Pediatric Research (2018) 10.1038/s41390-018-0135-4
Leila Moslemi, Mohammadreza Esmaeili dooki, Ali Akbar Moghadamnia, Morteza Alijanpour Aghamaleki, Mohammad Pornasrollah, Hassan Ashrafianamiri, Haji-Ghorban Nooreddini, Sohrab Kazemi, Mahdi Pouramir & Ali Bijani
Resulting Vitamin D Response
2/week 3 weeks
2/week 3 weeks
|Measured at 3 weeks||42 ng||50 ng||63 ng|
|Vitamin D Life guess at 10 weeks||35 ng||40 ng||80 ng|
Overview Loading of vitamin D contains the followingLoading dose:
If a person is, or is suspected to be, very vitamin D deficient a loading dose is typically given
- Loading = repletion = quick replacement (previously known as Stoss)
- Loading doses range in size from 100,000 IU to 1,000,000 IU of Vitamin D3
- The size of the loading dose is a function of body weight - see below
Unfortunately, some doctors persist in using Vitamin D2 instead of D3
- Loading may be done as quickly as a single day, to as slowly as 3 months.
It appears that spreading the loading dose over 4-20 days is a good compromise
- Loading is typically oral, but sometimes by injection (I.M,)
- The loading dose persists in the body for about 3 months
The loading dose should be followed up with continuing maintenance
Unfortunately, many doctors fail to follow-up with the maintenance dosing.
- As about 1 in 300 people have some form of mild allergic reaction to vitamin D supplements,
it appears prudent to test with a small amount of vitamin D before giving a loading dose
- The causes of a mild allergic reaction appear to be: (in order of occurance)
1) lack of magnesium - which can be easily added
2) allergy to capsule contents - oil, additives (powder does not appear to cause any reaction)
3) allergy to the tiny amount of D3 itself (allergy to wool) ( alternate: D3 made from plants )
Injection category listing has
- Vitamin D injection lasts longer and has bigger response than weekly oral – Jan 2017 has the following
PDF is available free at Sci-Hub 10.1038/s41390-018-0135-4
Background: To evaluate the efficacy of stoss therapy using fortified biscuit for vitamin D-deficient children.
A total of 108 children aged 30–72 months with vitamin D deficiency were studied in a randomized single-blind clinical trial. The deficient children were assigned to three groups, namely, vitamin D-fortified biscuit (BG), capsule vitamin D (CG), and ampoule vitamin D (AG). Capsules and biscuits containing 50,000 IU of cholecalciferol were consumed twice per week for 3 consecutive weeks. Ampoules with 300,000 IU of cholecalciferol were injected intramuscularly in a single dose. Three weeks after treatment, serum 25(OH)D concentrations were measured, and the three groups were compared.
Each method of treatment could increase the mean serum 25(OH)D concentration to optimal level. Serum 25(OH)D concentrations ≥100 ng/mL were observed in six children, including four from AG and two from CG (P = 0.09). The comparison of the mean serum 25(OH)D concentrations after treatment showed between ampoule and capsule (P = 0.3) and capsule and biscuit (P = 0.62) were insignificant; however, the ampoule and biscuit groups differed significantly (P = 0.012).
Stoss therapy using fortified biscuit may be an effective way to improve compliance in children who cannot take capsules without adverse effects and may also be recommended for prevention purposes.
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