Vitamin D3 Dose Requirement That Raises 25-Hydroxyvitamin D to Desirable Level in Overweight and Obese Elderly

Abstract

Purpose To investigate the impact of two vitamin D doses, bracketed between the IOM recommended dietary allowance (RDA) and the upper tolerable limit, on vitamin D nutritional status in elderly individuals. Methods This is a post-hoc analysis on data collected from a 12-month, double-blinded, randomized control trial. 221 ambulatory participants (≥ 65 years), with a mean BMI of 30.2 kg/m 2, and a mean baseline serum 25-hydroxyvitamin D [25(OH)D] level of 20.4 ± 7.4 ng/ml, were recruited from 3 out-patient centers in Lebanon. They all received 1,000 mg of elemental calcium from calcium citrate daily, and the daily equivalent of 600 IU or 3,750 IU, of vitamin D3. Results Mean 25-hydroxyvitamin D [25(OH)D] level at 12 months was 26.0 ng/ml with low dose and 36.0 ng/ml with high dose, of vitamin D3. The proportion of participants reaching a value ≥ 20 ng/ml was 86% in the low dose, and 99% in the high-dose arms, with no differences between genders. The increment of 25(OH)D per 100 IU/day was 1ng/ml with the low dose, and 0.41 ng/ml with the high dose. Serum 25 (OH)D levels at 1 year were highly variable in both treatment arms. Baseline 25(OH)D level and vitamin D dose, but not age, BMI, gender, nor season, were significant predictors of serum 25(OH)D level post-intervention. Conclusion The IOM RDA of 600 IU/day does not bring 97.5% of ambulatory elderly individuals above the desirable threshold of 20 ng/ml. Country-specific RDAs are best derived taking into account the observed variability and predictors of achieved 25(OH)D levels.

Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement

“…In detail, we recommend a vitamin D supplementation dose of 800 to 2000 IU per day for adults who want to ensure a sufficient vitamin D status, with up to 4000 IU per day for certain groups, particularly for patients with obesity and malabsorption syndromes, as well as for individuals with a dark skin pigmentation (see Table 5 ). The relatively wide dose ranges for vitamin D account for various differences in the dose-response relationship for a given supplemental vitamin D dose and the achieved 25(OH)D concentration with higher dose requirements with increasing body weight and vice versa [ 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ]. If a clinician is asked by a random individual which vitamin D dose is safe and very likely avoids vitamin D deficiency, a dose of 800 to 1000 IU per day should fulfill these criteria for the vast majority, even if individual characteristics, including the 25(OH)D status, is unknown.…”

PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment

“…This approach may be an effective weapon in obese women and in the treatment of PCOS patients with insulin-resistance. Excluding kidney, liver, or internistic disease that modifies absorption, after evaluation of VD3 dose requirement, data from the literature suggest that the dose of 1000 IU per day corresponding to 25 mcg seems to be the most effective at raising 25-OH-D levels to sufficient amounts, during three months of therapy in PCOS women with VD deficiency [ 85 ].…”

Effect of 12-Week BMI-Based Vitamin D3 Supplementation in Parkinson’s Disease with Deep Brain Stimulation on Physical Performance, Inflammation, and Vitamin D Metabolites

“…The recommended dose for healthy young adults is 1000–2000 International Units (IU)/day [ 51 ]. For obese and overweight individuals, the doses are higher and range between 2500 and 4800 IU/day [ 52 , 53 , 54 ]. Taking these recommendations into consideration, along with the fact that serum concentration in PD patients is insufficient and lower than in healthy age-matched controls, the following doses were prescribed: for BMI under 25, 4000 International Units (IU)/day; for BMI between 25 and 30, 5000 IU/day; and for BMI over 30, 6000 IU/day.…”