Overview Loading of vitamin D

Loading dose: studies at VitaminDWiki

Vitamin D loading dose (stoss therapy) proven to improve health overview

If a person is or is suspected to be, very vitamin D deficient a loading dose should be given

• Loading = restore = quick replacement by 1 or more doses

• Loading doses range in total size from 100,000 IU to 1,000,000 IU of Vitamin D3

  • = 2.5 to 25 milligrams

• The size of the loading dose is a function of body weight - see below

  • Unfortunately, some doctors persist in using Vitamin D2 instead of D3

• Loading may be done as quickly as a single day (Stoss), to as slowly as 3 months.

  • It appears that spreading the loading dose over 4+ days is slightly better if speed is not essential

• Loading is typically oral, but can be Topical

• Loading dose is ~3X faster if done topically or swished inside of the mouth

  • Skips the slow process of stomach and intestine, and might even skip liver and Kidney as well

• The loading dose persists in the body for 1 - 3 months

  • The loading dose should be followed up with on-going maintenance dosing

  • Unfortunately, many doctors fail to follow-up with the maintenance dosing.

• About 1 in 300 people have some form of a mild allergic reaction to vitamin D supplements, including loading doses

  • it appears prudent to test with a small amount of vitamin D before giving a loading dose

  • The causes of a mild allergic reaction appear to be: (in order of occurrence)

  • 1) lack of magnesium - which can be easily added

  • 2) allergy to capsule contents - oil, additives (powder does not appear to cause any reaction)

  • 3) allergy to the tiny amount of D3 itself (allergy to wool) ( alternate: D3 made from plants )

  • 4) allergy of the gut to Vitamin D - alternative = topical

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Cholecalciferol loading dose guideline for vitamin D-deficient adults.

Eur J Endocrinol. 2010 Apr;162(4):805-11. Epub 2010 Feb 5.

CONCLUSION: The cholecalciferol loading dose required to reach the serum 25-OHD(3) target level of 75 nmol/l can be calculated as follows:

dose (IU)=40x(75 - serum 25-OHD(3))xbody weight.

Download the PDF from VitaminDWiki

To use ng and pound multipy by 35 instead of 40

      Dose to get 30 ng (in ng and pounds) = 35 x (30 - serum 25-OHD(3)) x body weight.

Typically spread over 8 weeks

A very commonly prescribed loading dose in the US is 50,000 IU per week for 8 weeks, for a total of 400,000 IU

Example uses of the equation to achieve 30 ng (on average)

Dose	starting level	weight
140,000 IU	10 ng	200 lb
70,000 IU	20 ng	200 lb
105,000 IU	10 ng	150 lb

Dose to get 50 ng (in ng and pounds) = 35 x (50 - serum 25-OHD(3)) x body weight.

Example uses of the equation to achieve 50 ng (on average)

Dose	starting level	weight
280,000 IU	10 ng	200 lb
210,000 IU	20 ng	200 lb

There is a HUGE variation in response between individuals for the average (equation)

Response to weekly or biweekly dosing

for a total of 100,000 IU, 150,000 IU, and 200,000 IU vary a lot between individuals

[tiki-download_file.php?fileId=1592]

153 studies cited this study as of Feb 2023

• Vitamin D oral intermittent treatment (DO IT) study, a randomized clinical trial with individual loading regimen - Sept 2021

  • 300,000 loading dose got average to 30 ng 📄 PDF

• Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths - April 2020

  • founder of VitaminDWiki is a co-author

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3 day response time to a loading dose

• 600000 IU dose raised youth vitamin D level by 60 ng in 3 days – July 2010 60 ng 16 ng ==> 77 ng
  • 62 ng after 30 days

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See also at VitaminDWiki

• Vitamin D loading dose (stoss therapy) proven to improve health

• Large single dose of more than 300,000 IU of vitamin D works well for 3 months – Review Nov 2013

• Vitamin D loading doses of up to 400,000 IU OK for adolescents – meta-analysis Dec 2014

• Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016

• 400,000 IU of vitamin D reduced adult pain and improved quality of life – March 2014

• 300,000 IU loading dose of vitamin D stopped gestational diabetes in RCT – Oct 2011

• 300,000 IU vitamin D helped seniors in many ways – May 2011

• Vitamin D3 loading dose of 500,000 IU for elderly – Aug 2009

• Loading dose of 500,000 IU for elderly - Whiting 2010 PDF file

• 540000 IU before ICU raised vitamin D by 25 ng in 2 days – March 2011 25 ng

• Will lots of vitamin D help in ICU – RCT Nov 2012 540,000 loading dose

• Single 600,000 IU dose raised youth vitamin D level by 60 ng in just 3 days – July 2010

• 600,000 IU vitamin D normalized virtually all seniors in 3 months – May 2012

• Variety of vitamin D loading dose recommendations in the UK

• Can You Overdose on Vitamin D - It's Harder Than You Think

• Doctors now able to prescribe vitamin D3 as of March 2012

• Many reasons why vitamin D deficiency has become epidemic

• Must balance co-factors when increasing vitamin D

• Vitamin D Replentishment – Feb 2012 Plotnikoff

• Overview Rare Allergic reaction to vitamin D about 1 in 300 people

• Huge gap between vitamin D advice and actual prescriptions – April 2012

  • only 1.4% of those with < 10 nanograms of vitamin D got any loading dose

• Overview Toxicity of vitamin D >2,000,000 every day for a week is toxic

• Guideline following hip fracture – 50000 IU vitamin D daily for 7 days – Jan 2013

  • daily, with no testing needed, 40 ng : 12 ng ==> 52 ng ( 350,000 IU, measured on day 14)

• Review of Vitamin D (including free, frequency, injection, how much.) – Sept 2013

• Better than Daily category listing has items along with related searches

  • Unaware of a single study which found that daily was best

• Healthy in Seven Days - Loading dose of Vitamin D – book 2014 has the following chart

600,000 vitamin D loading doses – good response to both oral and muscular – Oct 2015 has the following

Dose	>20 ng	Level
600,000 IU IM	94%	30 ng
600,000 IU oral	83%	20 ng
200,000 IU IM	88%	18 ng
200,000 IU oral	71%	14 ng

Take vitamin D3 daily, weekly, or bi-weekly has the following

Response to a single dose of 100,000 IU starting at 27 ng/ml, half life is about 50 days

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pages are in both categories: Intervention AND Loading Dose

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pages are in both categories: Trauma/Surgery AND Loading Dose

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