2D2), which activates the
vitamin D receptor The vitamin D receptor (VDR also known as the calcitriol receptor) is a member of the nuclear receptor family of transcription factors. Calcitriol (the active form of vitamin D, 1,25-(OH)2vitamin D3) binds to VDR, which then forms a heterodim ...
. Unlike
cholecalciferol Cholecalciferol, also known as vitamin D3 and colecalciferol, is a type of vitamin D that is made by the skin when exposed to sunlight; it is found in some foods and can be taken as a dietary supplement. Cholecalciferol is made in the skin fo ...
, 25-hydroxylation is not performed by CYP27A1 for ergocalciferol. Ergocalciferol and metabolites have lower affinity to the
vitamin D-binding protein Vitamin D-binding protein (DBP), also/originally known as gc-globulin (group-specific component), is a protein that in humans is encoded by the ''GC'' gene. DBP is genetically the oldest member of the albuminoid family and appeared early in the e ...
compared to the D3 counterparts. The binding affinity of ercalcitriol to the vitamin D receptor is similar to that of
calcitriol Calcitriol is the active form of vitamin D, normally made in the kidney. It is also known as 1,25-dihydroxycholecalciferol. It is a hormone which binds to and activates the vitamin D receptor in the nucleus of the cell, which then increases the ...
. Ergocalciferol itself and metabolites can be deactivated by 24-hydroxylation.


Sources

Fungus, from USDA nutrient database (per 100g), D2 + D3: * Mushrooms, Agaricus bisporus: ** raw portobello: 0.3 μg (10 IU); exposed to ultraviolet light: 11.2 µg (446 IU) ** raw crimini: 0.1 μg (3 IU); exposed to ultraviolet light: 31.9 µg (1276 IU) * Mushrooms, shiitake: ** raw: Vitamin D (D2 + D3): 0.4 μg (18 IU) ** dried: Vitamin D (D2 + D3): 3.9 μg (154 IU) Lichen * ''
Cladina ''Cladonia'' is a genus of moss-like lichens in the family Cladoniaceae. They are the primary food source for reindeer/caribou. ''Cladonia'' species are of economic importance to reindeer-herders, such as the Sami in Scandinavia or the Nenets ...
arbuscula'' specimens grown under different natural conditions contain provitamin D2 and vitamin D2, ranges 89-146 and 0.22-0.55 μg/g dry matter respectively. They also contain vitamin D3 (range 0.67 to 2.04 μg/g) although provitamin D3 could not be detected. Vitamin D levels correlate positively with UV irradiation. Plantae * Alfalfa (''Medicago sativa'' subsp. sativa), shoot: 4.8 μg (192 IU) vitamin D2, 0.1 μg (4 IU) vitamin D3


Biosynthesis

The vitamin D2 content in mushrooms and ''C. arbuscula'' increase with exposure to ultraviolet light. Ergosterol (provitamin D2) found in these fungi is converted to previtamin D2 on UV exposure, which then turns into vitamin D2. As cultured mushrooms are generally grown in darkness, less vitamin D2 is found compared to those grown in the wild or dried in the sun. When fresh mushrooms or dried powders are purposely exposed to ultraviolet light, vitamin D2 levels can be concentrated to much higher levels. The irradiation procedure does not cause significant discoloration, or whitening, of mushrooms. Claims have been made that a normal serving (approx. 2 oz or 60 grams) of fresh mushrooms treated with ultraviolet light have increased vitamin D content to levels up to 80 micrograms or 3200 IU if exposed to just five minutes of UV light after being harvested. Button mushrooms with enhanced vitamin D2 content produced this way functions similarly to a vitamin D2 supplement; both effectively improves vitamin D status. Vitamin D2 from UV-irradiated yeast baked into bread or mushrooms is bioavailable and increases blood levels of 25(OH)D.


Names

Viosterol, the name given to early preparations of irradiated ergosterol, is essentially synonymous with ergocalciferol. However, currently, Viosterol is also the brand name for
cholecalciferol Cholecalciferol, also known as vitamin D3 and colecalciferol, is a type of vitamin D that is made by the skin when exposed to sunlight; it is found in some foods and can be taken as a dietary supplement. Cholecalciferol is made in the skin fo ...
(vitamin D3) in some countries. Ergocalciferol is manufactured and marketed under various names, including Deltalin ( Eli Lilly and Company), Drisdol (Sanofi-Synthelabo) and Calcidol (Patrin Pharma).


References


External links

*
NIST Chemistry WebBook page for ergocalciferol
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