Vitamin D: Deficiency, Supplementation, and Clinical Roles | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"La vitamine D est essentielle \u00e0 l'absorption du calcium et \u00e0 la min\u00e9ralisation osseuse. Carence rachitisme ost\u00e9omalacie ost\u00e9oporose, 25-OH vitamine D dosage, chol\u00e9calcif\u00e9rol suppl\u00e9mentation 1000-2000 UI et prise en charge au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"vitamine D, carence vitamine D, suppl\u00e9mentation vitamine D, 25-OH vitamine D, rachitisme vitamine D, ost\u00e9omalacie, vitamine D ost\u00e9oporose, chol\u00e9calcif\u00e9rol D3, vitamine D calcium, vitamine D Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=dump');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Endocrinologie & Nutrition clinique & M\u00e9decine de famille<\/span>\n <h1>Vitamin D<\/h1>\n\n <div class=\"co-intro\">\n La vitamine D est une prohormone liposoluble essentielle \u2014 unique parmi les vitamines car l'organisme peut la synth\u00e9tiser endog\u00e8nement par photoconversion cutan\u00e9e du 7-d\u00e9hydrocholest\u00e9rol sous l'action des rayonnements ultraviolets B (UVB 290\u2013315 nm) \u2014 qui joue un r\u00f4le central dans l'hom\u00e9ostasie phosphocalcique + la min\u00e9ralisation osseuse + et de nombreuses fonctions extra-squelettiques. Elle existe sous deux formes naturelles : la vitamine D3 (chol\u00e9calcif\u00e9rol \u2014 synth\u00e8se cutan\u00e9e + sources animales : poissons gras + jaune d'\u0153uf + foie) + et la vitamine D2 (ergocalcif\u00e9rol \u2014 sources v\u00e9g\u00e9tales + champignons expos\u00e9s aux UV) \u2192 les deux sont converties dans le foie en 25-hydroxyvitamine D (25-OH-D \u2014 calcidiol) \u2014 le marqueur de stockage mesur\u00e9 dans le sang pour \u00e9valuer le statut en vitamine D \u2014 puis dans le rein (tubule proximal) et les tissus p\u00e9riph\u00e9riques en 1,25-dihydroxyvitamine D (calcitriol \u2014 la forme biologiquement active) sous l'action de la 1\u03b1-hydroxylase r\u00e9nale stimul\u00e9e par la PTH et l'hypophosphat\u00e9mie. Le calcitriol agit comme une hormone st\u00e9ro\u00efde en se liant au r\u00e9cepteur de la vitamine D (VDR) pr\u00e9sent dans plus de 36 types cellulaires diff\u00e9rents \u2192 r\u00e9gulation de l'expression de plus de 200 g\u00e8nes \u2192 effets biologiques tr\u00e8s au-del\u00e0 du m\u00e9tabolisme osseux : immunit\u00e9 (modulation des lymphocytes T + activation des macrophages) + prolif\u00e9ration cellulaire + diff\u00e9renciation + fonction cardiovasculaire + s\u00e9cr\u00e9tion d'insuline. La pr\u00e9valence de la carence en vitamine D au Qu\u00e9bec est particuli\u00e8rement \u00e9lev\u00e9e en raison de la latitude g\u00e9ographique (45\u201350\u00b0N) qui limite la synth\u00e8se cutan\u00e9e \u00e0 seulement 4\u20135 mois par an (avril \u00e0 septembre) + des hivers longs + et des comportements modernes (temps pass\u00e9 \u00e0 l'int\u00e9rieur + protection solaire). Des \u00e9tudes populationnelles canadiennes estiment que 25 \u00e0 40 % des adultes qu\u00e9b\u00e9cois ont un taux de 25-OH-D insuffisant (<50 nmol\/L) \u00e0 la fin de l'hiver.\n <\/div>\n\n <h2>Dosage et interpr\u00e9tation du taux de 25-OH-D<\/h2>\n <ul class=\"co-list\">\n <li><strong>D\u00e9ficit s\u00e9v\u00e8re (<25 nmol\/L ou <10 ng\/mL) :<\/strong> rickets (child) + osteomalacia (adult) + symptomatic hypocalcemia + proximal myopathy + tetany \u2192 urgent intensive supplementation<\/li>\n <li><strong>Insuffisance (25\u201350 nmol\/L ou 10\u201320 ng\/mL) :<\/strong> Reactive secondary hyperparathyroidism (high PTH \u2192 increased bone resorption) + risk of falls and fractures + supplementation necessary<\/li>\n <li><strong>Optimal pour la sant\u00e9 osseuse (50\u2013125 nmol\/L ou 20\u201350 ng\/mL) :<\/strong> Recommended target by Osteoporosis Canada + Health Canada for the general population \u2192 maintenance supplementation according to dietary intake and sun exposure<\/li>\n <li><strong>Cible \u00e9lev\u00e9e discut\u00e9e (75\u2013150 nmol\/L ou 30\u201360 ng\/mL) :<\/strong> recommended by some experts for at-risk populations (elderly + chronic diseases + malabsorption) \u2192 evidence is still insufficient to universally recommend this higher target<\/li>\n <li><strong>Toxicit\u00e9 (>250 nmol\/L ou >100 ng\/mL) :<\/strong> hypercalc\u00e9mie + hypercalciurie + lithiase r\u00e9nale + calcifications vasculaires + naus\u00e9es + fatigue \u2192 uniquement avec des doses >10 000 UI\/j prolong\u00e9es ou lors d'intoxications accidentelles + jamais avec l'exposition solaire seule (m\u00e9canisme de r\u00e9gulation cutan\u00e9e protecteur)<\/li>\n <li><strong>Note importante \u2014 unit\u00e9s :<\/strong> nmol\/L (Canada + Europe) vs ng\/mL (United States) \u2192 conversion: nmol\/L \u00f7 2.5 = ng\/mL (e.g., 50 nmol\/L = 20 ng\/mL)<\/li>\n <\/ul>\n\n <h2>Populations \u00e0 risque de carence \u2014 Qu\u00e9bec<\/h2>\n <ul class=\"co-list\">\n <li><strong>Tous les Qu\u00e9b\u00e9cois en hiver (novembre \u00e0 mars) :<\/strong> latitude 45\u201350\u00b0N \u2192 insufficient solar angle for cutaneous synthesis + universal supplementation recommendation<\/li>\n <li><strong>Personnes \u00e2g\u00e9es (>65 ans) :<\/strong> Reduced skin synthesis capacity by 75% % + reduced sun exposure + often poor diet + decreased intestinal absorption + frequent kidney failure (reduced 1\u03b1-hydroxylase)<\/li>\n <li><strong>Personnes \u00e0 peau fonc\u00e9e :<\/strong> melanin filters UVB \u2192 reduced skin synthesis \u2192 3 to 5 times longer exposure needed to reach the same rate<\/li>\n <li><strong>Ob\u00e9sit\u00e9 :<\/strong> sequestration of fat-soluble vitamin D in adipose tissue \u2192 reduced bioavailability \u2192 higher supplementation doses needed<\/li>\n <li><strong>Fat malabsorption<\/strong> Crohn's disease + celiac disease + cystic fibrosis + bariatric surgery (gastric bypass ++) + chronic pancreatitis \u2192 strongly reduced absorption of fat-soluble vitamin D \u2192 high-dose supplementation + monitoring of levels<\/li>\n <li><strong>Pregnancy and breastfeeding:<\/strong> increased needs (1,500\u20132,000 IU\/day recommended) + low vitamin D breast milk \u2192 supplement breastfed infant from birth (400 IU\/day \u2014 Health Canada)<\/li>\n <li><strong>M\u00e9dicaments induisant le catabolisme de la vitamine D :<\/strong> Antiepileptics (phenytoin + carbamazepine + phenobarbital \u2014 CYP24A1 inducers) + rifampicin + long-term glucocorticoids + antiretrovirals<\/li>\n <\/ul>\n\n <h2>Suppl\u00e9mentation \u2014 recommandations pratiques<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Population<\/th>\n <th>Dose recommand\u00e9e<\/th>\n <th>Remarks<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Nourrisson allait\u00e9 au sein (0\u201312 mois)<\/td>\n <td>400 UI\/j (10 \u00b5g\/j) d\u00e8s la naissance<\/td>\n <td>Lait maternel pauvre en vitamine D + risque de rachitisme \u2192 recommandation Sant\u00e9 Canada + Soci\u00e9t\u00e9 canadienne de p\u00e9diatrie<\/td>\n <\/tr>\n <tr>\n <td>Enfant et adolescent (1\u201318 ans)<\/td>\n <td>600 UI\/j (15 \u00b5g\/j) \u2014 apport nutritionnel recommand\u00e9 + suppl\u00e9mentation si alimentation insuffisante<\/td>\n <td>Augmenter \u00e0 1 000\u20132 000 UI\/j si peu d'exposition solaire + peau fonc\u00e9e + r\u00e9gime v\u00e9g\u00e9talien<\/td>\n <\/tr>\n <tr>\n <td>Adult <65 years<\/td>\n <td>600\u20131 000 UI\/j en \u00e9t\u00e9 + 1 000\u20132 000 UI\/j en hiver (octobre \u00e0 avril au Qu\u00e9bec)<\/td>\n <td>Chol\u00e9calcif\u00e9rol D3 pr\u00e9f\u00e9r\u00e9 \u00e0 l'ergocalcif\u00e9rol D2 (plus efficace pour \u00e9lever et maintenir le taux de 25-OH-D) + suppl\u00e9mentation continue recommand\u00e9e au Qu\u00e9bec<\/td>\n <\/tr>\n <tr>\n <td>Adult >65 years old<\/td>\n <td>800\u20132 000 UI\/j en continu<\/td>\n <td>Ost\u00e9oporose Canada recommande 800\u20132 000 UI\/j + combiner avec calcium si apports alimentaires insuffisants + surveillance du taux de 25-OH-D annuellement<\/td>\n <\/tr>\n <tr>\n <td>Ost\u00e9oporose + fractures<\/td>\n <td>800\u20132 000 UI\/j + calcium 1 000\u20131 200 mg\/j (alimentaire de pr\u00e9f\u00e9rence)<\/td>\n <td>Cible 75\u2013125 nmol\/L + calcium alimentaire pr\u00e9f\u00e9r\u00e9 aux suppl\u00e9ments calciques (risque cardiovasculaire des suppl\u00e9ments calciques d\u00e9battu)<\/td>\n <\/tr>\n <tr>\n <td>Malabsorption + Bariatric Surgery<\/td>\n <td>3 000\u20136 000 UI\/j + ou dose haute (50 000 UI\/semaine) supervis\u00e9e<\/td>\n <td>Surveillance du taux de 25-OH-D tous les 3\u20136 mois + forme D3 + fortes doses n\u00e9cessaires car absorption tr\u00e8s r\u00e9duite<\/td>\n <\/tr>\n <tr>\n <td>Correction d'une carence document\u00e9e<\/td>\n <td>50 000 UI\/semaine \u00d7 8\u201312 semaines (D2 ou D3) + puis entretien<\/td>\n <td>Protocole de correction rapide pour les carences profondes (<25 nmol\/L) + contr\u00f4le du taux \u00e0 3 mois<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Au Qu\u00e9bec, la synth\u00e8se cutan\u00e9e de vitamine D n'est physiologiquement possible que de mai \u00e0 septembre (environ) \u2014 de novembre \u00e0 mars + m\u00eame par temps ensoleill\u00e9 + l'angle des rayons UVB est trop faible pour d\u00e9clencher la photoconversion cutan\u00e9e. Cela signifie que pratiquement tous les Qu\u00e9b\u00e9cois d\u00e9pendent de leur alimentation et de leurs suppl\u00e9ments pour maintenir leur taux de vitamine D en hiver. Une suppl\u00e9mentation de 1 000 \u00e0 2 000 UI\/j de chol\u00e9calcif\u00e9rol (D3) de octobre \u00e0 avril est une mesure simple + s\u00e9curitaire + et peu co\u00fbteuse pour maintenir un taux optimal chez la majorit\u00e9 des adultes en bonne sant\u00e9.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin si des douleurs osseuses diffuses + une faiblesse musculaire proximale + des crampes + ou une hypocalc\u00e9mie symptomatique (paresth\u00e9sies p\u00e9ribuccales + spasme carpop\u00e9dal + signe de Chvostek) apparaissent \u2014 ces signes peuvent indiquer une carence s\u00e9v\u00e8re en vitamine D (ost\u00e9omalacie) n\u00e9cessitant un dosage urgent et une suppl\u00e9mentation intensive. Pour le dosage de la 25-OH vitamine D et la prescription d'une suppl\u00e9mentation adapt\u00e9e, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron dosent la 25-OH vitamine D dans les populations \u00e0 risque (personnes \u00e2g\u00e9es + malabsorption + grossesse + peau fonc\u00e9e + anti\u00e9pileptiques), prescrivent la suppl\u00e9mentation en chol\u00e9calcif\u00e9rol D3 adapt\u00e9e au taux et au profil du patient, surveillent l'efficacit\u00e9 de la correction par dosage de contr\u00f4le \u00e0 3 mois, int\u00e8grent la vitamine D dans la prise en charge globale de l'ost\u00e9oporose, et \u00e9duquent les patients sur l'exposition solaire s\u00e9curitaire. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un endocrinologue. Le dosage syst\u00e9matique de la vitamine D n'est pas recommand\u00e9 dans la population g\u00e9n\u00e9rale asymptomatique \u2014 il est r\u00e9serv\u00e9 aux populations \u00e0 risque. Ne pas d\u00e9passer 4 000 UI\/j sans surveillance m\u00e9dicale. La toxicit\u00e9 de la vitamine D (hypercalc\u00e9mie) survient uniquement avec des doses prolong\u00e9es tr\u00e8s \u00e9lev\u00e9es \u2014 jamais avec l'exposition solaire seule.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Vitamine D : carence, suppl\u00e9mentation et r\u00f4les cliniques | Clinique Omicron Endocrinologie & Nutrition clinique & M\u00e9decine de famille Vitamine D La vitamine D est une prohormone liposoluble essentielle \u2014 unique parmi les vitamines car l’organisme peut la synth\u00e9tiser endog\u00e8nement par photoconversion cutan\u00e9e du 7-d\u00e9hydrocholest\u00e9rol sous l’action des rayonnements ultraviolets B (UVB 290\u2013315 nm) \u2014… <a href=\"https:\/\/cliniqueomicron.ca\/en\/vitamine-d\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Vitamin D: Deficiency, Supplementation, and Clinical Roles | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Vitamine D | Brossard | Clinique Omicron","_metasync_otto_description":"Vitamine D Vitamine D est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test est disponible \u00e0 la Clinique Omicron e...","_metasync_otto_keywords":"vitamine d, Clinique Omicron, clinique m\u00e9dicale Qu\u00e9bec, m\u00e9decin g\u00e9n\u00e9raliste Montr\u00e9al, Qu\u00e9bec","_metasync_otto_og_title":"","_metasync_otto_og_description":"Vitamine D Vitamine D est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test est disponible \u00e0 la Clinique Omicron e...","_metasync_otto_twitter_title":"","_metasync_otto_twitter_description":"Vitamine D Vitamine D est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. 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\n\t\t\t\t\t\n\n\n\n\nVitamin D: Deficiency, Supplementation, and Clinical Roles | Clinique Omicron<\/title>\n<meta name=\"description\" content=\"La vitamine D est essentielle \u00e0 l'absorption du calcium et \u00e0 la min\u00e9ralisation osseuse. Carence rachitisme ost\u00e9omalacie ost\u00e9oporose, 25-OH vitamine D dosage, chol\u00e9calcif\u00e9rol suppl\u00e9mentation 1000-2000 UI et prise en charge au Qu\u00e9bec.\">\n<meta name=\"keywords\" content=\"vitamine D, carence vitamine D, suppl\u00e9mentation vitamine D, 25-OH vitamine D, rachitisme vitamine D, ost\u00e9omalacie, vitamine D ost\u00e9oporose, chol\u00e9calcif\u00e9rol D3, vitamine D calcium, vitamine D Qu\u00e9bec\">\n<link rel=\"preconnect\" href=\"https:\/\/fonts.googleapis.com\">\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=swap\" rel=\"stylesheet\">\n<style>\n@import url('https:\/\/fonts.googleapis.com\/css2?family=Cinzel:wght@600&family=Poppins:wght@400;500;600;700&display=dump');\n\n.co-wrap * {\n font-family: 'Poppins', sans-serif;\n box-sizing: border-box;\n}\n.co-wrap {\n max-width: 1100px;\n margin: 0 auto;\n padding: 30px 0 60px;\n margin-top: 10px;\n}\n.co-label {\n font-family: 'Cinzel', serif;\n font-size: 14px;\n font-weight: bold;\n letter-spacing: 1px;\n text-transform: uppercase;\n color: #4D6577;\n margin-bottom: 14px;\n display: block;\n}\n.co-wrap h1 {\n font-size: 32px;\n font-weight: 500;\n color: #323C52;\n margin: 0 0 22px;\n line-height: 1.2;\n letter-spacing: 0.5px;\n}\n.co-intro {\n font-size: 16px;\n font-weight: 400;\n line-height: 1.75;\n color: #4D6577;\n margin-bottom: 36px;\n padding-bottom: 32px;\n border-bottom: 1px solid rgba(77,101,119,.2);\n}\n.co-wrap h2 {\n font-size: 20px;\n font-weight: 600;\n color: #323C52;\n margin: 32px 0 12px;\n letter-spacing: 0.3px;\n}\n.co-wrap p {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.7;\n margin-bottom: 14px;\n}\n.co-list {\n list-style: none;\n padding: 0;\n margin: 12px 0 24px;\n}\n.co-list li {\n font-size: 15px;\n font-weight: 400;\n color: #4D6577;\n padding: 10px 14px 10px 38px;\n margin-bottom: 8px;\n border-radius: 6px;\n position: relative;\n background: rgba(77,101,119,.06);\n border-left: 3px solid #4D6577;\n}\n.co-list li::before {\n content: \"\u2713\";\n position: absolute;\n left: 12px;\n font-weight: 700;\n color: #4D6577;\n}\n.co-table {\n width: 100%;\n border-collapse: collapse;\n margin: 14px 0 22px;\n font-size: 14px;\n border-radius: 8px;\n overflow: hidden;\n}\n.co-table thead tr {\n background: #323C52;\n color: #fff;\n}\n.co-table thead th {\n padding: 11px 16px;\n text-align: left;\n font-weight: 600;\n font-size: 13px;\n}\n.co-table tbody tr:nth-child(even) {\n background: rgba(77,101,119,.06);\n}\n.co-table tbody tr:nth-child(odd) {\n background: #fff;\n}\n.co-table td {\n padding: 10px 16px;\n color: #4D6577;\n border-bottom: 1px solid rgba(77,101,119,.12);\n font-size: 14px;\n vertical-align: top;\n}\n.co-table td:first-child {\n font-weight: 600;\n color: #323C52;\n}\n.co-infobox {\n display: flex;\n gap: 12px;\n background: rgba(77,101,119,.06);\n border-radius: 8px;\n border-left: 4px solid #4D6577;\n padding: 14px 18px;\n margin: 18px 0 28px;\n font-size: 14px;\n font-weight: 400;\n color: #4D6577;\n line-height: 1.65;\n}\n.co-infobox .ico {\n font-size: 18px;\n flex-shrink: 0;\n}\n.co-urgence {\n background: #fff8f8;\n border-left: 5px solid #c0392b;\n border-radius: 6px;\n padding: 20px 26px;\n margin: 24px 0 32px;\n}\n.co-urgence .co-urgence-titre {\n font-size: 13px;\n font-weight: 700;\n color: #c0392b;\n letter-spacing: 1.5px;\n text-transform: uppercase;\n margin-bottom: 10px;\n}\n.co-urgence p {\n color: #5a2020;\n font-size: 14px;\n margin: 0 0 10px;\n line-height: 1.7;\n}\n.co-urgence p:last-child {\n margin-bottom: 0;\n}\n.co-disclaimer {\n font-size: 13px;\n color: #8a9aaa;\n font-style: italic;\n border-top: 1px solid rgba(77,101,119,.15);\n padding-top: 24px;\n margin-top: 40px;\n line-height: 1.6;\n}\n<\/style>\n<\/head>\n<body>\n<div class=\"co-wrap\">\n\n <span class=\"co-label\">Endocrinologie & Nutrition clinique & M\u00e9decine de famille<\/span>\n <h1>Vitamin D<\/h1>\n\n <div class=\"co-intro\">\n La vitamine D est une prohormone liposoluble essentielle \u2014 unique parmi les vitamines car l'organisme peut la synth\u00e9tiser endog\u00e8nement par photoconversion cutan\u00e9e du 7-d\u00e9hydrocholest\u00e9rol sous l'action des rayonnements ultraviolets B (UVB 290\u2013315 nm) \u2014 qui joue un r\u00f4le central dans l'hom\u00e9ostasie phosphocalcique + la min\u00e9ralisation osseuse + et de nombreuses fonctions extra-squelettiques. Elle existe sous deux formes naturelles : la vitamine D3 (chol\u00e9calcif\u00e9rol \u2014 synth\u00e8se cutan\u00e9e + sources animales : poissons gras + jaune d'\u0153uf + foie) + et la vitamine D2 (ergocalcif\u00e9rol \u2014 sources v\u00e9g\u00e9tales + champignons expos\u00e9s aux UV) \u2192 les deux sont converties dans le foie en 25-hydroxyvitamine D (25-OH-D \u2014 calcidiol) \u2014 le marqueur de stockage mesur\u00e9 dans le sang pour \u00e9valuer le statut en vitamine D \u2014 puis dans le rein (tubule proximal) et les tissus p\u00e9riph\u00e9riques en 1,25-dihydroxyvitamine D (calcitriol \u2014 la forme biologiquement active) sous l'action de la 1\u03b1-hydroxylase r\u00e9nale stimul\u00e9e par la PTH et l'hypophosphat\u00e9mie. Le calcitriol agit comme une hormone st\u00e9ro\u00efde en se liant au r\u00e9cepteur de la vitamine D (VDR) pr\u00e9sent dans plus de 36 types cellulaires diff\u00e9rents \u2192 r\u00e9gulation de l'expression de plus de 200 g\u00e8nes \u2192 effets biologiques tr\u00e8s au-del\u00e0 du m\u00e9tabolisme osseux : immunit\u00e9 (modulation des lymphocytes T + activation des macrophages) + prolif\u00e9ration cellulaire + diff\u00e9renciation + fonction cardiovasculaire + s\u00e9cr\u00e9tion d'insuline. La pr\u00e9valence de la carence en vitamine D au Qu\u00e9bec est particuli\u00e8rement \u00e9lev\u00e9e en raison de la latitude g\u00e9ographique (45\u201350\u00b0N) qui limite la synth\u00e8se cutan\u00e9e \u00e0 seulement 4\u20135 mois par an (avril \u00e0 septembre) + des hivers longs + et des comportements modernes (temps pass\u00e9 \u00e0 l'int\u00e9rieur + protection solaire). Des \u00e9tudes populationnelles canadiennes estiment que 25 \u00e0 40 % des adultes qu\u00e9b\u00e9cois ont un taux de 25-OH-D insuffisant (<50 nmol\/L) \u00e0 la fin de l'hiver.\n <\/div>\n\n <h2>Dosage et interpr\u00e9tation du taux de 25-OH-D<\/h2>\n <ul class=\"co-list\">\n <li><strong>D\u00e9ficit s\u00e9v\u00e8re (<25 nmol\/L ou <10 ng\/mL) :<\/strong> rickets (child) + osteomalacia (adult) + symptomatic hypocalcemia + proximal myopathy + tetany \u2192 urgent intensive supplementation<\/li>\n <li><strong>Insuffisance (25\u201350 nmol\/L ou 10\u201320 ng\/mL) :<\/strong> Reactive secondary hyperparathyroidism (high PTH \u2192 increased bone resorption) + risk of falls and fractures + supplementation necessary<\/li>\n <li><strong>Optimal pour la sant\u00e9 osseuse (50\u2013125 nmol\/L ou 20\u201350 ng\/mL) :<\/strong> Recommended target by Osteoporosis Canada + Health Canada for the general population \u2192 maintenance supplementation according to dietary intake and sun exposure<\/li>\n <li><strong>Cible \u00e9lev\u00e9e discut\u00e9e (75\u2013150 nmol\/L ou 30\u201360 ng\/mL) :<\/strong> recommended by some experts for at-risk populations (elderly + chronic diseases + malabsorption) \u2192 evidence is still insufficient to universally recommend this higher target<\/li>\n <li><strong>Toxicit\u00e9 (>250 nmol\/L ou >100 ng\/mL) :<\/strong> hypercalc\u00e9mie + hypercalciurie + lithiase r\u00e9nale + calcifications vasculaires + naus\u00e9es + fatigue \u2192 uniquement avec des doses >10 000 UI\/j prolong\u00e9es ou lors d'intoxications accidentelles + jamais avec l'exposition solaire seule (m\u00e9canisme de r\u00e9gulation cutan\u00e9e protecteur)<\/li>\n <li><strong>Note importante \u2014 unit\u00e9s :<\/strong> nmol\/L (Canada + Europe) vs ng\/mL (United States) \u2192 conversion: nmol\/L \u00f7 2.5 = ng\/mL (e.g., 50 nmol\/L = 20 ng\/mL)<\/li>\n <\/ul>\n\n <h2>Populations \u00e0 risque de carence \u2014 Qu\u00e9bec<\/h2>\n <ul class=\"co-list\">\n <li><strong>Tous les Qu\u00e9b\u00e9cois en hiver (novembre \u00e0 mars) :<\/strong> latitude 45\u201350\u00b0N \u2192 insufficient solar angle for cutaneous synthesis + universal supplementation recommendation<\/li>\n <li><strong>Personnes \u00e2g\u00e9es (>65 ans) :<\/strong> Reduced skin synthesis capacity by 75% % + reduced sun exposure + often poor diet + decreased intestinal absorption + frequent kidney failure (reduced 1\u03b1-hydroxylase)<\/li>\n <li><strong>Personnes \u00e0 peau fonc\u00e9e :<\/strong> melanin filters UVB \u2192 reduced skin synthesis \u2192 3 to 5 times longer exposure needed to reach the same rate<\/li>\n <li><strong>Ob\u00e9sit\u00e9 :<\/strong> sequestration of fat-soluble vitamin D in adipose tissue \u2192 reduced bioavailability \u2192 higher supplementation doses needed<\/li>\n <li><strong>Fat malabsorption<\/strong> Crohn's disease + celiac disease + cystic fibrosis + bariatric surgery (gastric bypass ++) + chronic pancreatitis \u2192 strongly reduced absorption of fat-soluble vitamin D \u2192 high-dose supplementation + monitoring of levels<\/li>\n <li><strong>Pregnancy and breastfeeding:<\/strong> increased needs (1,500\u20132,000 IU\/day recommended) + low vitamin D breast milk \u2192 supplement breastfed infant from birth (400 IU\/day \u2014 Health Canada)<\/li>\n <li><strong>M\u00e9dicaments induisant le catabolisme de la vitamine D :<\/strong> Antiepileptics (phenytoin + carbamazepine + phenobarbital \u2014 CYP24A1 inducers) + rifampicin + long-term glucocorticoids + antiretrovirals<\/li>\n <\/ul>\n\n <h2>Suppl\u00e9mentation \u2014 recommandations pratiques<\/h2>\n\n <table class=\"co-table\">\n <thead>\n <tr>\n <th>Population<\/th>\n <th>Dose recommand\u00e9e<\/th>\n <th>Remarks<\/th>\n <\/tr>\n <\/thead>\n <tbody>\n <tr>\n <td>Nourrisson allait\u00e9 au sein (0\u201312 mois)<\/td>\n <td>400 UI\/j (10 \u00b5g\/j) d\u00e8s la naissance<\/td>\n <td>Lait maternel pauvre en vitamine D + risque de rachitisme \u2192 recommandation Sant\u00e9 Canada + Soci\u00e9t\u00e9 canadienne de p\u00e9diatrie<\/td>\n <\/tr>\n <tr>\n <td>Enfant et adolescent (1\u201318 ans)<\/td>\n <td>600 UI\/j (15 \u00b5g\/j) \u2014 apport nutritionnel recommand\u00e9 + suppl\u00e9mentation si alimentation insuffisante<\/td>\n <td>Augmenter \u00e0 1 000\u20132 000 UI\/j si peu d'exposition solaire + peau fonc\u00e9e + r\u00e9gime v\u00e9g\u00e9talien<\/td>\n <\/tr>\n <tr>\n <td>Adult <65 years<\/td>\n <td>600\u20131 000 UI\/j en \u00e9t\u00e9 + 1 000\u20132 000 UI\/j en hiver (octobre \u00e0 avril au Qu\u00e9bec)<\/td>\n <td>Chol\u00e9calcif\u00e9rol D3 pr\u00e9f\u00e9r\u00e9 \u00e0 l'ergocalcif\u00e9rol D2 (plus efficace pour \u00e9lever et maintenir le taux de 25-OH-D) + suppl\u00e9mentation continue recommand\u00e9e au Qu\u00e9bec<\/td>\n <\/tr>\n <tr>\n <td>Adult >65 years old<\/td>\n <td>800\u20132 000 UI\/j en continu<\/td>\n <td>Ost\u00e9oporose Canada recommande 800\u20132 000 UI\/j + combiner avec calcium si apports alimentaires insuffisants + surveillance du taux de 25-OH-D annuellement<\/td>\n <\/tr>\n <tr>\n <td>Ost\u00e9oporose + fractures<\/td>\n <td>800\u20132 000 UI\/j + calcium 1 000\u20131 200 mg\/j (alimentaire de pr\u00e9f\u00e9rence)<\/td>\n <td>Cible 75\u2013125 nmol\/L + calcium alimentaire pr\u00e9f\u00e9r\u00e9 aux suppl\u00e9ments calciques (risque cardiovasculaire des suppl\u00e9ments calciques d\u00e9battu)<\/td>\n <\/tr>\n <tr>\n <td>Malabsorption + Bariatric Surgery<\/td>\n <td>3 000\u20136 000 UI\/j + ou dose haute (50 000 UI\/semaine) supervis\u00e9e<\/td>\n <td>Surveillance du taux de 25-OH-D tous les 3\u20136 mois + forme D3 + fortes doses n\u00e9cessaires car absorption tr\u00e8s r\u00e9duite<\/td>\n <\/tr>\n <tr>\n <td>Correction d'une carence document\u00e9e<\/td>\n <td>50 000 UI\/semaine \u00d7 8\u201312 semaines (D2 ou D3) + puis entretien<\/td>\n <td>Protocole de correction rapide pour les carences profondes (<25 nmol\/L) + contr\u00f4le du taux \u00e0 3 mois<\/td>\n <\/tr>\n <\/tbody>\n <\/table>\n\n <div class=\"co-infobox\">\n <span class=\"ico\">\u2119\ufe0f<\/span>\n <span>Au Qu\u00e9bec, la synth\u00e8se cutan\u00e9e de vitamine D n'est physiologiquement possible que de mai \u00e0 septembre (environ) \u2014 de novembre \u00e0 mars + m\u00eame par temps ensoleill\u00e9 + l'angle des rayons UVB est trop faible pour d\u00e9clencher la photoconversion cutan\u00e9e. Cela signifie que pratiquement tous les Qu\u00e9b\u00e9cois d\u00e9pendent de leur alimentation et de leurs suppl\u00e9ments pour maintenir leur taux de vitamine D en hiver. Une suppl\u00e9mentation de 1 000 \u00e0 2 000 UI\/j de chol\u00e9calcif\u00e9rol (D3) de octobre \u00e0 avril est une mesure simple + s\u00e9curitaire + et peu co\u00fbteuse pour maintenir un taux optimal chez la majorit\u00e9 des adultes en bonne sant\u00e9.<\/span>\n <\/div>\n\n <div class=\"co-urgence\">\n <div class=\"co-urgence-titre\">Medical consultation recommended<\/div>\n <p>Consulter un m\u00e9decin si des douleurs osseuses diffuses + une faiblesse musculaire proximale + des crampes + ou une hypocalc\u00e9mie symptomatique (paresth\u00e9sies p\u00e9ribuccales + spasme carpop\u00e9dal + signe de Chvostek) apparaissent \u2014 ces signes peuvent indiquer une carence s\u00e9v\u00e8re en vitamine D (ost\u00e9omalacie) n\u00e9cessitant un dosage urgent et une suppl\u00e9mentation intensive. Pour le dosage de la 25-OH vitamine D et la prescription d'une suppl\u00e9mentation adapt\u00e9e, Clinique Omicron offre des consultations m\u00e9dicales dans ses points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#c0392b;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n <\/div>\n\n <h2>Consult at Clinique Omicron<\/h2>\n <p>Les m\u00e9decins et infirmiers praticiens sp\u00e9cialis\u00e9s (IPS) de Clinique Omicron dosent la 25-OH vitamine D dans les populations \u00e0 risque (personnes \u00e2g\u00e9es + malabsorption + grossesse + peau fonc\u00e9e + anti\u00e9pileptiques), prescrivent la suppl\u00e9mentation en chol\u00e9calcif\u00e9rol D3 adapt\u00e9e au taux et au profil du patient, surveillent l'efficacit\u00e9 de la correction par dosage de contr\u00f4le \u00e0 3 mois, int\u00e8grent la vitamine D dans la prise en charge globale de l'ost\u00e9oporose, et \u00e9duquent les patients sur l'exposition solaire s\u00e9curitaire. Des consultations sont disponibles dans plusieurs points de service au Qu\u00e9bec et en t\u00e9l\u00e9m\u00e9decine. Pour prendre rendez-vous, visitez <a href=\"https:\/\/cliniqueomicron.ca\" style=\"color:#4D6577;font-weight:600;text-decoration:none;\">cliniqueomicron.ca<\/a>.<\/p>\n\n <p class=\"co-disclaimer\">Le contenu de cette page est fourni \u00e0 titre informatif uniquement et ne remplace pas l'avis d'un m\u00e9decin ou d'un endocrinologue. Le dosage syst\u00e9matique de la vitamine D n'est pas recommand\u00e9 dans la population g\u00e9n\u00e9rale asymptomatique \u2014 il est r\u00e9serv\u00e9 aux populations \u00e0 risque. Ne pas d\u00e9passer 4 000 UI\/j sans surveillance m\u00e9dicale. La toxicit\u00e9 de la vitamine D (hypercalc\u00e9mie) survient uniquement avec des doses prolong\u00e9es tr\u00e8s \u00e9lev\u00e9es \u2014 jamais avec l'exposition solaire seule.<\/p>\n\n<\/div>\n<\/body>\n<\/html>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Vitamine D : carence, suppl\u00e9mentation et r\u00f4les cliniques | Clinique Omicron Endocrinologie & Nutrition clinique & M\u00e9decine de famille Vitamine D La vitamine D est une prohormone liposoluble essentielle \u2014 unique parmi les vitamines car l’organisme peut la synth\u00e9tiser endog\u00e8nement par photoconversion cutan\u00e9e du 7-d\u00e9hydrocholest\u00e9rol sous l’action des rayonnements ultraviolets B (UVB 290\u2013315 nm) \u2014… <a href=\"https:\/\/cliniqueomicron.ca\/en\/vitamine-d\/\" rel=\"bookmark\">Read More \"<span class=\"screen-reader-text\">Vitamin D: Deficiency, Supplementation, and Clinical Roles | Clinique Omicron<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"off","neve_meta_content_width":100,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","_themeisle_gutenberg_block_has_review":false,"_metasync_otto_title":"Vitamine D | Brossard | Clinique Omicron","_metasync_otto_description":"Vitamine D Vitamine D est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test est disponible \u00e0 la Clinique Omicron e...","_metasync_otto_keywords":"vitamine d, Clinique Omicron, clinique m\u00e9dicale Qu\u00e9bec, m\u00e9decin g\u00e9n\u00e9raliste Montr\u00e9al, Qu\u00e9bec","_metasync_otto_og_title":"","_metasync_otto_og_description":"Vitamine D Vitamine D est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test est disponible \u00e0 la Clinique Omicron e...","_metasync_otto_twitter_title":"","_metasync_otto_twitter_description":"Vitamine D Vitamine D est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. Ce test est disponible \u00e0 la Clinique Omicron e...","rank_math_title":"","rank_math_description":"","_yoast_wpseo_title":"","_yoast_wpseo_metadesc":"","_aioseo_title":"Vitamine D : carence, suppl\u00e9mentation et r\u00f4les cliniques | Clinique Omicron","_aioseo_description":"La vitamine D est essentielle \u00e0 la min\u00e9ralisation osseuse et l'immunit\u00e9. 25-OH-D optimal 50-125 nmol\/L, chol\u00e9calcif\u00e9rol D3 1000-2000 UI hiver Qu\u00e9bec, ost\u00e9omalacie rachitisme carence s\u00e9v\u00e8re, toxicit\u00e9 >250 nmol\/L hypercalc\u00e9mie et suppl\u00e9mentation au Qu\u00e9bec.","_metasync_seo_title":"","_metasync_seo_desc":"","_metasync_breadcrumb_title":"","_metasync_primary_category":0,"_metasync_primary_product_cat":0,"_metasync_otto_disabled":"","_metasync_hreflang":"","_metasync_plugin_sync_ts":"{\"aioseo\":\"2026-05-26T20:36:35+00:00\"}","_metasync_robots_advanced":"","footnotes":""},"class_list":["post-25061","page","type-page","status-publish","hentry"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t<meta name=\"description\" content=\"Vitamine D Vitamine D est un test de laboratoire qui permet d'\u00e9valuer certains aspects de votre \u00e9tat de sant\u00e9. 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