Loading dose:
Vitamin D loading dose (stoss therapy) proven to improve health overview
If a person is or is suspected to be, very vitamin D deficient a loading dose should be given
- Loading = restore = quick replacement by 1 or more doses
- Loading doses range in total size from 100,000 IU to 1,000,000 IU of Vitamin D3
- = 2.5 to 25 milligrams
- The size of the loading dose is a function of body weight - see below
- Unfortunately, some doctors persist in using Vitamin D2 instead of D3
- Loading may be done as quickly as a single day (Stoss), to as slowly as 3 months.
- It appears that spreading the loading dose over 4+ days is slightly better if speed is not essential
- Loading is typically oral, but can be Injection (I.M,) and Topical
- Loading dose is ~3X faster if done topically or swished inside of the mouth
- Skips the slow process of stomach and intestine, and might even skip liver and Kidney as well
- The loading dose persists in the body for 1 - 3 months
- The loading dose should be followed up with on-going maintenance dosing
- Unfortunately, many doctors fail to follow-up with the maintenance dosing.
- About 1 in 300 people have some form of a mild allergic reaction to vitamin D supplements, including loading doses
- it appears prudent to test with a small amount of vitamin D before giving a loading dose
- The causes of a mild allergic reaction appear to be: (in order of occurrence)
- 1) lack of magnesium - which can be easily added
- 2) allergy to capsule contents - oil, additives (powder does not appear to cause any reaction)
- 3) allergy to the tiny amount of D3 itself (allergy to wool) ( alternate: D3 made from plants )
- 4) allergy of the gut to Vitamin D - alternative = topical
Cholecalciferol loading dose guideline for vitamin D-deficient adults.
Eur J Endocrinol. 2010 Apr;162(4):805-11. Epub 2010 Feb 5.
CONCLUSION: The cholecalciferol loading dose required to reach the serum 25-OHD(3) target level of 75 nmol/l can be calculated as follows:
dose (IU)=40x(75 - serum 25-OHD(3))xbody weight.
Download the PDF from VitaminDWiki
To use ng and pound multipy by 35 instead of 40
Dose to get 30 ng (in ng and pounds) = 35 x (30 - serum 25-OHD(3)) x body weight.
Typically spread over 8 weeks
A very commonly prescribed loading dose in the US is 50,000 IU per week for 8 weeks, for a total of 400,000 IU
Example uses of the equation to achieve 30 ng (on average)
| Dose | starting level | weight |
| 140,000 IU | 10 ng | 200 lb |
| 70,000 IU | 20 ng | 200 lb |
| 105,000 IU | 10 ng | 150 lb |
Dose to get 50 ng (in ng and pounds) = 35 x (50 - serum 25-OHD(3)) x body weight.
Example uses of the equation to achieve 50 ng (on average)
| Dose | starting level | weight |
| 280,000 IU | 10 ng | 200 lb |
| 210,000 IU | 20 ng | 200 lb |
There is a HUGE variation in response between individuals for the average (equation)
Response to weekly or biweekly dosing
for a total of 100,000 IU, 150,000 IU, and 200,000 IU vary a lot between individuals
CLICK HERE for 2010 PDF
153 studies cited this study as of Feb 2023
- Vitamin D oral intermittent treatment (DO IT) study, a randomized clinical trial with individual loading regimen - Sept 2021
- 300,000 loading dose got average to 30 ng PDF
- Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths - April 2020
- founder of VitaminDWiki is a co-author
3 day response time to a loading dose
- 600000 IU dose raised youth vitamin D level by 60 ng in 3 days – July 2010 60 ng 16 ng ==> 77 ng
62 ng after 30 days
See also at VitaminDWiki
- Vitamin D loading dose (stoss therapy) proven to improve health
- Large single dose of more than 300,000 IU of vitamin D works well for 3 months – Review Nov 2013
- Vitamin D loading doses of up to 400,000 IU OK for adolescents – meta-analysis Dec 2014
- Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
- 400,000 IU of vitamin D reduced adult pain and improved quality of life – March 2014
- 300,000 IU loading dose of vitamin D stopped gestational diabetes in RCT – Oct 2011
- 300,000 IU vitamin D helped seniors in many ways – May 2011
- Vitamin D3 loading dose of 500,000 IU for elderly – Aug 2009
- Loading dose of 500,000 IU for elderly - Whiting 2010 PDF file
- 540000 IU before ICU raised vitamin D by 25 ng in 2 days – March 2011 25 ng
- Will lots of vitamin D help in ICU – RCT Nov 2012 540,000 loading dose
- Single 600,000 IU dose raised youth vitamin D level by 60 ng in just 3 days – July 2010
- 600,000 IU vitamin D normalized virtually all seniors in 3 months – May 2012
- Variety of vitamin D loading dose recommendations in the UK
- Can You Overdose on Vitamin D - It's Harder Than You Think
- Doctors now able to prescribe vitamin D3 as of March 2012
- Many reasons why vitamin D deficiency has become epidemic
- Must balance co-factors when increasing vitamin D
- Vitamin D Replentishment – Feb 2012 Plotnikoff
- Overview Rare Allergic reaction to vitamin D about 1 in 300 people
- Huge gap between vitamin D advice and actual prescriptions – April 2012
only 1.4% of those with < 10 nanograms of vitamin D got any loading dose - Overview Toxicity of vitamin D >2,000,000 every day for a week is toxic
- Guideline following hip fracture – 50000 IU vitamin D daily for 7 days – Jan 2013
daily, with no testing needed, 40 ng: 12 ng ==> 52 ng ( 350,000 IU, measured on day 14) - Review of Vitamin D (including free, frequency, injection, how much.) – Sept 2013
- Better than Daily category listing has
33 items along with related searches - Unaware of a single study which found that daily was best
- Healthy in Seven Days - Loading dose of Vitamin D – book 2014 has the following chart
600,000 vitamin D loading doses – good response to both oral and muscular – Oct 2015 has the followingDose >20 ng Level 600,000 IU IM 94% 30 ng 600,000 IU oral 83% 20 ng 200,000 IU IM 88% 18 ng 200,000 IU oral 71% 14 ng
Take vitamin D3 daily, weekly, or bi-weekly has the following
Response to a single dose of 100,000 IU starting at 27 ng/ml, half life is about 50 days
47 pages are in both categories: Intervention AND Loading Dose - Single 600,000 IU dose of nanoemulsion Vitamin D is safe and effective to fight COVID, even if delay until enter ICU – RCT May 2024
- Vitamin D loading dose of 30,000 IU twice a week is safe and effective – RCT July 2023
- Vitamin D 100,000 IU loading dose and stem cell transplants – RCT Oct 2023
- Randomized Controlled Trials in VitaminDWiki - many studies
- NAFLD and Vitamin D - many studies
- Half as much AFIB after bypass if 600,000 IU of vitamin D before surgery – RCT April 2022
- COVID-19 mortality reduced 4X (chart looks like 2X) by large, infrequent doses of Vitamin D in France – July 2021
- Stoss (loading) dose of vitamin D resulted in bigger response at 30 days (again) – RCT April 2021
- Half as many problems if take Vitamin D (300,000 IU) before thyroidectomy – RCT Jan 2021
- Those getting an injection of 300,000 IU Vitamin D got out of the ICU a week sooner – RCT Dec 2020
- COVID-19 defeated 3x faster by 420,000 IU Vitamin D nanoemulsion – RCT Nov 12, 2020
- 44 percent of successful RCTs in VitaminDWiki used non-daily dosing - Nov 2020
- Vitamin D during pregnancy – single 200,000 IU similar to daily 5,000 IU – April 2020
- Traumatic Brain Injury – 120,000 IU of Vitamin D resulted in 3 fewer days on ventilators – RCT March 2020
- Several Diabetic pains reduced by injection of 300,000 IU of Vitamin D – RCT Feb 2020
- Vitamin D levels in children optimized with six Vitamin D biscuits – RCT Nov 2018
- Pregnancies helped a lot by Vitamin D (injection then 50,000 IU monthly) – RCT May 2018
- Far more Vitamin D in breast milk from a 150,000 IU dose than from daily 5,000 IU – RCT May 2018
- Weekly dosing of vitamin D is far better than single large dose (chronic liver, children) – March 2018
- Waist size reduced 3 cm by Vitamin D in those with Metabolic Syndrome – Jan 2017
- Birth rates doubled with Vitamin D - 300,000 for infertile men – RCT Nov 2017
- Childhood asthma problems eliminated for months by 600,000 IU of Vitamin D injection – June 2017
- Ulcerative colitis treated by injection of 300,000 IU of vitamin D – RCT July 2016
- Vitamin D injection is far better than oral for diabetics (poor gut) – RCT March 2017
- Fatigue reduced by a single dose of vitamin D (100,000 IU) – RCT Dec 2016
- Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016
- Newborn Vitamin D - single 50,000 IU is better than daily – RCT Sept 2016
- Diabetic neuropathy reduced by injection of 600,000 IU of vitamin D – Feb 2016
- Inflammation reduced by a single dose of Vitamin D (200,000 IU) – RCT Jan 2016
- PMS reduced by half in girls who had low levels of vitamin D – RCT Dec 2015
- Rheumatoid arthritis reduced by 440,000 IU of Vitamin D over 4 months – Oct 2015
- Common cause of dizziness (BPPV) reduced 5 X by several doses of 50,000 IU of vitamin D – 2015, 2016
- 200,000 IU restored levels in HIV children having low vitamin D - Nov 2014
- Single dose (up to 60,000 IU) vitamin D raised levels in 87 percent of Cystic fibrosis patients – RCT March 2013
- 500,000 IU of vitamin D cut in half the hospital days following a lung failure – RCT 2015
- 5 days of 100,000 IU of Vitamin D increased hemoglobin in critical illness – RCT April 2015
- Clinical trials using a LOT of vitamin D intervention – Jan 2015
- Vitamin D restored in teens by doses totalling 300,000 IU – Nov 2014
- Sickle cell Vitamin D deficiency corrected with 160 K IU loading dose – July 2014
- Neonate loading dose of 30,000 IU vitamin D helped a lot – May 2014
- Diabetes (Type II) reduced by single injection of 300,000 IU of vitamin D3 – RCT March 2014
- 400,000 IU of vitamin D reduced adult pain and improved quality of life – March 2014
- Vitamin D injections of a total of 1,800,000 IU reduced shinbone tenderness – Feb 2013
- Lupus flares totally eliminated by loading dose then 100000 IU of vitamin D each month – Oct 2012
- Recurrence of child pneumonia delayed by 100000 IU of vitamin D – RCT Oct 2010
- 300,000 IU injection loading dose of vitamin D3 stopped gestational diabetes in RCT – Oct 2011
- Grade A recommendations for vitamin D - May 2009
38 pages are in both categories: Trauma/Surgery AND Loading Dose - Surgery complications cut in half by 300,000 IU of vitamin D 2 weeks before (hip and knee) – RCT May 2024
- Some ICU patients got 540,000 IU of Vitamin D: good responders lived longer than controls or poor responders – RCT June 2024
- Large dose Vitamin D before surgery was found to help by 35 studies
- Vitamin D is needed before most surgeries – many studies and RCTs
- Half as much AFIB after bypass if 600,000 IU of vitamin D before surgery – RCT April 2022
- ICU mortality reduced by non-oral vitamin D – meta-analysis May 2021
- Taking Vitamin D just before and after surgery helps (open-heart in this case) – RCT Feb 2021
- Half as many problems if take Vitamin D (300,000 IU) before thyroidectomy – RCT Jan 2021
- Fewer days in hospital if 300,000 IU of vitamin D before brain surgery - RCT Feb 2021
- ICU Vitamin D injection (300,000 IU) helped - RCT Feb 2021
- Those getting an injection of 300,000 IU Vitamin D got out of the ICU a week sooner – RCT Dec 2020
- ICU patients greatly helped by Vitamin D loading doses – if gut-friendly – Oct 2020
- Fewer days in ICU after 300,000 IU of vitamin D, but not 540,000 – meta-analysis Aug 2020
- 3X less Septic Shock in children with sepsis getting 150,000 IU of Vitamin D - RCT June 2020
- 100,000 IU daily of Vitamin D for 5 days increased Hemoglobin in Mechanically Ventilated adults – RCT Jan 2018
- Traumatic Brain Injury – 120,000 IU of Vitamin D resulted in 3 fewer days on ventilators – RCT March 2020
- Hip surgery with multiple doses of 50,000 IU of vitamin D weekly both before and after – RCT 2023
- Use of Vitamin D in a trauma surgery - Dr. Matthews on Facebook – Jan 2020
- Surgeries often deplete Vitamin D - 300,000 IU resulted in little response – Nov 2018
- 10 fewer days of ICU Mechanical Ventilation 300,000 IU injection of vitamin D – RCT March 2019
- Intensive Care (ICU) helped by Vitamin D – review of past and on-going studies – Dec 2018
- ICU adults getting 540,000 IU of Vitamin D were 2X more likely to be alive 30 days later – RCT June 2019
- Traumatic Brain Injury recovery helped by injection of 100,000 IU of Vitamin D – March 2019
- Rapidly restore Vitamin D levels with 10,000 IU per kg for children in ICU – RCT 2024
- Esophageal Cancer surgery helped by 300,000 IU of Vitamin D – RCT Sept 2018
- Severe sepsis may be prevented by 400,000 IU of vitamin D – RCT 2023
- Critically ill children – randomized clinical trial to give single doses of up to 400,000 IU of vitamin D – 2019
- Vitamin D loading doses reduce ICU mortality by 30 percent – meta-analysis April 2017
- Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016
- Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
- Vitamin D Loading dose - 20,000 IU daily is not enough if obese, etc. (Cancer) great table and chart – Oct 2016
- Rapid Normalization of Vitamin D in Critically Ill Children (10,000 IU per kg) – clinical trial
- VITdAL-ICU - AMA RCT Sept 2014
- Critically ill need vitamin D – how much and which test to use is TBD – Nov 2014
- ICU survival increased with vitamin D single 540K IU loading dose - JAMA Sept 2014
- 540000 IU before ICU raised vitamin D by 25 ng in 2 days – March 2011
- Hip surgery followed by 100000 IU then 1000 IU of vitamin D daily – June 2010
- 600,000 IU intramuscular D3 helped BMD after pancreatic surgery – June 2010
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