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Vitamin D loading dose was as effective as daily dosing (rickets in this case) – RCT July 2021

Low Dose Depot Oral Vitamin D3 Versus Daily Oral Vitamin D3 for Treating Nutritional Rickets: A Randomized Clinical Trial

Br J Nutr. 2021 Jul 19;1-18. doi: 10.1017/S0007114521002713
Ravneet Kaur Saluja 1, Pooja Dewan 1, Sunil Gomber 1, S V Madhu 2, Shuchi Bhatt 3, Piyush Gupta 1

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Note; Radiological healing if Thatcher Score <1.5

VitaminDWiki

For infants:  2,000 IU daily  or single dose of 60,000 IU
For 1-5 year:  4,000 IU daily  or single dose of 150,000 IU

Wonder why they call 60,000 IU or 150,000 IU low doses


Better than Daily has the following

Non-daily (Bolus) is sometimes better - Possible reasons include:

  1. Better compliance
    • Fewer opportunities to forget
    • Fewer times to have to take a pill - for those who dislike it
  2. High concentration resulting from infrequent dosing gets past some gene and gut limitations
    • Note: Many studies have found non-daily to be better than daily
      I am unaware of a single study which has found daily to be better than non-daily - Founder of VitaminDWiki Dec 2019

Overview of Rickets and vitamin D contains the following summary

Rate of rickets is usually < 0.1% of births, unless dark skin or breastfed
Rate of rickets has greatly increased with the drop in vitamin D levels during the past 40 years
400 IU can prevent/treat most rickets Turkey gave vitamin D to EVERY child and eliminated Rickets
A low serum level of vitamin D does not indicate rickets
Sometimes rickets is also associated with a poor vitamin D receptor
Giving enough Vitamin D to the mother PREVENTS Rickets
Rate of rickets in some countries varies from 10% to 70% (typically poor health overall)
Rickets has been more than doubling in many countries
Rickets is strongly associated with severe breathing problems (weak ribs)
Bowed legs is not the primary indication of rickets (3 other indications of rickets are seen more often)
Vitamin D and Rickets consensus took 80 years

Rickets category has 123 items

Loading Dose of Vitamin D category has the following

171 items in category
see also Overview Loading of vitamin D   Overview Toxicity of vitamin D
Injection category listing has 58 items
 
It appears that over 1 million Vitamin D loading doses have been taken
Doses ranged from 100,000 to 600,000 IU over a period of a day to a month
No reports of adverse reactions
Many studies report on the benefits resulting from loading doses

The TOP articles in Loading Dose of Vitamin D are listed here:


Pages in both categories Infant/Child and Loading Dose:

 Download the PDF from VitaminDWiki

Objective: To compare the efficacy of daily versus low dose depot oral vitamin D3 for treating nutritional rickets.

Design: Randomized Controlled Trial.

Setting: Paediatrics department of a tertiary care hospital catering to semi-urban and rural population in Delhi, India.

Methods: We randomized 66 children aged 3 months to 5 years with nutritional rickets to receive either daily oral vitamin D3 drops (3-12 months: 2000 IU; >12 months-5y: 4000 IU; n=33) for 12 weeks duration, or a single oral depot dose of vitamin D3 granules (3-12 months: 60,000 IU; >12 months-5y: 150,000 IU; n=33).

Results: Participants in both groups had comparable demographic characteristics, laboratory features and radiological severity of rickets. 33 participants in each group received the assigned intervention and all were followed up till 12 weeks. At 12 weeks follow up, children in both groups showed a significant improvement in all biochemical parameters [serum calcium, phosphorus, alkaline phosphatase, parathormone and 25(OH) vitamin D levels] as well as radiological healing. At 12 weeks, the mean (SD) serum 25(OH) vitamin D levels (nmol/L) were statistically comparable in both groups [daily: 120.2 (83.2), depot: 108 (74), P=0.43] and 31 (94%) children in each group had radiological healing (Thacher score <1.5). Two children in each group persisted to have raised alkaline phosphatase and one child each in the daily group continued to have hypocalcemia and hypophosphatemia at 12 weeks.

Conclusion: Low dose oral depot vitamin D3 is an effective alternative to daily oral vitamin D3 for nutritional rickets.


Created by admin. Last Modification: Monday July 19, 2021 15:36:45 GMT-0000 by admin. (Version 7)

Attached files

ID Name Comment Uploaded Size Downloads
15932 Rickets RCT.pdf PDF 2021 admin 19 Jul, 2021 12:11 478.17 Kb 2
15931 Rickets RCT table.jpg admin 19 Jul, 2021 12:10 131.26 Kb 49
15930 Rickets RCT.png admin 19 Jul, 2021 12:10 178.08 Kb 2
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