Guideline following hip fracture – 50000 IU vitamin D daily for 7 days – Jan 2013

Vitamin D levels in hip fractures: rationale and guidelines for rapid substitution therapy

Bone Joint J 2013 vol. 95-B no. SUPP 1 1
A de Jong, K Woods, M Suresh and M Porteous; Bury St. Edmunds, United Kingdom

Introduction Assessment for and treatment of osteoporosis is recommended following hip fracture. All forms of osteoporosis treatment require an adequate calcium intake and normal vitamin D levels. This study assesses vitamin D levels in patients with hip fractures and describes guidelines on how to manage low vitamin D levels with high dose oral vitamin D3 (cholecalciferol).

Materials and methods Circulating 25-hydroxyvitamin D levels were measured in consecutive patients with a hip fracture over an 18 month period. Substitution therapy with high dose oral cholecalciferol was started in 2 selected cohorts; one group received substitution therapy for 3 days, the second group for 7 days.

Results 381 patients with 387 hip fractures were included.
Only 27 patients had sufficient (>75 nmol/L) vitamin D levels (mean 91.2 nmol/L) and of these 22 were taking supplements. The remainder, 354 patients, had low vitamin D levels (mean 26.4 nmol/L).

Substitution with 50,000 IU cholecalciferol daily for 3 days in 14 patients resulted in an increase in vitamin D levels from 29.6 nmol/L to 81.4 nmol/L (p < 0.0001), at a mean of 14 days. 71% of patients achieved levels above the desired threshold of 75 nmol/L.

Substitution with 50,000 IU cholecalciferol for 7 days in 54 patients resulted in an increase in vitamin D levels from 31.4 nmol/L to 131.1 nmol/L (p < 0.0001), at a mean of 16 days.
100% of patients achieved levels above the desired threshold. No clinical or biochemical side effects were reported.

Discussion Virtually all patients who are not taking vitamin D supplements and sustain a hip fracture have abnormally low circulating vitamin D levels and all require substitution.
The routine measurement of vitamin D levels may be unnecessary.
Substitution with 50,000 IU oral cholecalciferol daily for 7 days increases vitamin D levels rapidly, safely and consistently.


PDF of slideshow of this study is attached at the bottom of this page
Here are 2 of the images from the slideshow
Image

Image

Comment by VitaminDWiki

This is great,
Would have been far better if the people had enough vitamin D and cofactors so as to not have a hip fracture in the first place

See also VitaminDWiki

PDF of another publication is attached at the bottom of this page

11584 visitors, last modified 23 Dec, 2022,
Printer Friendly Follow this page for updates