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Vitamin D Deficiency Prevalent, Minimum Recommended Dose May Be Too Low: Presented at ASBMR
By Em Brown
HONOLULU, HI -- September 26, 2007 -- Responses to vitamin D supplements vary among individuals, so clinicians need to monitor serum levels of 25 hydroxyvitamin D (25[OH]D) levels and evaluate monthly patterns, especially among patients who are vitamin D deficient.
Epidemiological studies have shown that more than a third of the American population has vitamin and calcium deficiency.
At the 29th Annual Meeting of the American Society for Bone and Mineral Research (ASBMR), Neil Binkley, MD, Associate Professor of Medicine, University of Wisconsin, Madison, Wisconsin, United States, presented the results of a study conducted to compare daily versus monthly vitamin D2 and D3 supplementation.
The year-long, double-blind, placebo-controlled prospective clinical trial randomised 32 men and women aged 65 years or more and living in the community to daily dosing with 1,600 IU of D2 or D3 or to monthly dosing with 50,000 IU of D2 or D3. The researchers analysed the effects of supplementation on serum 25(OH)D serum levels, Dr. Binkley said in his presentation.
The research team also investigated the potential importance of obtaining trough 25(OH)D levels in adults over age 65 years.
Baseline 25(OH)D levels ranged from 10 to 60 ng/mL and the mean serum concentration at baseline was 31.1 ng/mL (+- 2.2 ng/mL).
"Calcium supplements -- either 1,600 IU daily or 25,000 IU monthly -- corrects the imbalance in few patients," Dr. Binkley said.
In the group randomised to receive 50,000 IU monthly, serum 25(OH)D concentrations increased by 8.6 ng/mL (+- 0.6 ng/mL; P <.001) at 3 days and by 6.7 ng/mL (+- 1.4 ng/mL) at 7 days.
Serum 25(OH) levels "did not change from baseline in those receiving daily therapy with D2 or D3 or monthly D2," Dr. Binkley said.
"Between-individual response to vitamin D dosing varies substantially. Understanding the mechanisms underlying these differences is necessary to optimum population vitamin D status," he said.
"Given this variability, recommending a single vitamin D dose is unlikely to assure adequacy on a population basis, unless the recommended dose is quite high."
He added that "our preliminary observations support the possibility that therapy with D3 may be more effective."
[Presentation title: Daily Versus Monthly Oral Vitamin D2 and D3: Effect on Serum 25OHD Concentration. Abstract M451]
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