SUMMARY: Daily dosing with vitamin D often fails to achieve optimal outcomes, and it is uncertain what the target level of 25-hydroxyvitamin D should be. This study found that large loading doses of vitamin D(3) rapidly and safely normalize 25OHD levels, and that monthly dosing is similarly effective after 3-5 months. With baseline 25OHD > 50 nmol/L, vitamin D supplementation does not reduce PTH levels. INTRODUCTION: There is concern that vitamin D supplementation doses are frequently inadequate, and that compliance with daily medication is likely to be suboptimal. METHODS: This randomized double-blind trial compares responses to three high-dose vitamin D(3) regimens and estimates optimal 25-hydroxyvitamin D (25OHD) levels, from changes in parathyroid hormone (PTH), and procollagen typeI amino-terminal propeptide (P1NP) in relation to baseline 25OHD. Sixty-three elderly participants were randomized to three regimens of vitamin D supplementation: a 500,000-IU loading dose; the loading dose plus 50,000 IU/month; or 50,000 IU/month. RESULTS: The Loading and Loading + Monthly groups showed increases in 25OHD of 58 +/- 28 nmol/L from baseline to 1 month. Thereafter, levels gradually declined to plateaus of 69 +/- 5 nmol/L and 91 +/- 4 nmol/l, respectively. In the Monthly group, 25OHD reached a plateau of ~80 +/- 20 nmol/L at 3-5 months. There were no changes in serum calcium concentrations. PTH and P1NP were only suppressed by vitamin D treatment in those with baseline 25OHD levels <50 and <30 nmol/L, respectively. CONCLUSIONS: Large loading doses of vitamin D(3) rapidly and safely normalize 25OHD levels in the frail elderly. Monthly dosing is similarly effective and safe, but takes 3-5 months for plateau 25OHD levels to be reached.
RCT Entities:
SUMMARY: Daily dosing with vitamin D often fails to achieve optimal outcomes, and it is uncertain what the target level of 25-hydroxyvitamin D should be. This study found that large loading doses of vitamin D(3) rapidly and safely normalize 25OHD levels, and that monthly dosing is similarly effective after 3-5 months. With baseline 25OHD > 50 nmol/L, vitamin D supplementation does not reduce PTH levels. INTRODUCTION: There is concern that vitamin D supplementation doses are frequently inadequate, and that compliance with daily medication is likely to be suboptimal. METHODS: This randomized double-blind trial compares responses to three high-dose vitamin D(3) regimens and estimates optimal 25-hydroxyvitamin D (25OHD) levels, from changes in parathyroid hormone (PTH), and procollagen type I amino-terminal propeptide (P1NP) in relation to baseline 25OHD. Sixty-three elderly participants were randomized to three regimens of vitamin D supplementation: a 500,000-IU loading dose; the loading dose plus 50,000 IU/month; or 50,000 IU/month. RESULTS: The Loading and Loading + Monthly groups showed increases in 25OHD of 58 +/- 28 nmol/L from baseline to 1 month. Thereafter, levels gradually declined to plateaus of 69 +/- 5 nmol/L and 91 +/- 4 nmol/l, respectively. In the Monthly group, 25OHD reached a plateau of ~80 +/- 20 nmol/L at 3-5 months. There were no changes in serum calcium concentrations. PTH and P1NP were only suppressed by vitamin D treatment in those with baseline 25OHD levels <50 and <30 nmol/L, respectively. CONCLUSIONS: Large loading doses of vitamin D(3) rapidly and safely normalize 25OHD levels in the frail elderly. Monthly dosing is similarly effective and safe, but takes 3-5 months for plateau 25OHD levels to be reached.
Authors: Heike A Bischoff-Ferrari; Thomas Dietrich; E John Orav; Frank B Hu; Yuqing Zhang; Elisabeth W Karlson; Bess Dawson-Hughes Journal: Am J Clin Nutr Date: 2004-09 Impact factor: 7.045
Authors: Denise G von Mühlen; Gail A Greendale; Cedric F Garland; Lori Wan; Elizabeth Barrett-Connor Journal: Osteoporos Int Date: 2005-06-01 Impact factor: 4.507
Authors: D K Roy; T W O'Neill; J D Finn; M Lunt; A J Silman; D Felsenberg; G Armbrecht; D Banzer; L I Benevolenskaya; A Bhalla; J Bruges Armas; J B Cannata; C Cooper; J Dequeker; M N Diaz; R Eastell; O B Yershova; B Felsch; W Gowin; S Havelka; K Hoszowski; A A Ismail; I Jajic; I Janott; O Johnell; J A Kanis; G Kragl; A Lopez Vaz; R Lorenc; G Lyritis; P Masaryk; C Matthis; T Miazgowski; C Gennari; H A P Pols; G Poor; H H Raspe; D M Reid; W Reisinger; C Scheidt-Nave; J J Stepan; C J Todd; K Weber; A D Woolf; J Reeve Journal: Osteoporos Int Date: 2003-01 Impact factor: 4.507
Authors: M Kärkkäinen; M Tuppurainen; K Salovaara; L Sandini; T Rikkonen; J Sirola; R Honkanen; J Jurvelin; E Alhava; H Kröger Journal: Osteoporos Int Date: 2010-03-04 Impact factor: 4.507
Authors: Luke J Peppone; Aaron S Rickles; Michelle C Janelsins; Michael R Insalaco; Kristin A Skinner Journal: Ann Surg Oncol Date: 2012-03-24 Impact factor: 5.344
Authors: C Neuerburg; R Schmidmaier; S Schilling; C Kammerlander; W Böcker; W Mutschler; U Stumpf Journal: Unfallchirurg Date: 2015-11 Impact factor: 1.000