Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents

Chel, V.G.M.; Wijnhoven, Hanneke A. H.; Smit, Johannes H.; Ooms, Marius; Lips, Paul

doi:10.1007/s00198-007-0465-2

Cited by 174 publications

(124 citation statements)

References 30 publications

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“…The increase in serum 25OHD was about 1.3 ng/100 IU, in line with most previous studies in subjects with a similarly low baseline vitamin D status. The results confirm a previous (equally small) study in elderly subjects (mean age of 80 years [9]), whereas others found a slightly lower efficacy of monthly compared to daily or weekly doses [10]. Collectively, however, these reports confirm that these strategies yield essentially similar results especially when taking into account the wide interindividual differences.…”

supporting

confidence: 80%

Optimal vitamin D supplementation strategies

Bouillon

2017

Endocrine

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Humans survived evolution without vitamin D-rich food or without vitamin D supplementation until vitamin D deficiency, rickets, became a major health problem from the 17th century onwards [1]. During the 20 th century, it became clear that exposure to sunlight and UVB should be avoided (infants and young children), or limited because of life time risks of skin damage or skin cancers. Moreover, voluntary avoidance (e.g. for cultural or religious reasons) of sun exposure or mismatch between skin color and climate (dark skinned immigrants living in Northern or Southern latitudes) severely limits the endogenous production of vitamin D well below the normal vitamin D requirements. This cannot be compensated by promoting natural vitamin D-rich food as there is simply not enough fatty fish in the ocean. Therefore vitamin D supplementation (either as vitamin D enriched food or by intake of supplements) will remain necessary for all infants and young children, for most elderly subjects and for other risk groups [2,3]. The major remaining questions are the overall health implications of vitamin D beyond bone health, the precise requirements (and thus the definition of vitamin D deficiency and the associated serum 25OHD concentrations) and the practical modalities to implement and maintain this supplementation for many years or for a lifetime to millions or even billions of people in a cost efficient way. Vitamin D is rapidly cleared from the circulation after its oral intake but it has nevertheless a long biological life time and its major metabolite, 25OHD, has a half-life of about 2 weeks [4]. As to enhance compliance, high dose intermittent therapy (once every 6-12 months) has been introduced in the past but several recent studies documented either transient hypercalcemia in children [5] or transient increased risks of falls or fractures [6,7] and therefore this strategy is no longer a valid option. Daily, weekly or monthly use of vitamin D (in equivalent cumulative dosage) could enhance long term compliance depending on the behavior or preference of the target groups. Whether such intermittent therapy generates the same vitamin D status has been studied by a group of Hungarian scientists [8]. They randomized modestly vitamin D deficient adults (mean age 53 years; mean baseline 25OHD of~13 ng/ml) to receive either daily (1000 IU), weekly (7000 IU) or monthly (30,000 IU) doses of vitamin D 3 and found very similar increase in the serum 25OHD after 3 months. This conclusion was essentially the same whether or not the data were corrected for several potentially confounding factors. The increase in serum 25OHD was about 1.3 ng/100 IU, in line with most previous studies in subjects with a similarly low baseline vitamin D status. The results confirm a previous (equally small) study in elderly subjects (mean age of 80 years [9]), whereas others found a slightly lower efficacy of monthly compared to daily or weekly doses [10]. Collectively, however, these reports confirm that these strategies yield essentially similar results ...

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supporting

confidence: 80%

Optimal vitamin D supplementation strategies

Bouillon

2017

Endocrine

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“…Some studies evaluated the efficacy of high doses at monthly or 3-month intervals, but most studies have used the officially recommended cholecalciferol dose of 600-800 IU/day, or equivalents thereof (12)(13)(14)(15)(16). Most studies used predefined fixed doses, irrespective of the degree of vitamin D deficiency and body weight, and assessed the efficacy of the regimen after 4-6 months or longer.…”

Section: Discussionmentioning

confidence: 99%

Cholecalciferol loading dose guideline for vitamin D-deficient adults

Groningen

Opdenoordt

Sorge³

et al. 2010

European Journal of Endocrinology

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Introduction: Severe vitamin D deficiency is very common. Evidence-based guidelines for rapid correction with high-dose oral cholecalciferol are not yet available. Objective: To develop a practical cholecalciferol loading dose regimen. Materials and methods: A total of 208 vitamin D-deficient subjects (serum 25-hydroxyvitamin D 3 (25-OHD 3 ) level !50 nmol/l), aged 18-88 years, were treated with solubilized cholecalciferol, 50 000 IU/ml. They received either 25 000 IU every fortnight for 8 weeks (total dose 100 000 IU), 25 000 IU every week for 6 weeks (total dose 150 000 IU), or 25 000 IU every week for 8 weeks (total dose 200 000 IU). Blood samples were collected at baseline and 10 days after the final dose of cholecalciferol. Results: Most patients were severely vitamin D deficient: 76% had a serum 25-OHD 3 level !30 nmol/l at baseline. Cholecalciferol in a cumulative dose of 100 000, 150 000, and 200 000 IU increased mean serum 25-OHD 3 level by 29 nmol/l (95% confidence interval (CI): 23-35 nmol/l), 43 nmol/l (95% CI: 36-50 nmol/l), and 69 nmol/l (95% CI: 64-75 nmol/l) respectively. The change in 25-OHD 3 (D25-OHD 3 ) was related to the dose per kilogram body weight (R

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“…One of the reasons for that would be the short duration of the intervention. Chel et al (25) studied the effects of daily supplementation with 600 IU vitamin D3 for 4 mo in elderly nursing home residents. The serum 25OH-D level increased from 9.2 to 28.0 ng/mL, and the percentage of subjects with serum 25OH-D below 20 ng/mL was only 10.9%.…”

Section: Discussionmentioning

confidence: 99%

Improvement of Vitamin D Status in Japanese Institutionalized Elderly by Supplementation with 800 IU of Vitamin D3

Kuwabara¹,

Tsugawa²,

Tanaka³

et al. 2009

J Nutr Sci Vitaminol

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SummaryTo study the adequate intake (AI) for vitamin D in the elderly, we have performed an intervention study with 800 IU/d of vitamin D 3 in the institutionalized elderly. Sixty-two institutionalized elderly were randomly assigned to two groups; receiving either supplements of 200 mg calcium plus 800 IU vitamin .3 ng/mL in the Ca ϩ VD group and to 11.1 ng/mL in the Ca group. Post intervention serum 25OH-D level was significantly higher in the Ca ϩ VD group than in the Ca group ( p Ͻ 0.001). In 53 subjects (85.5%) who took more than 80% of their supplements for 30 d, serum PTH level in the Ca ϩ VD group was significantly lower than in the Ca groups ( p ϭ 0.05). Bone turnover markers were not significantly changed after intervention in either group. Daily supplementation of 800 IU vitamin D 3 was considered effective in the institutionalized elderly with minimal chance of sun exposure, but further studies with longer duration are necessary.

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Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents

Cited by 174 publications

References 30 publications

Optimal vitamin D supplementation strategies

Optimal vitamin D supplementation strategies

Cholecalciferol loading dose guideline for vitamin D-deficient adults

Improvement of Vitamin D Status in Japanese Institutionalized Elderly by Supplementation with 800 IU of Vitamin D3

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