Vitamin D: Daily vs. Monthly Use in Children and Elderly—What Is Going On?

Nutrients 2017, 9(7), 652; doi:10.3390/nu9070652

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Luca Dalle Carbonare 1, OrcID, Maria Teresa Valenti 1, Francesco del Forno 1, Elena Caneva 2 and Angelo Pietrobelli 2,3
1 Clinic of Internal Medicine, section D, Department of Medicine, University of Verona, Verona 37134, Italy
2 Pediatric Unit, Verona University Medical School, Verona 37122, Italy
3 Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA

Vitamin D deficiency is highly prevalent among children and adults worldwide. Agreement exists that vitamin D deficiency should be corrected. However, the definitions of vitamin deficiency and effective vitamin D replacement therapy are inconsistent in the literature. Not only is the dosing regimen still under debate, but also the time and period of administration (i.e., daily vs. monthly dose). In pediatric as well as elderly subjects, dosing regimens with high vitamin D doses at less frequent intervals were proposed to help increase compliance to treatment: these became widespread in clinical practice, despite mounting evidence that such therapies are not only ineffective but potentially harmful, particularly in elderly subjects. Moreover, in the elderly, high doses of vitamin D seem to increase the risk of functional decline and are associated with a higher risk of falls and fractures. Achieving good adherence to recommended prophylactic regimens is definitely one of the obstacles currently being faced in view of the wide segment of the population liable to the treatment and the very long duration of prophylaxis.

The daily intake for extended periods is, in fact, one of the frequent causes of therapeutic drop-outs, while monthly doses of vitamin D may effectively and safely improve patient compliance to the therapy. The aim of our paper is a quasi-literature review on dosing regimens among children and elderly. These two populations showed a particularly significant beneficial effect on bone metabolism, and there could be different outcomes with different dosing regimens.