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Vitamin-D2 treatment-associated decrease in 25(OH)D3 level is a reciprocal phenomenon: a randomized controlled trial.

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Vitamin D2 and D3 treatments both decrease levels of the other vitamin metabolite, suggesting a shared regulatory pathway. This indicates that neither vitamin D2 nor D3 uniquely impacts vitamin D metabolite levels.

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25-hydroxyvitamin D2 level25-hydroxyvitamin D3 levelCholecalciferol treatmentErgocalciferol treatment

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Area of Science:

  • Endocrinology
  • Nutritional Science
  • Biochemistry

Background:

  • Vitamin D2 (D2) treatment has been observed to decrease 25-hydroxyvitamin D3 (25(OH)D3) levels.
  • This observation suggests that D3 treatment might be preferable for increasing total 25-hydroxyvitamin D (25(OH)D).
  • A study was conducted to investigate if the decrease in 25(OH)D3 during D2 treatment is specific to D2 or a general response to increased 25(OH)D levels.

Purpose of the Study:

  • To determine if Vitamin D3 (D3) treatment causes a decrease in 25-hydroxyvitamin D2 (25(OH)D2) levels, similar to the observed decrease in 25(OH)D3 during D2 treatment.
  • To explore the relationship between changes in 25(OH)D2 and 25(OH)D3 levels following D2 and D3 administration.
  • To investigate potential common regulatory mechanisms influencing vitamin D metabolite levels.

Main Methods:

  • Two randomized, double-blind studies were conducted involving 97 volunteers.
  • Study 1: Volunteers received either 50,000 IU D2 or placebo orally once.
  • Study 2: Volunteers received 50,000 IU D2 orally once, followed by either 50,000 IU D3 or placebo orally four days later. Serum 25(OH)D2 and 25(OH)D3 levels were measured at baseline and up to day 56 using HPLC.

Main Results:

  • D3 treatment was associated with a decrease in 25(OH)D2 levels, comparable in magnitude to the decrease in 25(OH)D3 levels observed with D2 treatment.
  • The effect of D3 on 25(OH)D2 levels was less sustained than the effect of D2 on 25(OH)D3 levels.
  • Significant negative correlations were found between changes in 25(OH)D2 and 25(OH)D3 levels, and between changes in 25(OH)D2 and baseline 25(OH)D levels, suggesting a common regulatory mechanism.

Conclusions:

  • Vitamin D3 treatment leads to a decrease in 25(OH)D2 levels, similar in magnitude to the decrease in 25(OH)D3 levels seen with Vitamin D2 treatment.
  • The observed changes in 25(OH)D2 and 25(OH)D3 levels are correlated, indicating a potential shared regulatory pathway.
  • These findings challenge the notion that one form of vitamin D is inherently superior for raising overall vitamin D levels due to metabolite interactions.