Efficacy of daily 800 IU vitamin D supplementation in reaching vitamin D sufficiency in nursing home residents: cross-sectional patient file study.
BMC Geriatr. 2014 Sep 19;14(1):103. [Epub ahead of print]
Veleva BI, Chel VG, Achterberg WP.
Nursing Home: Average age 82
Capsule (powder or solid?): mean vitamin D = 36 ng, 0% < 12 ng
Drop : mean vitamin D = 16 ng, 32 % < 12 ng
Drop users were 35 X more likely to be insufficient at the end of the study
Possible problems of drops include
- Intestines do not process active vitamin D as well as you age – June 2012
content of capsules might be more bio-available
BACKGROUND:
The Dutch Health Council advises a standard daily vitamin D supplementation of 800 IU (20 mcg) for persons aged >= 70 years, with a target 25(OH)D serum concentration of >= 50 nmol/l. This recommendation is in line with advice from the Institute of Medicine (IOM) (2011) and the Expert Working Group on vitamin D (2012). A target 25(OH)D serum concentration of >= 75 nmol/l is also recommended in the literature. It is unknown whether this advice, initially designed for healthy adults/elderly, will lead to vitamin D sufficiency in the large majority of nursing home residents, taking into account the frailty of this population.
METHODS:
Cross-sectional patient file study. Participants were 71 psychogeriatric nursing home residents (25 males, 46 females) with a mean age of 83 (SD 7) years using cholecalciferol capsules (5600 IU) once a week, or cholecalciferol drops (50,000 IU/ml) 3 drops a week (7500 IU), for at least 3 months. Main outcome measure was serum 25(OH)D level after supplementation.
RESULTS:
Of all participants, 19 used cholecaliferol drops and 52 used cholecaliferol capsules. In total, mean serum 25(OH)D was 77 (SD 30) nmol/L and 55 residents (78%) were vitamin D sufficient. Among capsule users, mean serum 25(OH)D was 90 (SD 22) nmol/L and 49 (94%) were vitamin D sufficient. Among users of drops, mean serum 25(OH)D was 41 (SD 8) nmol/L and 6 (32%) were vitamin D sufficient.
CONCLUSION:
In most of these residents, vitamin D supplementation once a week with cholecalciferol capsules containing 5600 IU (equivalent to 800 IU daily) resulted in vitamin D sufficiency (serum 25(OH)D >= 50 nmol/L). When choosing a vitamin D preparation for routine supplementation in nursing home residents it should be noted that major differences may exist in efficacy, even when the various preparations contain the same amount of vitamin D.
PMID: 25238786
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See also VitaminDWiki
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- 4700 IU of vitamin D needed by most seniors – an equation -July 2014
- Vitamin D for Italians – Senior 2300 IU, if deficient loading dose of at least 300,000 IU– Med Society 2011
- 13 reasons why many seniors need more vitamin D (both dose and level) - July 2023 has the following
- Senior skin produces 4X less Vitamin D for the same sun intensity
- Seniors have fewer vitamin D receptor genes as they age
Receptors are needed to get Vitamin D in blood actually into the cells - Many other Vitamin D genes decrease with age
- Since many gene activations are not detected by a blood test,
more Vitamin D is often needed, especially by seniors - Seniors are indoors more than when they were younger
not as agile, weaker muscles; frail, no longer enjoy hot temperatures - Seniors wear more clothing outdoors than when younger
Seniors also are told to fear skin cancer & wrinkles - Seniors often take various drugs which end up reducing vitamin D
Some reductions are not detected by a vitamin D test of the blood
statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc - Seniors often have one or more diseases that consume vitamin D
osteoporosis, diabetes, Multiple Sclerosis, Cancer, ... - Seniors generally put on weight as they age - and a heavier body requires more vitamin D
- Seniors often (40%) have fatty livers – which do not process vitamin D as well
- Reduced stomach acid means less Magnesium is available to get vitamin D into the cells
- Vitamin D is not as bioavailable in senior intestines
- Seniors with poorly functioning kidneys do not process vitamin D as well
- Glutathione (which increases Vitamin D getting to cells) decreases with age
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