The effect of oral and parenteral vitamin D supplementation in the elderly: a prospective, double-blinded, randomized, placebo-controlled study

Abstract

Hypovitaminosis D in the elderly causes falls and fractures as a result of impaired neuromuscular functions and also may be a reason for nonspecific musculosceletal pain. The aim of this study is to investigate the benefits of a single dose per os or parenterally administrated vitamin D on increasing the quality of life and functional mobility and decreasing the pain in the elderly. The community-dwelling elderly subjects over 65 years age were included in the study. The subjects were given 300.000 IU Vitamin D via per os and parenteral route and assessed after 4 weeks. The serum creatinine, calcium, phosphorous, ALT, ALP, 24-h urine calcium excretion, PTH, and vitamin D levels, as well as VAS (visual analog scale) for pain assessment, functional mobility with TUG (timed up and go test) and quality of life with SF-36 before and after the treatment were evaluated. The serum vitamin D levels were measured by the RIA method. The subjects were divided into four groups each consisting of 30 subjects. The 1st group took i.m. vitamin D, the 2nd group took i.m. placebo, the 3rd group took p.o. vitamin D, and the 4th group took p.o. placebo. The mean age of all the participants was 70.1 ± 4.3 years. There was no difference in the age and gender between the groups (P > 0.05). After treatment, the PTH level of first group was decreased (P = 0.0001) and the vitamin D level increased (P = 0.0001) significantly. In the third group, the PTH level of first group was decreased (P = 0.0001) and the vitamin D level increased (P = 0.004) and the 24-h calcium excretion in urine (P = 0.015) increased significantly. When the pain, the functional mobility, and the quality of life were evaluated, in the first group, the TUG (P = 0.0001) and the VAS (P = 0.0001) decreased significantly, whereas the SF-36 subtitles: physical functioning (P = 0.0001), role physical (0.006), bodily pain (P = 0.0001), general health (P = 0.007), social functioning (P = 0.05), and mental health (P = 0.048) increased significantly. In group two, the VAS (P = 0.001) decreased, the role physical (P = 0.009), and role emotional (P = 0.034) increased significantly; In group three, the TUG (P = 0.0001) and the VAS (P = 0.002) decreased, whereas the physical function (P = 0.0001) and role physical (0.001) increased significantly; In group four, the VAS (P = 0.007) decreased significantly. The megadose vitamin D administration increases quality of life, decreases pain, and improves functional mobility via po or im route in the elderly.

Vitamin D Supplementation for Nonspecific Musculoskeletal Pain in Non-Western Immigrants: A Randomized Controlled Trial

“…[40][41][42][43] Another RCT assessing the effect of vitamin D supplementation on pain was published recently. 32 This trial among elderly Turkish patients (with or without vitamin D defi ciency) from a rheumatology outpatient clinic found improvement in pain 4 weeks after administration of a megadose of vitamin D. Regrettably, the authors do not report on the statistical signifi cance of the difference in change between the vitamin D and placebo groups.…”

“…One trial did not fi nd a pain-relieving effect of vitamin D 3 (800 IU/d or 2 treatments with 10,000 IU) at 6 months in vitamin D-defi cient non-Western immigrants aged 18 to 65 years, the majority of whom had fi bromyalgia 31 ; however, this trial was not designed to evaluate the pain-modifying effect of vitamin D. The other trial was done in elderly Turkish patients from a rheumatology clinic (patients with fi bromyalgia were excluded) and found no differences in pain as assessed with a visual analogue scale 4 weeks after administration of 300,000 IU vitamin D (orally or intramuscularly) vs placebo. 32 We aimed to assess the effect of high-dose vitamin D supplementation on nonspecifi c musculoskeletal symptoms in non-Western vitamin D-defi cient immigrants.…”

No beneficial effects of vitamin D supplementation on muscle function or quality of life in primary hyperparathyroidism: results from a randomized controlled trial

“…Our findings of a preoperative increased QoL score in the RP and GH domains resulting in an improved MCS score in the placebo group compared with the vitamin D group were against our a priori expectation of beneficial effects of vitamin D. In groups of patients without PHPT, low plasma 25OHD have also been associated with reduced QoL (24), and an RCT suggested improved QoL after vitamin D repletion (25). It is well known that PHPT is associated with a reduced QoL as measured by SF-36 (27), and may exert negative effects on neuronal function and synaptic plasticity (28).…”

Eficácia da reposição de vitamina d3 em idosos na dose de 50.000 Ui por semana durante 8 semanas: é o suficiente?

“…Após a suplementação, o ganho médio estimado pelos autores nas concentrações séricas da 25(OH)D foi de 8,27 ng/mL, ganho semelhante aos descritos por Sakali et al, 18 mas inferiores aos descritos por Al-Zahrani et al 19 e menores do que cálculo sugerido por Maeda et al 8 de aumento de 0,7 a 1,0 ng/mL nas concentrações de 25(OH) D para cada 100 UI suplementada. Em termos absolutos, esses aumentos foram maiores nos voluntários com deficiência (81%), seguidos daqueles com insuficiência (32%) e aqueles com concentrações normais (15%).…”