Vitamin D: Daily vs. Monthly Use in Children and Elderly—What Is Going On?

Abstract

Vitamin D deficiency is highly prevalent among children and adults worldwide. Agreement exists that vitamin D deficiency should be corrected. However, the definitions of vitamin deficiency and effective vitamin D replacement therapy are inconsistent in the literature. Not only is the dosing regimen still under debate, but also the time and period of administration (i.e., daily vs. monthly dose). In pediatric as well as elderly subjects, dosing regimens with high vitamin D doses at less frequent intervals were proposed to help increase compliance to treatment: these became widespread in clinical practice, despite mounting evidence that such therapies are not only ineffective but potentially harmful, particularly in elderly subjects. Moreover, in the elderly, high doses of vitamin D seem to increase the risk of functional decline and are associated with a higher risk of falls and fractures. Achieving good adherence to recommended prophylactic regimens is definitely one of the obstacles currently being faced in view of the wide segment of the population liable to the treatment and the very long duration of prophylaxis. The daily intake for extended periods is in fact one of the frequent causes of therapeutic drop-outs, while monthly doses of vitamin D may effectively and safely improve patient compliance to the therapy. The aim of our paper is a quasi-literature review on dosing regimens among children and elderly. These two populations showed a particularly significant beneficial effect on bone metabolism, and there could be different outcomes with different dosing regimens.

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

“…Interestingly, Scragg et al [75] used monthly bolus doses of 100,000 IU in their study. One consideration worth following with this study design is the bioavailability of vitamin D. A high-dose intervention with a long dosage interval might be a suboptimal study design [90]. All RCTs that used this study design failed to demonstrate major benefits of vitamin D supplementation, even though plasma levels were restored [75,79,80,82,86].…”

Comparison between Acupuncture and Nutraceutical Treatment with Migratens® in Patients with Fibromyalgia Syndrome: A Prospective Randomized Clinical Trial

“…In addition, animal models proved that the coenzyme Q10 deficiency may lead to increased levels of pro-inflammatory cytokines (IL-1, IL-18) and abnormal activation of the NLRP346 inflammosome, which may counteract coenzyme Q10 supplementation [42]. Vitamin D is an important element in the prevention of musculoskeletal diseases throughout life [43,44]. Hypovitaminosis D is frequently detected in in osteo-articular and other chronic painful diseases, suggesting a correlation between these conditions and pain [45].…”

Oral intermittent Vitamin D substitution: Influence of pharmaceutical form and dosage frequency on medication adherence: A randomized clinical trial

“…Recommended cumulative doses and frequencies of intermittent administration vary widely: 300.000 IU annually [19], 50.000 IU twice weekly [13,20] or 20-25.000 IU weekly [16,21]. Compared with 24.000 IU vitamin D monthly, the administration of 60.000 IU monthly or additional 24.000 IU calcifediol resulted in 25-hydroxyvitamin D levels above 75 nmol/l more often. However, the improvement of the lower extremity function did not differ among the treatment groups, while the incidence of falls differed significantly, with higher incidences in the 60.000 IU group and the 24.000 IU plus calcifediol group [22].…”

“…[23]. In addition, the intake is more reliable with intermittent intake [24,25]. In Switzerland, several oily and alcoholic solutions are currently commercially available for oral daily or intermittent use as well as newly formulated tablets for daily use.…”