Vitamin D3 dose requirement to raise 25-hydroxyvitamin D to desirable levels in adolescents: Results from a randomized controlled trial
Journal of Bone and Mineral Research, Vol. 28 Issue 10; DOI: 10.1002/jbmr.2111
Laila Al-Shaar MSc, MPH1,2,
Rania Mneimneh BS4,
Mona Nabulsi MD, MSc1,3,
Joyce Maalouf MS, MPH4,
Ghada El-Hajj Fuleihan MD, MPH1,4, firstname.lastname@example.org
- Scholars in HeAlth Research Program, Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Vascular Medicine Program, Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Calcium Metabolism and Osteoporosis Program & WHO Collaborating Center for Metabolic Bone Disorder, Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Several organizations issued recommendations on desirable serum 25-hydroxy vitamin D [25(OH)D] levels and doses of vitamin D needed to achieve them.
Trials allowing the formulation of evidence-based recommendations in adolescents are scarce.
We investigated the ability of two doses of vitamin D3 in achieving recommended vitamin D levels in this age group.
Post-hoc analyses on data from a one year double-blind trial that randomized 336 Lebanese adolescents, age 13 ± 2 years, to placebo, vitamin D3 at 200 IU/day (low dose), or 2,000IU/day (high dose). Serum 25(OH)D level and proportions of children achieving levels ≥ 20 ng/ml and 30 ng/ml were determined.
At baseline, mean 25(OH)D was 15 ± 7 ng/ml,
- 16.4 ± 7 ng/ml in boys and
- 14 ± 8 ng/ml in girls, p = 0.003;
with a level ≥ 20 ng/ml in 18% and ≥30 ng/ml in 5% of subjects.
At one year, mean levels were 18.6 ± 6.6 ng/ml in the low dose group, 17.1 ± 6 ng/ml in girls and 20.2 ± 7 ng/ml in boys, p = 0.01; and 36.3 ± 22.3ng/ml in the high dose group, with no gender differences. 25(OH)D increased to ≥ 20 ng/ml in 34% of children in the low dose and 96% in the high dose group, being higher in boys in the low dose arm only; it remained ≥30 ng/ml in 4% of children in the low dose arm but increased to 64% in the high dose arm. Baseline 25(OH)D level, BMI, and vitamin D dose assigned were the most significant predictors for reaching a 25(OH)D level ≥20 ng/ml and 30 ng/ml.
A daily dose of 2,000IU raised 25(OH)D level ≥20 ng/ml in 96% of adolescents (98% boys vs. 93% girls).
Dose response studies are needed to determine in a definitive manner the daily allowance of vitamin D for Middle Eastern adolescents with a similar profile.
© 2013 American Society for Bone and Mineral Research
Note: 64% of youths getting 2,000 IU achieved levels of vitamin D >30 ng
Wonder how many IU would be needed to get majority of youths to minimum optimal ( >40 ng): 3,000 IU?, 4,000 IU?
Wonder if they noticed any benefits in the 2,000 IU group such as: weight loss, fewer cavities, feeling better, better at sports, less depression. less asthma,
Wonder if they considered youth with dark skins, obese
- Milk fortification of 1000 IU got most children above 20ng of vitamin D – March 2013 need less because of less weight?
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- Vitamin D insufficiency in UK youths – 37X more likely if dark skin – July 2011
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- Obese need 2.5 IU of vitamin D per kg to increase 1 ng (about 3.4 X more) – RCT Sept 2013
- Those low on vitamin D were 2.4X more likely to gain weight – June 2013
- Overview Middle East and vitamin D