Daily versus fortnightly oral vitamin D3 in treatment of symptomatic vitamin D deficiency in children aged 1-10 years: An open labelled randomized controlled trial
Clin Endocrinol (Oxf) . 2024 Aug 13. doi: 10.1111/cen.15124 PDF is behind a paywall
Kumar Arghya Prasanna Mondal 1, Preeti Singh 1, Ritu Singh 2, Rajeev Kumar Malhotra 3, Anju Seth 1
Objective: Compare the efficacy and safety of daily versus fortnightly oral vitamin D3 in treating symptomatic vitamin D deficiency in children aged 1-10 years.
Design: Open labelled randomized controlled trial.
Patients: Eighty children with symptomatic vitamin D deficiency were randomized into group daily (D) and group bolus (B) [40 in each group] to receive oral vitamin D3, 4000 IU daily or 60,000 IU fortnightly for 12 weeks respectively. Both groups received daily oral calcium of 500 mg/day.
Measurements: Serum calcium (Ca), phosphate (P), alkaline phosphatase (ALP), 25-hydroxy cholecalciferol (25(OH)D), parathyroid hormone (PTH) levels, urine calcium: creatinine ratio and radiological score were assessed at baseline, 4 weeks and 12 weeks. At the end of 12 weeks, 74 children were available for evaluation of the efficacy and safety of both regimens.
Results: Both regimens led to a significant increase in Ca and P levels and a fall in ALP and PTH levels from baseline to 4 and 12 weeks of therapy, with no intergroup difference. At 4- and 12-week assessments, all children in both treatment arms achieved 25(OH)D level in sufficiency range, with no significant difference in their geometric mean. Both regimens were associated with asymptomatic transient hypercalcemia [group D-51.4% vs. group B-34.3%; p -0.14] and hypercalciuria (5.7%) in group D that resolved spontaneously on follow-up.
Conclusions: Daily and fortnightly oral vitamin D3 in similar cumulative doses are efficacious for treating symptomatic vitamin D deficiency in children (1-10 years). Treated children should be monitored for serum 25(OH)D, Ca and urinary calcium creatinine ratio.
VitaminDWiki – Monthly vitamin D dosing better for children than daily (again) - Oct 2023
VitaminDWiki – Better than Daily contains:
Non-daily (Bolus) is better:
- Better compliance for everyone
- Fewer opportunities to forget.
- If happen to forget, just take the dose many days later
- Fewer times to have to take a pill - for those who dislike doing so
- Non-daily gets more vitamin D to the cells for the ~20% who have a poor Vitamin D Receptor
- A high concentration gradient is one of 14+ ways to get past Vitamin D Receptor limitations
- So, while 80% get no extra benefit from non-daily dosing, 20% will get an extra benefit
- Weekly Vitamin D better than daily – lower cost, less pill burden, perhaps 1.5X better response – meta-analysis Oct 2024
- Vitamin D given daily, weekly, or monthly has similar response (116 RCTs) – meta-analysis Aug 2023
- 44 percent of successful RCTs in VitaminDWiki used non-daily dosing - Nov 2020
- Monthly vitamin D dosing better for children than daily (again) - Oct 2023
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