An effective oral vitamin D replacement therapy in persons with spinal cord injury
Authors: Bauman, William A.1; Emmons, Racine R.1; Cirnigliaro, Christopher M.1; Kirshblum, Steven C.2; Spungen, Ann M.1
Journal of Spinal Cord Medicine, Volume 34, Number 5, September 2011 , pp. 455-460(6)
Background/objective: Vitamin D deficiency is prevalent in chronic spinal cord injury (SCI). A 3-month course of oral vitamin D3 to ‘normalize’ serum vitamin D levels was investigated.
Design: Prospective drug-intervention study.
Setting: VA Medical Center; private rehabilitation facility.
Methods: Seven individuals with chronic SCI and vitamin D deficiency completed 3 months of oral vitamin D3 (i.e. cholecalciferol) supplementation. At screening, baseline, and months 1 and 3, blood was collected for serum calcium, 25 hydroxyvitamin D [25(OH)D], intact parathyroid hormone (iPTH), and N-telopeptide (NTx); 24-hour urine for calcium, creatinine, and NTx was performed.
Oral vitamin D3 (2000 IU daily) and elemental calcium (1.3 g daily) were prescribed for 90 days. The results are expressed as mean ± standard deviation (SD). Analysis of variance with a Fisher's post-hoc analysis was performed to test for differences between study visits.
Subjects were classified as deficient (<20 ng/ml), relatively deficient (20-30 ng/ml), or not deficient (>30 ng/ml) in 25(OH)D.
Results: Serum 25(OH)D levels were greater at months 1 and 3 than at baseline (26 ± 6 and 48 ± 17 vs. 14 ± 2 ng/ml; P = 0.005). Six of seven subjects were no longer deficient [25(OH)D >30 ng/ml] by month 3. Serum iPTH levels were significantly decreased at month 1 and month 3; serum NTx levels were significantly lower at month 3 than at baseline. Serum and urinary calcium levels remained within the normal range.
Conclusion: A daily prescription of 2000 IU of oral vitamin D3 for 3 months safely raised serum 25(OH)D levels into the normal range in persons with chronic SCI on calcium supplementation.
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2,000 IU vitamin D 14 ng ==> 48 ng at 3 months
Suspect one or more of the following (to account for the large dose response)
Few were obese
Few were pregnant
During the summer and the patients got outdoors
Few had medical conditions which consume, restrict conversion, or restrict absorption of vitamin D
Injury happened years before the vitamin D therapy - so the body was till not in trauma and consuming a lot of the dose
See also VitaminDWiki
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