Vitamin D3 Dose Requirement to Raise 25-Hydroxyvitamin D to Desirable Levels in Adolescents: Results from a Randomized Controlled Trial

Abstract

Several organizations issued recommendations on desirable serum 25-hydroxy vitamin D [25(OH)D] levels and doses of vitamin D needed to achieve them. Trials allowing the formulation of evidence-based recommendations in adolescents are scarce. We investigated the ability of two doses of vitamin D 3 in achieving recommended vitamin D levels in this age group. Post hoc analyses on data from a 1-year double-blind trial that randomized 336 Lebanese adolescents, aged 13 AE 2 years, to placebo, vitamin D 3 at 200 IU/ day (low dose), or 2000 IU/day (high dose). Serum 25(OH)D level and proportions of children achieving levels !20 ng/mL and 30 ng/ mL were determined. At baseline, mean 25(OH)D was 15 AE 7 ng/mL, 16.4 AE 7 ng/mL in boys, and 14 AE 8 ng/mL in girls, p ¼ 0.003, with a level !20 ng/mL in 18% and !30 ng/mL in 5% of subjects. At 1 year, mean levels were 18.6 AE 6.6 ng/mL in the low-dose group, 17.1 AE 6 ng/mL in girls, and 20.2 AE 7 ng/mL in boys, p ¼ 0.01, and 36.3 AE 22.3 ng/mL in the high-dose group, with no sex differences. 25(OH)D increased to !20 ng/mL in 34% of children in the low-dose and 96% in the high-dose group, being higher in boys in the lowdose arm only; it remained !30 ng/mL in 4% of children in the low-dose arm but increased to 64% in the high-dose arm. Baseline 25 (OH)D level, body mass index (BMI), and vitamin D dose assigned were the most significant predictors for reaching a 25(OH)D level !20 ng/mL and 30 ng/mL. A daily dose of 2000 IU raised 25(OH)D level !20 ng/mL in 96% of adolescents (98% boys versus 93% girls). Dose-response studies are needed to determine in a definitive manner the daily allowance of vitamin D for Middle Eastern adolescents with a similar profile.

Hypovitaminosis D in a Young Lebanese Population: Effect of GC Gene Polymorphisms on Vitamin D and Vitamin D Binding Protein Levels

“…A deficiency in vitamin D has indeed been observed in different studies and categories of the Lebanese population (adolescents, university students, adults, and postmenopausal women) (Gannagé-Yared et al, 2003;Gannagé-Yared et al, 2009a, b, 2010Al-Shaar et al, 2014;Hoteit et al, 2014).…”

The Effect of Oral Supplementation of Vitamin D3 on Serum Levels of Vitamin D: A Review

“…Figure 1, which shows the data from the twenty most reliable and homogeneous studies [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26], exhibits a positive correlation between amounts of oral vitamin D administered and change in serum vitamin D levels. Figure 1 shows the change in vitamin D serum levels from the most rigorous studies that gave daily doses of cholecalciferol.…”

“…We found 25 informative studies which showed a significant dose-response between oral supplementation and serum levels of vitamin D with an r 2 of 0.61.These data are consistent with single studies and meta-analyses.In conclusion, the data show a consistent relationship that appears to be independent of multiple confounders. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Nine studies meeting our criteria evaluated individuals with disease included individuals with vitamin D deficiency [23,24], individuals with diabetes [25][26][27], relapsing multiple sclerosis patients [28], individuals with early stage prostate cancer [29], patients with previous hip fractures [30], and Parkinson Disease [31].…”

Vitamin D Supplementation in Children With Epilepsy and Intellectual Disability

“…They found many factors to be associated with reaching the desired level, such as baseline 25-(OH)D concentration, supplementation dose, and factors influencing vitamin D metabolism. 30,31 According to the Dutch guidelines, supplementation is recommended without measuring the vitamin D level. 7,25 Based on multivariate analysis in our study, the only factor significantly associated with 25(OH)D concentration at 15 months was baseline 25-(OH)D concentration.…”

“…It seems that the effect in these children differs from that in healthy children. [26][27][28][29][30][31] We investigated the factors that are associated with serum 25-hydroxyvitamin D (25-(OH) D) concentrations in children with epilepsy and intellectual disability. We will also determine whether supplementation in doses which were at least equal to the amount recommended by the guidelines leads to a sufficient vitamin D status in all these children after 6 and 15 months.…”