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Much more than 2,000 IU of vitamin D is needed daily (Middle East studies agree) – meta-analysis Nov 2016

Impact of vitamin D replacement in adults and elderly in the Middle East and North Africa: a systematic review and meta-analysis of randomized controlled trials.

Osteoporos Int. 2016 Nov 22. [Epub ahead of print] DOI: 10.1007/s00198-016-3837-7
Chakhtoura M1, Akl EA2, El Ghandour S2, Shawwa K2, Arabi A3, Mahfoud Z4, Habib RH2, Hoballah H2, El Hajj Fuleihan G3.

  • This meta-analysis of several Randomized Controlled Trials found that to get to just 20 ng/mL of vitamin D that more than 2,000 IU would be needed

  • Many previous studies have found that to achieve 30 ng/mL that 4,000 IU is needed

  • More than 4,000 IU of vitamin D is needed if:
    avoid the sun
    wear excessive clothing
    have various health problems
    pregnant or breastfeeding.

See also VitaminDWiki

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In the Middle East and North Africa (MENA), a vitamin D dose =2000 IU/day may be needed to allow to the majority of the population to reach the target 25-hydroxyvitamin D (25(OH)D) level =20 ng/ml. Data in the region on the effect of vitamin D supplementation on various skeletal and extra-skeletal effects are scarce.

Hypovitaminosis D is prevalent worldwide, more so in the Middle East and North Africa (MENA). This study aims to determine the effects of vitamin D replacement on the mean difference in 25-hydroxyvitamin D [25(OH)D] level reached and other outcomes, in the MENA.

This is a meta-analysis of randomized trials from the MENA, administering vitamin D supplementation for at least 3 months, without language or time restriction. We conducted a comprehensive search in seven databases until July 2015. We abstracted data from published reports, independently and in duplicate. We calculated the mean difference (MD) and 95 % CI of 25(OH)D level reached for eligible comparisons, and pooled data using RevMan version 5.3.

We identified 2 studies in elderly and 17 in adults; for the latter, 11 were included in the meta-analysis. Comparing a high vitamin D dose (>2000 IU/day) to placebo (nine studies), the MD in 25(OH)D level achieved was 18.3 (CI 14.1; 22.5) ng/ml; p value < 0.001; I 2 = 92 %. Comparing an intermediate dose (800-2000 IU/day) to placebo (two studies), the MD in 25(OH)D level achieved was 14.7 (CI 4.6; 24.9) ng/ml; p value 0.004; I 2 = 91 %. Accordingly, 89 and 71 % of participants, in the high and intermediate dose groups, respectively, reached the desirable level of 20 ng/ml. The risk of bias in the included studies was unclear to high, except for three studies.

In the MENA region, vitamin D doses =2000 IU/day may be needed to reach the target 25(OH)D level =20 ng/ml. The long-term safety and the efficacy of such doses on various outcomes are unknown.

PMID: 27878316 DOI: 10.1007/s00198-016-3837-7