Osteoporosis International

, Volume 22, Issue 1, pp 231–240 | Cite as

Are commonly recommended dosages for vitamin D supplementation too low? Vitamin D status and effects of supplementation on serum 25-hydroxyvitamin D levels—an observational study during clinical practice conditions

  • G. Leidig-Bruckner
  • H. J. Roth
  • T. Bruckner
  • A. Lorenz
  • F. Raue
  • K. Frank-Raue
Original Article
First Online:
Received:
Accepted:

Abstract

Summary

Vitamin D deficiency is associated with increased fracture risk. The observational study aimed to investigate vitamin D status and supplementation in ambulatory patients. Only 20% of patients had optimal serum 25-hydroxyvitamin D [25(OH)D] levels. Commonly recommended dosages were insufficient to achieve clinically relevant increase of 25(OH)D levels. Higher dosages were safe and effective under clinical practice conditions.

Introduction

Vitamin D deficiency is associated with adverse health outcome. The study aimed to investigate vitamin D status and supplementation in ambulatory patients.

Methods

Nine hundred seventy-five women and 188 men were evaluated for bone status from January 2008 to August 2008 within an observational study; 104 patients (n = 70 osteoporosis) received follow-up after 3 months. Dosage of vitamin D supplementation was documented and serum 25(OH)D and parathyroid hormone (PTH) determined.

Results

In all patients (age, 60.4 ± 14.1 years), distribution of 25(OH)D was 56.3 ± 22.3 nmol/L (normal range, 52–182 nmol/L) and PTH 53.8 ± 67.5 ng/L (normal range, 11–43 ng/L). The proportion of patients with 25(OH)D < 25, 25 to <50, 50 to <75, ≥75 nmol/L was 7.5%, 33.3%, 38.9% and 20.2% in the total group and 20.1%, 38.5%, 30.8%, 10.6% at baseline in the follow-up group, respectively. After 3 months, 3.9% had still 25(OH)D < 25 nmol/L; only 12.5% achieved 25(OH)D ≥ 75 nmol/L. In osteoporosis patients, 25(OH)D increased more in those taking ≥1,500 (median, 3,000) IU vitamin D per day (33.1 ± 14.7 nmol/L) compared with ≤1,000 (median, 800) IU/day (10.6 ± 20.0 nmol/L) (p < 0.0008). PTH decreased more in patients taking ≥1,500 IU/day (−13.2 ± 15.2 ng/L) compared with ≤1,000 IU/day (−7.6 ± 19.2 ng/L; p = 0.29). 25(OH)D was negatively correlated to PTH (r = −0.49, p < 0.0001). An increase of 25(OH)D ≥ 75 nmol/L resulted in normalised PTH.

Conclusion

Supplementation with higher vitamin D dosages (2,000–3,000 IU/day) is required to achieve a relevant increase of 25(OH)D and normalisation of PTH.

Keywords

Hyperparathyroidism Osteoporosis Parathyroid hormone Vitamin D 
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Notes

Conflicts of interest

None.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2010

Authors and Affiliations

  • G. Leidig-Bruckner
    • 1
  • H. J. Roth
    • 2
  • T. Bruckner
    • 3
  • A. Lorenz
    • 1
  • F. Raue
    • 1
  • K. Frank-Raue
    • 1
  1. 1.Gemeinschaftspraxis für Endokrinologie, Nuklearmedizin und HumangenetikHeidelbergGermany
  2. 2.MVZ Dr. Limbach+KollegenHeidelbergGermany
  3. 3.Institut für Medizinische Biometrie und Informatik, INF 305Universität HeidelbergHeidelbergGermany

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