Guidelines for Preventing and Treating Vitamin D Deficiency and Insufficiency Revisited

Boston University Medical Center, School of Medicine, 715 Albany Street, M 1013, Boston, Massachusetts 2118, USA.
The Journal of Clinical Endocrinology and Metabolism (Impact Factor: 6.31). 03/2012; 97(4):1153-8. DOI: 10.1210/jc.2011-2601
Source: PubMed

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Available from: David A Hanley, Apr 07, 2015
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    • "Vitamin D deficiency is also associated with an increased risk of falls and fractures in the elderly [5] [6] and with potential " nonskeletal " effects, notably on the cardiovascular [7] [8] [9] and immune [10] systems as well as in cancers [11] [12]. Dietary sources of VTD are very limited and usual daily intakes are generally not higher than 200–400 IU in western countries [13] [14] [15]. The major source of VTD comes from UVB light-driven skin photosynthesis "
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    ABSTRACT: In this double blind, unicentre, randomized, placebo controlled study, we evaluated the changes in 25-hydroxyvitamin D (25(OH)D) serum levels in 150 young Belgian adults (18-30 years), monthly supplemented with 50,000 IU of vitamin D (VTD) or placebo for 6 months, from November 2010 to May 2011. At T0, 30% of the population presented 25(OH)D serum levels below 20 ng/mL. In the VTD-treated group, mean serum levels increased from 21.2 ± 8.2 to 30.6 ± 8.8 ng/mL (P < 0.001) at T3mo and to 36.0 ± 9.2 ng/mL (P < 0.001) at T6mo. Despite documented VTD intake, no changes in serum levels were, however, observed in 10% of the treated group. In the placebo group, mean 25(OH)D serum levels decreased from 22.8 ± 8.5 to 14.0 ± 6.9 ng/mL at T3mo (P < 0.001) but returned to values not significantly different from those observed at T0 (23.5 ± 8.6 ng/mL) at T6mo. No difference between serum calcium levels was observed between the groups throughout the study. In conclusion, monthly supplementation with 50,000 UI of VTD in winter can warrant serum 25(OH)D levels above 20 ng/mL in 96.2% of those healthy young adults without inducing unacceptably high 25(OH)D concentration. This supplementation is safe and may be proposed without 25(OH)D testing.
    International Journal of Endocrinology 11/2013; 2013:652648. DOI:10.1155/2013/652648 · 1.52 Impact Factor
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    • "Suggested cutoffs for vitamin D deficiency according to 25(OH)D serum concentrations are <12 ng/ml (multiply by 2.496 to convert ng/ml to nmol/l), <20, and <30 ng/ml. A particularly hot debate is ongoing as to whether levels of 20 or 30 ng/ ml can be considered sufficient (Holick et al. 2012; Rosen et al. 2012). In this context, it should be acknowledged that not all studies and meta-analyses have shown significant vitamin D effects on fractures and falls, so questions still remain regarding musculoskeletal vitamin D effects. "
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    ABSTRACT: The high worldwide prevalence of vitamin D deficiency is largely the result of low sunlight exposure with subsequently limited cutaneous vitamin D production. Classic manifestations of vitamin D deficiency are linked to disturbances in bone and mineral metabolism, but the identification of the vitamin D receptor in almost every human cell suggests a broader role of vitamin D for overall and cardiovascular health. The various cardiovascular protective actions of vitamin D such as anti-diabetic and anti-hypertensive effects including renin suppression as well as protection against atherosclerosis and heart diseases are well defined in previous experimental studies. In line with this, large epidemiological studies have highlighted vitamin D deficiency as a marker of cardiovascular risk. However, randomized controlled trials (RCTs) on vitamin D have largely failed to show its beneficial effects on cardiovascular diseases and its conventional risk factors. While most prior vitamin D RCTs were not designed to assess cardiovascular outcomes, some large RCTs have been initiated to evaluate the efficacy of vitamin D supplementation on cardiovascular events in the general population. When considering the history of previous disappointing vitamin RCTs in general populations, more emphasis should be placed on RCTs among severely vitamin D-deficient populations who would most likely benefit from vitamin D treatment. At present, vitamin D deficiency can only be considered a cardiovascular risk marker, as vitamin D supplementation with doses recommended for osteoporosis treatment is neither proven to be beneficial nor harmful in cardiovascular diseases.
    Archives of Toxicology 10/2013; 87(12). DOI:10.1007/s00204-013-1152-z · 5.08 Impact Factor
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    ABSTRACT: Many people worldwide are vitamin D (VTD) deficient or insufficient, and there is still no consensus on the dose of VTD that should be administered to achieve a 25(OH)D concentration of 20 or 30 ng/mL. In this study, we aimed to determine an adapted supplementation of VTD able to quickly and safely increase the vitamin D status of healthy adults with low 25(OH)D. One hundred and fifty (150) subjects were randomized into three groups, each to receive, orally, a loading dose of 50,000, 100,000 or 200,000 IU of VTD3 at Week 0, followed by 25,000, 50,000 or 100,000 IU at Week 4 and Week 8. Whereas 25(OH)D baseline values were not different between groups (p = 0.42), a significant increase was observed at Week 12 (p < 0.0001) with a mean change from baseline of 7.72 ± 5.08, 13.3 ± 5.88 and 20.12 ± 7.79 ng/mL. A plateau was reached after eight weeks. No related adverse event was recorded. This study demonstrated a linear dose-response relationship with an increase in 25(OH)D levels proportional to the dose administered. In conclusion, a loading dose of 200,000 IU VTD3 followed by a monthly dose of 100,000 IU is the best dosing schedule to quickly and safely correct the VTD status.
    Nutrients 7(7):5413-5422. DOI:10.3390/nu7075227 · 3.15 Impact Factor
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