Vitamin D supplementation therapy – comparison of efficacy of three different protocols

Abstract

Background: To study the efficacy of vitamin D supplementation therapy with three different protocols. Methods:In protocols 1 (intensive) and 3 (standard) oral cholecalciferol was given 60,000 IU/week/8 weeks followed bimonthly for 12 weeks. In protocol 2 parenteral-bolus cholecalciferol was given as 600,000 IU loading dose, 8 weeks later followed by cholecalciferol 60,000IU bimonthly for 12 weeks. Elemental calcium (1 g/day) was administered for full duration of study in all three protocols. Serum albumin, calcium, phosphorous, alkaline phosphatase, 25-hydroxy vitamin D (25OHD) and parathyroid hormone were tested at baseline, at 2 nd , and 5 th months. Statistical analysis was performed using random measures analysis of variance. As patients receiving protocol 3 were significantly older compared to the other two groups, age-adjusted analysis was carried out.Results: Intention-to-treat and per-protocol analysis showed that patients receiving protocol 2 had achieved 25OHD sufficiency levels at 8 weeks suggesting that protocol 2 appeared to perform best among the three protocols. However, these differences were not sustained at 5 months suggesting the need for continuing supervision. Conclusions:Despite varied responses of different biochemical markers, all three protocols were effective in bringing up 25OHD levels. However, protocol 2 performed the best among the three protocols. Our observation also highlight the importance of need for ongoing supplementation and continuing supervision of the same.

Osteoporosis in a Rural Community – Long-Term Effects of a Community Level Program of Calcium and Vitamin D Supplementation – A Prospective Observational Study

“…There is no consensus on the amount of vitamin D supplement required nor the route of administration. The previous studies[ 13 23 ] attest to the advantages of this approach, as such doses were better able to sustain normal (>20 ng/mL) serum levels of 25(OH) vitamin D. A comparison of three different protocols of vitamin D administration in vitamin D-deficient Indian women[ 24 ] concluded that the most effective regimen was the one that employed a high parenteral dose at the beginning followed by oral doses. In the WHI (Womens’ Health Initiative) study, the majority of subjects were already on calcium and vitamin D supplements and additional supplements did not protect against fractures.…”