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Tuesday, June 26, 2012

ENDO Conference:Standard Dose of Vitamin D May Not Enough For Some Patients

[MON-350] Evaluation of Response to Treatment with 50,000 IU of Vitamin D3 in Deficient Patients

Tatiane Vilaca, Marilia Camargo, Marise Lazaretti-Castro. Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.

Background: Inadequate vitamin D status has been associated with an increased risk of several diseases, including osteoporosis, cardiovascular disease, diabetes, cancer, multiple sclerosis and infections. Serum 25-hydroxyvitamin D is the classic marker of vitamin D status and is determined by environmental (season, latitude, sunlight, diet), demographic (ethnicity, body mass index) and genetic (polymorphism in metabolism and transport genes) factors. (1) However, the features that modify the response to vitamin D supplementation remain unclear. The Endocrine Society suggests the use of 50,000 IU of vitamin D2 or D3 weekly over eight weeks for the treatment of deficient adults to achieve a blood level of 25-hydroxyvitamin D above 30 ng/mL. (2)
Objective: The aim of the present study was to evaluate the response to supplementation with 50,000 IU of vitamin D3 in deficient patients.
Patients and Methods: Twenty-five osteoporotic female patients with vitamin D deficiency (25-hydroxyvitamin D < 20 ng/ml) received eight capsules of 50,000 IU of vitamin D3 for treatment. All capsules were manufactured at the same place. The patients were instructed to take one capsule a week for eight weeks. All patients reported appropriate adherence to treatment and none reported any gastrointestinal problems.
Results: After treatment, serum levels of 25-hydroxyvitamin D were reevaluated. More than half of the patients (13/25) did not achieve the levels recommended by the Endocrine Society (> 30 ng/ml). Both groups of patients (successful treatment and unsuccessful treatment) had similar body mass index values and initial pretreatment levels of 25(OH)-vitamin D. The group with the worse response was older.
Discussion: A number of authors have reported considerable inter-individual variation in serum 25-hydroxyvitamin D response to supplementation with identical doses. In the present study, this variation was found using the dose recommended by the Endocrine Society. The data suggest that the standard dose may not be enough to treat all patients and that reevaluation of vitamin D levels after treatment should always be considered.

1 Mason RS et al. European Journal of Clinical Nutrition (2011) 65, 986–993. 2 Holick MF el al. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30.

Sources of Research Support: São Paulo Research Foundation (FAPESP 2008/555677).

Nothing to Disclose: TV, MC, ML-C

Date: Monday, June 25, 2012
Session Info: POSTER SESSION: Vitamin D Deficiency & Metabolic Outcomes (1:30 PM-3:30 PM)
Presentation Time: 1:30 pm
Room: Expo

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