Relative Efficacy of Vitamin D2 and Vitamin D3 in Improving Vitamin D Status: Systematic Review and Meta-Analysis
Nutrients 2021, 13(10), 3328; https://doi.org/10.3390/nu13103328 (registering DOI)
by Rakesh Balachandar 1 , Raghu Pullakhandam 2 , Bharati Kulkarni 2,* and Harshpal Singh Sachdev 3
1 ICMR-National Institute of Occupational Health, Ahmedabad 380016, India
2 ICMR-National Institute of Nutrition, Hyderabad 500007, India
3 Sitaram Bhartia Institute of Science and Research, New Delhi 110016, India
Vitamin D3 instead of D2 category in VitaminDWiki starts withSome of the
- Overview Vitamin D3 not D2
- Physicians Desk Reference still only lists D2, but not Vitamin D3 – Feb 2022
- Vitamin D3 better than D2, especially if non-daily or high dose - meta-analysis Sept 2021
- It’s Time to Say “Goodbye” to Vitamin D2 - 2015
- Vitamin D2 decreases levels of D3 (again) and visa versa – RCT Jan 2019
- It’s (way past) time to stop prescribing with Vitamin D2 (ergocalciferol) – Oct 2018
- If you have a vitamin D prescription, be sure that it is for D3– June 2017
- Vitamin D reduces risk of cause specific death, unless it is D2 – meta-analysis BMJ April 2014
- Vitamin D2 should not be used as a Vitamin supplement for any mammal – Oct 2006
- Loading dose of Vitamin D2 REDUCED vitamin D blood in a third of the patients – Jan 2015
Background: Widespread prevalence of vitamin D deficiency has been documented globally. Commonly used interventions to address this deficiency include supplementation and/or fortification with either ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3), but the relative efficacy of these two vitamers is unclear. The current study aimed to evaluate the relative efficacy of ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) for raising the serum levels of vitamin D metabolites and functional indicators including serum parathyroid (PTH) levels, isometric muscle strength, hand grip strength and bone mineral density.
Methods: Randomized and non-randomized controlled studies evaluating relative efficacy of ergocalciferol and cholecalciferol were systematically reviewed to synthesize quantitative and qualitative evidence as per the recommendations of according to “Preferred Reporting Items for Systematic reviews and Meta-analysis” guidelines. Search terms were constructed on the basis of the “participants”, “intervention”, “control”, “outcome” and “study type” (PICOS) strategy to systematically search the popular electronic databases. Relevant data from studies meeting inclusion and exclusion criteria were extracted and analyzed. Meta-regression, subgroup and sensitivity analyses were performed to investigate the influence of study-level characteristics including intervention dosage, frequency of dosing, interval between the last dose and test for outcome assessment, participant characteristics and analytical methods.
Results: Apparently healthy human participants (n = 1277) from 24 studies were included for meta-analysis. The quantitative analysis suggested higher efficacy of cholecalciferol than ergocalciferol in improving total 25(OH)D (mean difference: 15.69, 95%CI: 9.46 to 21.93 nmol/L) and reducing PTH levels, consistently across variable participant demographics, dosage and vehicle of supplementation. Meta-regression suggested smaller differences in the efficacy of cholecalciferol and ergocalciferol at lower doses. Average daily dose was the single significant predictor of effect size, as revealed by multivariate meta-regression analysis.
Conclusions: Compared to ergocalciferol, cholecalciferol intervention was more efficacious in improving vitamin D status (serum levels of total 25(OH)D and 25(OH)D3) and regulating PTH levels, irrespective of the participant demographics, dosage and vehicle of supplementation.
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