High‐Dose Vitamin D₃ Administration Is Associated With Increases in Hemoglobin Concentrations in Mechanically Ventilated Critically Ill Adults: A Pilot Double‐Blind, Randomized, Placebo‐Controlled Trial

Abstract

In these critically ill adults, treatment with 500,000 IU D was associated with increased hemoglobin concentrations over time and acutely reduced serum hepcidin concentrations. These findings suggest that high-dose vitamin D may improve iron metabolism in critical illness and should be confirmed in larger studies.

The effect of vitamin D supplementation on hemoglobin concentration: a systematic review and meta-analysis

“…Cholecalciferol was the main form of vitamin D that were supplemented in these studies. The duration of supplementation with vitamin D also varied from 3 h to 6 months [40][41][42][43][44][45][46][47][48][49][50][51][52][53].…”

Vitamin D Status Is Associated with Hepcidin and Hemoglobin Concentrations in Children with Inflammatory Bowel Disease

“…Moreover, recent studies from our group also found that treatment with high-dose vitamin D reduced circulating hepcidin concentrations in healthy adults (23) and increased hemoglobin concentrations in critically ill adults (24). The anti-inflammatory and hepcidin-lowering effects of vitamin D may therefore increase iron bioavailability for erythropoiesis and hemoglobin synthesis, possibly improving anemia in individuals with vitamin D insufficiency.…”

“…This is consistent with several studies in chronic kidney disease, cardiovascular disease, and the general population, which have described a positive association between vitamin D status and hemoglobin and/or an inverse association between vitamin D status and anemia (9–13, 15, 39, 40). Data from clinical trials have been mixed (39–42), but recent studies in CKD and critically ill adult patient populations found that treatment with vitamin D or its analogues resulted in significant increases in hemoglobin concentrations (24, 43). This association has not been previously studied in IBD animal models or clinical studies.…”

Perspective: improving vitamin D status in the management of COVID-19

“…In line with our objective to improve vitamin D status and its associated outcomes in patients with COVID-19, studies have shown treatment with high dose of 250,000-500,000 IU vitamin D to be safe in mechanically ventilated, critically ill patients and was associated with decreased hospital length of stay, improved ability of the blood to carry oxygen and increased hemoglobin levels [24,25]. The risk of acute viral respiratory tract infections was twofold less if the vitamin D serum levels were ≥95 nmol/L (hazard ratio 0.51; 95% CI, 0.25-0.84; p < 0.0001) and the percentage of sick days was five times less (0.80% vs. 3.9%, p = 0.02) compared with the patients with levels <95 nmol/L [26].…”