Maintenance Dose of Vitamin D: How Much Is Enough?
J Bone Metab. 2018 Aug;25(3):161-164. doi: 10.11005/jbm.2018.25.3.161. Epub 2018 Aug 31.
Sadat-Ali M1, Al-Anii FM1, Al-Turki HA2, AlBadran AA1, AlShammari SM1.
1 Department of Orthopaedic Surgery, King Fahd Hospital of the University, Imam AbdulRahman Bin Faisal University, Al-Khobar, Saudi Arabia.
2 Department of Obstetrics and Gynecology, King Fahd Hospital of the University, Imam AbdulRahman Bin Faisal University, Al-Khobar, Saudi Arabia.
13 ng + 50,000 IU weekly for 3 months ==> 37 ng (good)
2,000 IU daily for next 3 months ==> 20 ng (not good)
- 2400 IU of Vitamin D is need to get most above 30 nanograms – Sept 2017
- Vitamin D supplementation guidelines (adults – 50,000 IU per week) – Feb 2017
- 2000 IU of vitamin D- doctors trained that it was too much, but it is often too little
4,000 IU daily or 50,000 IU every two weeks looks good
- Vitamin D - at least 4,000 IU to achieve 40-60 ng and reduce risk of early death – Holick June 2018
- 50,000 IU of vitamin D every two weeks – Jordan conclusion - RCT July 2017
- Even taking as much as 4200 IU vitamin D 43 percent had less than 30 ng in blood – RCT Jan 2013
- Seniors need at least 4,000 IU vitamin D, no test needed – Consensus Jan 2014
BACKGROUND:
It is still unclear the ideal vitamin D dosage once the deficiency and insufficiency is treated. Once deficiency was corrected we prospectively treated patients with 2,000 IU of vitamin D3 to check whether this dosage is enough to keep them above the 30 ng/mL of 25-hydroxy-vitamin D (25[OH]D).
METHODS:
One hundred and thirty-five Saudi Arabian men and women treatment naïve for the vitamin D deficiency and insufficiency were part of this study. History and clinical examination were done to rule out any metabolic bone disease. Weight and height was taken to calculate the body mass index (BMI). Patients who were vitamin D deficient (≥30 ng/mL), a standard treatment of 50,000 IU of vitamin D3 weekly for 3 months, a blood test for the vitamin D levels at the end of 3 months, maintenance dose of 2,000 IU of vitamin D3 for 3 months and a third blood sample after 3 months.
RESULTS:
The data for 128 patients was available for analysis. The average age was 44.95±12.97 years with the mean BMI of 29.60±2.59 kg/m2. The baseline 25(OH)D level was 13.16±3.30 ng/mL. The increase in the level of 25(OH)D on 50,000 IU weekly was significant from 13.16±3.3 ng/mL to 36.97±4.67 ng/mL (P<0.001) and then 2,000 IU daily for next 3 months, the level of 25(OH)D dropped top 20.38±5.42 ng/mL (P<0.001).
CONCLUSIONS:
Our study indicates that the maintenance dose of 2,000 IU of vitamin D is not enough for patients to keep the 25(OH)D levels above 30 ng/mL.