Vitamin D during pregnancy – single 200,000 IU similar to daily 5,000 IU – April 2020

Daily versus stat vitamin D supplementation during pregnancy; A prospective cohort study

PLoS One. 2020 Apr 16;15(4):e0231590. doi: 10.1371/journal.pone.0231590. eCollection 2020.
Nida Bokharee 1, Yusra Habib Khan 2, Tayyiba Wasim 3, Tauqeer Hussain Mallhi 2, Nasser Hadal Alotaibi 2, Muhammad Shahid Iqbal 4, Kanwal Rehman 5, Abdulaziz Ibrahim Alzarea 2, Aisha Khokhar 1

VitaminDWiki

Tests were made 2 months after start of supplementation

  • 2 months is not quite long enough to get full response to 5,000 IU daily
  • Response to a single dose will be falling after 2 months, and cannot last long enough for entire pregnancy
    • VitaminDWiki speculates that 150,000 IU monthly should be given during pregnancy
    • Thus 9 monthly doses vs 270 daily doses

Loading Dose of Vitamin D category has the following

200 items in category
see also Overview Loading of vitamin D   Overview Toxicity of vitamin D
Better than Daily 1: Fewer chances to forget, 2) Gets past receptor barrier
Injection category has 62 items
 
It appears that over 1 million Vitamin D loading doses have been taken
Doses ranged from 100,000 to 600,000 IU over a period of a day to a month
No reports of serious adverse reactions
Many studies report on the benefits resulting from loading doses

TOP articles in Loading Dose of Vitamin D

Pregnancy category starts with

884 items in Pregnancy category

 - see also


Healthy pregnancies need lots of vitamin D has the following summary

Problem
Vit. D
Reduces
Evidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRCT
3. Gestational Diabetes 3 times RCT
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times RCT
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times RCT
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
RCT
10. Childhood Wheezing 1.3 times RCT
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial


Items in both categories Pregnancy and Loading Dose are listed here:

 Download the PDF from VitaminDWiki
Image

Background: Despite favorable climatic conditions, vitamin D deficiency (VDD) is widespread in Pakistan. Current study was aimed to evaluate the prevalence of VDD in Pakistani pregnant women and effectiveness of various regimen of Vitamin D supplementation.

Methodology: This hospital-based prospective cohort study included pregnant women at 12th to 24th weeks of gestation attending Gynae clinic from October 2018 to April 2019. Patients were classified into control and treatment groups (Groups: G1, G2 and G3) according to the dose of vitamin D supplementation. Patients received various regimens of vitamin D including 2000 IU/day (G1), 5000 IU/day (G2) and stat 200000 IU (G3). The levels of vitamin D were measured before and after supplementation. The effectiveness of dosages were compared between and within the groups. Moreover, factors associated with vitamin D sufficiency and insufficiency were ascertained using appropriate statistical methods.

Results: Among 281 pregnant women (mean age: 28.22 ± 4.61 years), VDD was prevalent in 47.3% cases. Vitamin D supplementation caused significant rise in the levels 25(OH)D in treatment groups, while there was no significant difference in control group. The highest mean increment in vitamin D (23.14 ± 11.18 ng/ml) was observed with dose 5000 IU/day followed by doses 200000 IU stat (21.06 ± 13.73 ng/ml) and 2000 IU/day (10.24 ± 5.65 ng/ml). Vitamin D toxicity was observed in one patient who received 200000 IU stat of vitamin D. The frequency of VDD following the supplementation was 5.7%. Education status, duration of sun exposure and use of sunblock was substantially associated with vitamin D sufficiency in the current study.

Conclusion: Our findings underscore the high proportion of VDD among pregnant women in Pakistan. Maternal vitamin D supplementation substantially improved the levels of 25(OH)D. Of three used regimens, the dose of 5000 IU/day is considered safe and equally effective as of 200000 IU stat. Since pregnancy is a time of tremendous growth and physiological changes for mother and her developing fetus with lifelong implications for the child, gestational vitamin D supplementation should be considered to ensure the optimal vitamin D accrual in pregnant women. This study generates the hypothesis that vitamin D supplementation at a dose of 5000 IU/day during pregnancy is superior to the other regimens. However, well-controlled randomized trials are needed to confirm these findings.


PDF shows that one woman had >100 ng of vitamin D at 2 months, but had no medical problems

  • “Only one patient attained serum 25(OH)D > 100 ng/ml. However, serum biochemical indices were within the normal range and USG showed no stones in the kidneys. Levene’s test and normality checks were carried out and assumptions met.”
  • If they had also measured the vitamin D levels at say 1 month. they most likely would have found >10% with >100 ng of Vitamin D - which is not a problem

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