Vitamin D for Italians – Senior 2300 IU, if deficient loading dose of at least 300,000 IU– Med Society 2011

[Guidelines on prevention and treatment of vitamin D deficiency.

    Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS)].

Reumatismo. 2011 Nov 9;63(3):129-47. doi: 10.4081/reumatismo.2011.129. [Article in Italian]

Adami S1, Romagnoli E, Carnevale V, Scillitani A, Giusti A, Rossini M, Gatti D, Nuti R, Minisola S;

Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS).

1Unità di Reumatologia, Dipartimento di Medicina, Università di Verona, Roma, Italia. Silvano.adami@univr.it

The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has elaborated the following guidelines about the definition, prevention and treatment of inadequate vitamin D status. The highlights are presented here.

Daily vitamin D allowance ranges from

• 1,500 IU (healthy adults) to

• 2,300 IU (elderly with low calcium intake).

Since the average Italian diet includes around 300 IU/day,

• subjects with no effective sun exposure should be supplemented with 1,200-2,000 IU vitamin D per day.

The serum 25-hydroxy-vitamin D [25(OH)D] levels represents the most accurate way to assess vitamin D repletion, even though there are still no standardized assay methods.

Conditions of “deficiency” and “insufficiency” are defined by the following ranges of 25(OH)D levels: less than 20 ng/ml and 20-30 ng/ml, respectively.

In Italy, approximately 50% of young healthy subjects have vitamin D insufficiency during the winter months.

The prevalence of deficiency increases with ageing, affecting almost all elderly subjects not on vitamin D supplements.

When a condition of deficiency has been identified, a

cumulative dose of 300,000-1,000,000 IU, over 1-4 weeks is recommended .

In subjects recently treated for deficiency-insufficiency, a

maintenance dose of 800-2,000 IU/day (or weekly equivalent) is recommended .

In patients on daily doses over 1,000 IU, 25(OH)D levels should be checked regularly (e.g. once every two years).

The highest tolerated daily dose has been identified as 4,000 IU/day.

Vitamin D supplementation should be carefully monitored in patients at higher risk of vitamin D intoxication (granulomatosis) or with primary hyperparathyroidism.

In pregnant women, vitamin D supplements should be given as in non-pregnant women, but bolus administration (i.e.: single dose >25,000 IU) should be avoided.

PMID: 22257914

Italian PDF is attached at the bottom of this page

Author replied to VitaminDWiki March 2014 The official guidelines are going to be updated shortly …

which we take to mean about Summer 2014

See also VitaminDWiki

• Vitamin D Deficiency

• Italian youth vitamin D deficiency increased likelihood: 27X if winter, 5X if obese, etc. – Aug 2013

• Vitamin D is the only vitamin which is low in Europe – Jan 2013

• Many Italian seniors garden, have high levels of vitamin D and are healthy - April 2012

• Overview Loading of vitamin D 300,000 to 600,000 is common

• Loading Dose of Vitamin D category listing