Some Infants with 400 IU daily of Vitamin D2 actually decreased serum levels – Feb 2013

The change in plasma 25-hydroxyvitamin D did not differ between breast-fed infants that received a daily supplement of ergocalciferol or cholecalciferol for 3 months.

J Nutr. 2013 Feb;143(2):148-53. doi: 10.3945/jn.112.167858. Epub 2012 Dec 19.
Gallo S, Phan A, Vanstone CA, Rodd C, Weiler HA.
School of Dietetics and Human Nutrition, McGill University, Montréal, Québec, Canada.

The biological equivalency of ergocalciferol (D2) and cholecalciferol (D3) has been debated; several comparisons have appeared in the adult literature but are scarce in pediatrics. The objective of this study was to compare increases in plasma 25-hydroxyvitamin D [25(OH)D] concentrations and attainment of 50 and 75 mol/L status cutoffs following 3 mo of daily supplementation with D2 compared with D3. Healthy, breast-fed, 1-mo-old infants (n = 52) received 10 μg (400 ic) of either D2 or D3 daily. At 1 and 4 mo of age, plasma 25-hydroxyergocalciferol and 25-hydroxycholecalciferol concentrations were determined by liquid chromatography tandem MS (LC-MS/MS) and total 25(OH)D by chemiluminescent immunoassay (DiaSorin Liaison). Data were analyzed using t tests and χ² by intent to treat. A total of 23% of infants were deficient (≤24.9 nmol/L) at baseline and 2% at follow-up on the basis of LC-MS/MS. At 4 mo, 96% were breastfed and there were no differences in compliance, breastfeeding rates, or sun exposure among groups. The change in total 25(OH)D measured by LC-MS/MS did not differ between the D2 (17.6 ± 26.7 nmol/L) and D3 (22.2 ± 20.2 nmol/L) groups. In the combined groups, the baseline plasma 25(OH)D concentration was inversely related to the change in total 25(OH)D (r = -0.52; P < 0.001).

Overall, 86% of infants met the 50 nmol/L cutoff at follow-up; however, fewer infants in the D2 group (75%) met this level compared with the D3 group (96%) (P < 0.05). Similar results were obtained by immunoassay.

In conclusion, the increase in the 25(OH)D concentration among the D2 and D3 groups did not differ, suggesting daily intake of either isoform is acceptable for infants <4 mo.

PMID: 23256143

Quote on decrease on serum levels clipped from PDF We observed a significantly larger proportion of infants in the D2 group with decreases in 25(OH)D concentrations during the 3-mo period compared with infants in the D3 group. However, the mean decrease for 8 of the 24 infants in the D2 groupwas <10 nmol/L and compliance was questionable in 4 of these infants, who consumed <60% of doses (assessed either as reported or loss from bottle).

PDF is attached at the bottom of this page

How was possible that for the infants randomly selected into groups that the D2 group had significantlly lower starting levels of serum vitamin D?

Warning, some doctors will prescribe 50,000 IU of vitamin D2 monthly, but the half life is about 3 days

See also VitaminDWiki

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