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High-dose oral vitamin D3 supplementation in the elderly
C J Bacon1, G D Gamble, A M Horne
1Department of Medicine, University of Auckland, Auckland, New Zealand.
Summary
High-dose vitamin D(3) loading or monthly regimens effectively normalize vitamin D levels in the elderly. These strategies prove safe and efficient, addressing concerns about daily dosing inadequacy and compliance for optimal vitamin D status.
Area of Science:
- Endocrinology
- Nutritional Science
- Geriatrics
Background:
- Concerns exist regarding inadequate vitamin D supplementation doses.
- Suboptimal compliance with daily vitamin D medication regimens is a frequent issue.
Purpose of the Study:
- To compare the efficacy of high-dose vitamin D(3) regimens in normalizing 25-hydroxyvitamin D (25OHD) levels.
- To determine optimal target 25OHD levels by assessing changes in parathyroid hormone (PTH) and procollagen type I amino-terminal propeptide (P1NP).
Main Methods:
- A randomized double-blind trial involving 63 elderly participants.
- Comparison of three high-dose vitamin D(3) regimens: a 500,000-IU loading dose, loading dose plus 50,000 IU/month, or 50,000 IU/month.
- Assessment of 25OHD, PTH, P1NP, and serum calcium levels in relation to baseline 25OHD.
Main Results:
- Loading doses rapidly normalized 25OHD levels within 1 month.
- Monthly dosing achieved plateau 25OHD levels of approximately 80 nmol/L within 3-5 months.
- PTH and P1NP suppression occurred only in participants with baseline 25OHD levels below 50 nmol/L and 30 nmol/L, respectively. No changes in serum calcium were observed.
Conclusions:
- High-dose vitamin D(3) loading and monthly regimens are safe and effective for normalizing 25OHD in the frail elderly.
- Monthly dosing is effective but requires 3-5 months to reach plateau levels.
- Vitamin D supplementation does not lower PTH in individuals with baseline 25OHD > 50 nmol/L.
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