Authors: Bauman, William A.1; Emmons, Racine R.1; Cirnigliaro, Christopher M.1; Kirshblum, Steven C.2; Spungen, Ann M.1
Journal of Spinal Cord Medicine, Volume 34, Number 5, September 2011 , pp. 455-460(6)
Background/objective: Vitamin D deficiency is prevalent in chronic spinal cord injury (SCI). A 3-month course of oral vitamin D3 to ‘normalize’ serum vitamin D levels was investigated.
Design: Prospective drug-intervention study.
Setting: VA Medical Center; private rehabilitation facility.
Methods: Seven individuals with chronic SCI and vitamin D deficiency completed 3 months of oral vitamin D3 (i.e. cholecalciferol) supplementation. At screening, baseline, and months 1 and 3, blood was collected for serum calcium, 25 hydroxyvitamin D [25(OH)D], intact parathyroid hormone (iPTH), and N-telopeptide (NTx); 24-hour urine for calcium, creatinine, and NTx was performed.
Oral vitamin D3 (2000 IU daily) and elemental calcium (1.3 g daily) were prescribed for 90 days. The results are expressed as mean ± standard deviation (SD). Analysis of variance with a Fisher's post-hoc analysis was performed to test for differences between study visits.
Subjects were classified as deficient (<20 ng/ml), relatively deficient (20-30 ng/ml), or not deficient (>30 ng/ml) in 25(OH)D.
Results: Serum 25(OH)D levels were greater at months 1 and 3 than at baseline (26 ± 6 and 48 ± 17 vs. 14 ± 2 ng/ml; P = 0.005). Six of seven subjects were no longer deficient [25(OH)D >30 ng/ml] by month 3. Serum iPTH levels were significantly decreased at month 1 and month 3; serum NTx levels were significantly lower at month 3 than at baseline. Serum and urinary calcium levels remained within the normal range.
Conclusion: A daily prescription of 2000 IU of oral vitamin D3 for 3 months safely raised serum 25(OH)D levels into the normal range in persons with chronic SCI on calcium supplementation.
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2,000 IU vitamin D 14 ng ==> 48 ng at 3 months
Few were obese
Few were pregnant
During the summer and the patients got outdoors
Few had medical conditions which consume, restrict conversion, or restrict absorption of vitamin D
Injury happened years before the vitamin D therapy - so the body was till not in trauma and consuming a lot of the dose
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