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300,000 IU every 3 months helped raise vitamin D levels in half of RA patients – April 2012

Can one or two high doses of oral vitamin D3 correct insufficiency in a non-supplemented rheumatologic population?

D. Stoll, J. Dudler, O. Lamy, D. Hans, M. A. Krieg and B. Aubry-Rozier
Osteoporosis International, April 2012, DOI: 10.1007/s00198-012-1962-5

Summary: We evaluated the effectiveness of supplementation with high dose of oral vitamin D3 to correct vitamin D insufficiency. We have shown that one or two oral bolus of 300,000 IU of vitamin D3 can correct vitamin D insufficiency in 50% of patients and that the patients who benefited more from supplementation were those with the lowest baseline levels.

Introduction: Adherence with daily oral supplements of vitamin D3 is suboptimal. We evaluated the effectiveness of a single high dose of oral vitamin D3 (300,000 IU) to correct vitamin D insufficiency in a rheumatologic population.

Methods: Over 1 month, 292 patients had levels of 25-OH vitamin D determined. Results were classified as: deficiency <10 ng/ml, insufficiency ?10 to 30 ng/ml, and normal ?30 ng/ml. We added a category using the IOM recommended cut-off of 20 ng/ml.

Patients with deficient or normal levels were excluded, as well as patients already supplemented with vitamin D3.

Selected patients (141) with vitamin D insufficiency (18.5 ng/ml (10.2–29.1) received a prescription for 300,000 IU of oral vitamin D3 and were asked to return after 3 (M3) and 6 months (M6). Patients still insufficient at M3 received a second prescription for 300,000 IU of oral vitamin D3. Relation between changes in 25-OH vitamin D between M3 and M0 and baseline values were assessed.

Results: Patients (124) had a blood test at M3. Two (2%) had deficiency (8.1 ng/ml (7.5–8.7)) and 50 (40%) normal results (36.7 ng/ml (30.5–5.5)). Seventy-two (58%) were insufficient (23.6 ng/ml (13.8–29.8)) and received a second prescription for 300,000 IU of oral vitamin D3. Of the 50/124 patients who had normal results at M3 and did not receive a second prescription, 36 (72%) had a test at M6. Seventeen (47%) had normal results (34.8 ng/ml (30.3–42.8)) and 19 (53%) were insufficient (25.6 ng/ml (15.2–29.9)). Of the 72/124 patients who receive a second prescription, 54 (75%) had a test at M6. Twenty-eight (52%) had insufficiency (23.2 ng/ml (12.8–28.7)) and 26 (48%) had normal results (33.8 ng/ml (30.0–43.7)). At M3, 84% patients achieved a 25-OH vitamin D level >20 ng/ml. The lowest the baseline value, the highest the change after 3 months (negative relation with a correlation coefficient r?=??0.3, p?=?0.0007).

Conclusions
We have shown that one or two oral bolus of 300,000 IU of vitamin D3 can correct vitamin D insufficiency in 50% of patients.


Summary and observation by VitaminDWiki

  • They did not include people with < 10 ng
    They would have needed even more vitamin D
  • They did not include people with > 30 ng
  • 300,000 IU for 90 days = 3,333 IU daily average
  • Suspect there was no increase in bone density since no co-factors to build bone were given (Magnesium, Vitamin K2, Boron, Silicon, etc.)
  • No mention of reduced pain, etc.
  • 3 months is a very long time. Many studies have shown that 1 month provides much better results
    VitaminDWiki would suggest 100,000 every month to get the same average
  • Many other studies have not found benefits until blood levels are > 40 nanograms
    Which would have required higher average intake of vitamin D than was given
    VitaminDWiki would suggest 200,000 every month = 50,000 every week to achieve beneficial vitamin D levels (> 40 nanograms) for those who started with levels > 10 nanograms.

Recall: 300,000 IU over 90 days = 3333 IU/day – as an average, but it is not.
Summary by VitaminDWiki

3 month had 300,000 IU 6 month had 600,000 IU
60% still < 20 ng48% had 34 ng, 16% still < 20 ng

See also VitaminDWiki

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