Loading dose of 60,000 IU Vitamin D once a week for 5 weeks safely raised deficient to above 30 ng
Most of the world uses Vitamin D loading doses of
50,000 IU weekly
50,000 IU daily for a week
200,000 to 400,000 IU as a single dose in critical situations
India, and a few others, use 60,000 instead of 50,000 IU
Do not recall ever seeing an adverse reaction to any Vitamin D loading doses
Safety and Efficacy of Loading Doses of Vitamin D: Recommendations for Effective Repletion
Pharmaceuticals 2024, 17(12), 1620; https://doi.org/10.3390/ph17121620
by Béla E. Tóth 1,*,István Takács 2,Kristóf Kádár 3,Sara Mirani 1,Miklós Vecsernyés 1ORCID and Péter Lakatos 2
1 Department of Pharmaceutical Surveillance and Economy, Faculty of Pharmacy, University of Debrecen, 4032 Debrecen, Hungary
2 Department of Internal Medicine and Oncology, Semmelweis University, 1085 Budapest, Hungary
3 Department of Oral Biology, Semmelweis University, 1085 Budapest, Hungary
- Author to whom correspondence should be addressed.
Background/Objectives: Epidemiological data on vitamin D status revealed that, despite various dosage and durations of supplementation, the effectiveness often fails to achieve optimal outcomes. The need for higher doses than previously recommended was suggested, but several modifying factors should be considered, including the level of deficiency, and BMI. The objectives of this post hoc evaluation are to characterize treatment effectiveness based on the applied dose, duration and BMI; and to assess the safety aspects associated with rapid repletion of vitamin D.
Methods: Vitamin D deficient subjects selected in the post-hoc analysis: seventy patients included from a combined loading-maintenance supplementation (300,000 IU followed by 60,000 IU) protocol and 62 deficient subjects who received a low-dose maintenance (1000 IU/day) therapy. The risk of overload and the incidence of hypercalciuria and hypercalcemia resulting from loading or post-loading maintenance were investigated.
Results: The moderate–fast-loading schedule of 60,000 IU per week for 5 weeks, effectively achieves the target in 25(OH)D levels over 30 ng/mL for all deficient subjects, regardless of their BMI. Slower loading with lower weekly doses confirms the safety of supplementation, but the effectiveness is dependent on the subjects’ BMI; overweight and obese patients require higher doses to reach the same vitamin D levels. No difference in safety parameters observed compared to low-dose therapies.
Conclusions: The loading treatment involving a total dose of 300,000 IU administered over 5 or 10 weeks is effective for repletion, does not lead to 25(OH)D overload, and poses no additional risks of hypercalcemia or hypercalciuria. Furthermore, there are no safety concerns regarding changes in bone resorption markers. A combination of the loading treatment with a subsequent maintenance dose of 2000 IU daily is adequate to achieve the target vitamin D levels.
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