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Elderly Vitamin D Loading Dose of 500,000 IU is safe and effective – RCT 2009

High-dose oral vitamin D3 supplementation in the elderly

Osteoporosis International volume 20, Article number: 1407 (2009)
C. J. Bacon, G. D. Gamble, A. M. Horne, M. A. Scott & I. R. Reid

Vitamin D Life

Loading Dose of Vitamin D category has the following

155 items in category
see also Overview Loading of vitamin D   Overview Toxicity of vitamin D
Injection category listing has 53 items
 
It appears that over 1 million Vitamin D loading doses have been taken
Doses ranged from 100,000 to 600,000 IU over a period of a day to a month
No reports of adverse reactions
Many studies report on the benefits resulting from loading doses

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Started with > 50 nmol (<20 ng)

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Started with < 50 nmol <(20 ng)

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Summary
Daily dosing with vitamin D often fails to achieve optimal outcomes, and it is uncertain what the target level of 25-hydroxyvitamin D should be. This study found that large loading doses of vitamin D3 rapidly and safely normalize 25OHD levels, and that monthly dosing is similarly effective after 3–5 months. With baseline 25OHD > 50 nmol/L, vitamin D supplementation does not reduce PTH levels.

Introduction
There is concern that vitamin D supplementation doses are frequently inadequate, and that compliance with daily medication is likely to be suboptimal.

Methods
This randomized double-blind trial compares responses to three high-dose vitamin D3 regimens and estimates optimal 25-hydroxyvitamin D (25OHD) levels, from changes in parathyroid hormone (PTH), and procollagen type I amino-terminal propeptide (P1NP) in relation to baseline 25OHD. Sixty-three elderly participants were randomized to three regimens of vitamin D supplementation: a 500,000-IU loading dose; the loading dose plus 50,000 IU/month; or 50,000 IU/month.

Results
The Loading and Loading + Monthly groups showed increases in 25OHD of 58 ± 28 nmol/L from baseline to 1 month. Thereafter, levels gradually declined to plateaus of 69 ± 5 nmol/L and 91 ± 4 nmol/l, respectively. In the Monthly group, 25OHD reached a plateau of ~80 ± 20 nmol/L at 3–5 months. There were no changes in serum calcium concentrations. PTH and P1NP were only suppressed by vitamin D treatment in those with baseline 25OHD levels <50 and <30 nmol/L, respectively.

Conclusions
Large loading doses of vitamin D3 rapidly and safely normalize 25OHD levels in the frail elderly. Monthly dosing is similarly effective and safe, but takes 3–5 months for plateau 25OHD levels to be reached.


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13480 Start less than 50.jpg admin 12 Feb, 2020 11:29 40.39 Kb 225
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13478 High-dose elderly.pdf admin 12 Feb, 2020 11:15 200.41 Kb 139
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