High-Dose Vitamin D Intervention in Infants
--Effects on Vitamin D Status, Calcium Homeostasis, and Bone Strength.
J Clin Endocrinol Metab. 2012 Aug 29.
Holmlund-Suila E, Viljakainen H, Hytinantti T, Lamberg-Allardt C, Andersson S, Mäkitie O.
Children's Hospital (E.H.-S., H.V., S.A., O.M.), University of Helsinki and Helsinki University Central Hospital, 00029 Helsinki, Finland; Helsinki Maternity Hospital (T.H.), 00029 Helsinki, Finland; Calcium Research Unit (C.L.-A.), Department of Food and Environmental Sciences (Nutrition), University of Helsinki, 00014 Helsinki, Finland; and Folkhälsan Research Center (O.M.), 00014 Helsinki, Finland.
Context:Guidelines in Finland recommend 10 ?g of vitamin D3 daily for all infants.
Recent observations suggest that this may be insufficient to maintain optimal serum 25-hydroxyvitamin D (S-25-OHD).
Objective:The aim of the study was to evaluate effects of various vitamin D doses and determine a dose ensuring S-25-OHD of at least 80 nmol/liter in infants without signs of vitamin D excess.
Design:We conducted a randomized double-blind intervention study.
Cord blood was obtained at birth for S-25-OHD; 113 infants were randomized to receive vitamin D3 10, 30, or 40 ?g/d from age 2 wk to 3 months.
Setting:An investigator-initiated study was performed in a single maternity hospital in Helsinki, Finland.
Main Outcome Measures:S-25-OHD, calcium homeostasis, and skeletal characteristics were evaluated with peripheral quantitative computed tomography at age 3 months.
Results:Baseline S-25-OHD was similar in all three groups (median, 53 nmol/liter).
At 3 months, the mean S-25-OHD values were 88, 124, and 153 nmol/liter, and the minimum values were 46, 57, and 86 nmol/liter in the groups receiving 10, 30, and 40 ?g (ANOVA; P < 0.001).
No hypercalcemia occurred; plasma calcium, serum PTH, and urine calcium excretion was similar between the groups.
Peripheral quantitative computed tomography showed a trend toward larger tibial total bone and cortical bone area with higher vitamin D doses.
Conclusion:Vitamin D3 supplementation with up to 40 ?g/d from age 2 wk to 3 months was safe and caused no hypercalcemia or hypercalciuria.
The 40-?g dose maintained S-25-OHD above 80 nmol/liter in all infants.
More extensive and longer intervention studies are necessary to assess long-term effects.
PDF is attached at the bottom of this page
1600 IU of vitamin D was need to keep levels above 32 nanograms in all infants.
It is great that they considered > 20 nanograms to be needed
Strange that they did not seem to consider a dosing level proportional to weight
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