50,000 IU vitamin D suggested to prevent osteoporosis (weekly then monthly)

Vitamin D Supplementation in France in patients with or at risk for osteoporosis: Recent data and new practices

Joint Bone Spine. online 30 April 2019 https://doi.org/10.1016/j.jbspin.2019.04.004

With intermittent vitamin D supplementation, serum 25-hydroxyvitamin D (25OHD) levels may remain stable only if the dosing interval is shorter than 3 months, the ideal perhaps being about 1 month. Recent data support moderate daily vitamin D doses instead of high intermittent doses, notably in elderly patients prone to falls. The level of evidence is low, however, with no head-to-head comparisons of clinical outcomes such as fractures and falls in groups given identical dosages daily versus intermittently. A challenge to daily vitamin D supplementation in France is the absence of a suitable pharmaceutical formulation. In addition, daily dosing carries a high risk of poor adherence. Until suitable vitamin D3 formulations such as tablets or soft capsules each containing 1000 or 1500 IU become available, we suggest intermittent supplementation according to 2011 GRIO guidelines. Among the available dosages, the lowest should be preferred, with the shortest possible interval, e.g., 50,000 IU monthly rather than 100,000 every two months.

Extracted from Graphical Summary on the web

In patients with or at risk for osteoporosis Until daily dosing becomes feasible, intermittent dosing should remain standard practice, with the lowest available dosages and shorter dosing intervals. This strategy probably improves adherence compared to daily dosing.

Start with a loading phase

50 000 IU of vitamin D3 per week for 8 weeks in patients whose 250HD is <20 ng/mL

50 000 IU of vitamin D3 per week for 4 weeks in patients whose 250HD is between 20 and 30 ng/mL

After this loading phase , prescribe long-term supplementation: 50 000 IU of vitamin D3 per month

After 3-6 months of this long-term supplementation, repeat the 250HD If 250HD is still <30 ng/mL

either shorten the dosing interval (e.g., 50 000 IU every 2 weeks)

or increase the dosage (e.g., to 80 000 or 100 000 IU each month)

If 250HD is >60 ng/mL (extremely rare)

The only possibility contradicts the recommendations above:

increase the dosing interval (e.g., 50 000 UI every 2 months) until lower dosages become available

* Osteoporosis treatment – Vitamin D is the most cost-effective – April 2019 * Osteoporosis treatment guidelines by US Endocrinology groups – Sept 2016 1. Overview Osteoporosis and vitamin D contains the following summary {include} --- 1. Osteoporosis category includes the following {include}