800 IU vitamin D in capsule form (but not drops) helped nursing home residents – Sept 2014

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.

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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• Vitamin D for Italians – Senior 2300 IU, if deficient loading dose of at least 300,000 IU– Med Society 2011
• 10 reasons why seniors need more vitamin D has the following

1. Senior skin produces 3X less Vitamin D for the same sun intensity
2. Seniors have fewer vitamin D receptors as they age
3. Seniors are indoors more than than when they were younger
   • not as agile, weaker muscles; frail, no longer enjoy hot temperatures
   • (if outside, stay in the shade), however, seniors might start outdoor activities like gardening, biking, etc.
4. Seniors wear more clothing outdoors than when younger
   • Seniors also are told to fear skin cancer/wrinkles
5. Seniors often take various drugs which reduce vitamin D
   • Some reductions would not show up on vitamin D test
   • statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc
6. Seniors often have one or more diseases which consume vitamin D
   • osteoporosis, diabetes, MS, ...
7. Seniors generally put on weight at they age - and a heavier body requires more vitamin D
8. Seniors often (40%) have fatty livers – which do not process vitamin D as well
9. Reduced stomach acid ==>less Magnesium needed to utilize vitamin D
   (would not show up on vitamin D test)
10. Seniors with poorly functioning kidneys do not process vitamin D as well
    (would not show up on vitamin D test) 2009 full text online  Also PDF 2009
11. Vitamin D is not as bioavailable in senior digestive systems (Stomach acid or intestines?)

• Category Seniors and Vitamin D 393 items