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Finding the Optimal Dose of Vitamin D Following Roux-en-Y Gastric Bypass: A Prospective, Randomized Pilot Clinical Trial

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Abstract

Background

Vitamin D deficiency is common following bariatric surgery and is due to a combination of baseline deficiency and postoperative malabsorption. There are few prospective studies evaluating the appropriate dose of vitamin D to prevent and treat vitamin D deficiency following bariatric surgery.

Methods

We evaluated three doses of vitamin D3 (800, 2,000, and 5,000 IU/day) in a prospective, randomized pilot trial of 45 patients undergoing Roux-en-Y gastric bypass. Serum 25 hydroxy Vitamin D (25OHD), intact PTH (iPTH), calcium, and urine calcium/creatinine ratios were measured at 6, 12, and 24 months postoperatively. Due to a high dropout rate at 24 months, we focus on the 12-month data.

Results

At 12 months, the 800-, 2,000-, and 5,000-IU groups had a mean ± SD increase in 25OHD of 27.5 ± 40.0, 60.2 ± 37.4, and 66.1 ± 42.2 nmol/L, respectively (p = 0.09) with a maximum increase in each group of 87.4, 114.8, and 129.8 nmol/L. Forty-four percent, 78%, and 70% achieved 25OHD levels ≥75 nmol/L (p = 0.38). Results for the 6- and 24-month time points were similar to the 12-month results. Mean weight loss at 24 months of the study was not different among groups (p = 0.52). Serum calcium did not change significantly, and there were no cases of hypercalcemia or sustained hypercalciuria.

Conclusions

Higher doses of vitamin D supplementation trend towards higher levels of 25OHD. Vitamin D replacement as high as 5,000 IU /day is safe and necessary in many patients to treat vitamin D deficiency following Roux-en-Y gastric bypass yet is still suboptimal in others.

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Acknowledgements

This work was funded by a grant of the Clinical Research Center at the University of Nebraska Medical Center.

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Authors and Affiliations

  1. Section of Diabetes, Endocrinology, and Metabolism, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-3020, USA

    Whitney S. Goldner & Judi Erickson

  2. Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Julie A. Stoner

  3. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA

    Elizabeth Lyden

  4. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA

    Jon Thompson, Karen Taylor & Corrigan McBride

  5. Clinical Research Center, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Luann Larson

Authors
  1. Whitney S. Goldner
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  2. Julie A. Stoner
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  3. Elizabeth Lyden
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  4. Jon Thompson
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  5. Karen Taylor
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  6. Luann Larson
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  7. Judi Erickson
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  8. Corrigan McBride
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Correspondence to Whitney S. Goldner.

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Goldner, W.S., Stoner, J.A., Lyden, E. et al. Finding the Optimal Dose of Vitamin D Following Roux-en-Y Gastric Bypass: A Prospective, Randomized Pilot Clinical Trial. OBES SURG 19, 173–179 (2009). https://doi.org/10.1007/s11695-008-9680-y

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  • DOI: https://doi.org/10.1007/s11695-008-9680-y

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