Treatment of hypovitaminosis D with pharmacologic doses of Cholecalciferol, Oral versus Intramuscular; an open labeled RCT

Clinical Endocrinology accepted article Aug 2012
Mozhdeh Zabihiyeganeh1, Adel Jahed2 adeljahed at yahoo.com, Marzieh Nojomi3
1 Assistant Professor of Internal Medicine & Rheumatology, Department of Rheumatology, Firouzgar General Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Assistant Professor of Internal Medicine & Endocrinology, Department of Internal medicine, Booali General Hospital, Islamic Azad University, Tehran Medical Branch, Tehran, Iran
3 Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

Objective: itamin D deficiency is a worldwide health problem. Usual supplements are inadequate for prevention of hypovitaminosis D and much higher doses are needed for its treatment. This study was designed to compare the efficacy and practicality of high-dose intramuscular and oral cholecalciferol in treatment of hypovitaminosis D, and to evaluate durability of the effect of each remedy.

Design: inety-two patients with hypovitaminosis D [serum 25(OH)D level ?75 nmol/L] were enrolled in a randomised clinical trial. Participants were randomly assigned to receive 300,000 IU cholecalciferol, either intramuscularly as a single injection, or orally in six divided doses during three months period. Serum 25(OH)D level was measured at baseline, and at 3 and 6 months.

Results: oth treatment regimens significantly increased the serum 25(OH)D level. Delta change of serum 25(OH)D level from baseline (presented as mean±SEM) at month 3 was significantly higher in oral than injection group (90±11.2 nmol/L and 58.8±8.9 nmol/L respectively, p=0.03); but was similar at 6th month intervention (52.1±7.6 nmol/L and 62.2±6.7 nmol/L respectively, p=0.32). There was a marginally significant trend in favor of oral group in the proportion of cases attained vitamin D adequacy at 6th month (p= 0.06); but still 15% of all patients remained at < 50 nmol/L.

Conclusion
Both regimens were considerably effective, safe, and practical in treating hypovitaminosis D. Although we revealed superiority of oral route, at least at early short-time, the way of treatment may depend on the patient's choice, compliance, and availability of various forms of the drug in any regions.

© 2012 Blackwell Publishing Ltd
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See also Vitamin D Life

• Overview Vitamin D Dose-Response
• All items in category How Much Vitamin D 332 items
• All items in category Middle East and Vitamin D 132 items
  Note the very low vitamin D levels in the Middle East
  Since there was no vitamin D loading dose, the vitamin D levels were probably still increasing after the final blood test