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Effects of Vitamin D3 Supplementation on Muscle Strength, Mass, and Physical Performance in Women with Vitamin D Insufficiency: A Randomized Placebo-Controlled Trial

Abstract

Vitamin D insufficiency and hyperparathyroidism have been associated with reduced muscle strength, physical performance, postural stability, well-being, and quality of life. In a double-blinded, randomized placebo-controlled trial, we aimed to investigate effects of vitamin D3 supplementation on above-mentioned outcomes in healthy community-dwelling postmenopausal women with plasma levels of 25-hydroxyvitamin D (25(OH)D) below < 50 nmol/l and high parathyroid hormone (PTH) levels. Participants (N = 81) were 1:1 treated with vitamin D3, 70 µg (2800 IU)/day or identical placebo for three months during wintertime (56°N). Vitamin D3 supplementation increased levels of 25(OH)D and 1,25(OH)2D by 230% (95% CI 189 to 272)%, p < 0.001 and 58% (190 to 271%), p < 0.001, respectively, and reduced PTH by 17% (− 23 to − 11%), p < 0.001. Compared with placebo, vitamin D3 significantly reduced maximal handgrip strength by 9% (− 15 to − 3%; p < 0.01) and knee flexion strength by 13% (− 24 to − 2%; p = 0.02) and increased the time spent on performing the Timed Up and Go test by 4.4%; (0.1–8.6%; p < 0.05). Levels of physical activity, total lean body mass, appendicular lean mass index, postural stability, well-being, and quality of life did not change in response to treatment. Compared with placebo, a daily supplement with a relatively high dose of vitamin D3 had no beneficial effects on any outcomes. In some measures of muscle strength and physical performance, we even saw a small unfavorable effect. Our data call for caution on use of relatively high daily doses of vitamin D3 in the treatment of vitamin D insufficiency.

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Acknowledgements

Most importantly, we thank all participants for their extraordinary commitment and goodwill. We acknowledge the laboratory technicians and the hospital pharmacy at Aarhus University Hospital.

Funding

The study was funded by Aarhus University, T, The Augustinus Foundation, The Foundation of Endocrinology Aarhus University Hospital, Toyota Foundation, A.P. Møller & wife Chastine MC-Kinney Møllers Foundation, and P. A. Messerschmidt & wife foundation. Orkla Health A/S donated vitamin D and vitamin D placebo tablets free of charge, but had no influence on analyses or interpretation of data.

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Correspondence to Lise Sofie Bislev.

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Conflict of interest

Lise Sofie Bislev, Lene Langagergaard Rødbro, Lars Rolighed, Tanja Sikjaer, and Lars Rejnmark declare that they have no conflict of interest.

Ethical Approval

The study was carried out in accordance with the Helsinki Declaration. The study was approved by The Danish Data Protection Agency (1-16-02-492-14), the Regional Committee on Biomedical Research Ethics (1-10-72-326-14), The Danish Health Authority (2014-003645-10), and Danish Health Data Authority (FSEID-00001274). The local unit for Good Clinical Practice at Aarhus University Hospital monitored the study. Clinicaltrials.gov identifier: #NCT02572960.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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All participants provided an informed written consent prior to inclusion.

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Bislev, L.S., Langagergaard Rødbro, L., Rolighed, L. et al. Effects of Vitamin D3 Supplementation on Muscle Strength, Mass, and Physical Performance in Women with Vitamin D Insufficiency: A Randomized Placebo-Controlled Trial. Calcif Tissue Int 103, 483–493 (2018). https://doi.org/10.1007/s00223-018-0443-z

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Keywords

  • Vitamin D
  • Parathyroid hormone
  • Skeletal muscle
  • Muscle strength
  • Physical performance
  • Postural stability