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Low dose vitamin D may be more effective in preventing falls than high doses

Posted on: January 5, 2016   by  Vitamin D Council

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Researchers recently conducted a study to determine the ideal vitamin D dose to prevent bone problems in the elderly. Contrary to the researchers’ hypothesis, individuals who took the lowest dose of vitamin D, at 24,000 IU monthly, had less falls than those taking higher doses.

Time Magazine published a new article on the study. Click here to take a look.

7 Responses to Low dose vitamin D may be more effective in preventing falls than high doses

  1. hlahore@gmail.com

    Vitamin D INCREASED falls – 7 reasons why the study was probably invalid– Jan 2015
    http://vitamindwiki.com/tiki-index.php?page_id=7231
    7 reasons why it was not a random controlled trial.

  2. JA Larson

    http://archinte.jamanetwork.com/article.aspx?articleid=2478897

    1. Control group receiving 24 000 IU of vitamin D3 (24 000 IU group) 1x per month

    2. Group 2 received 60 000 IU of vitamin D3 (60 000 IU group) 1x/month

    3. Group 3 received 24 000 IU of vitamin D3 plus 300 µg of calcifediol (24 000 IU plus calcifediol group) 1x/month.

    Outcome measures (0, 6, 12 months):

    1. The SPPB score (our primary outcome) was used to assess lower extremity function by walking speed, successive chair stands, and a balance test.

    2. The secondary outcome was self-reported falls to the floor (diary & phone interviews).

    – Entry status:

    — All 200 participants had reported a fall in the year before enrollment.
    — Their mean (SD) age was 78 years, and 67.0% (134 of 200) were female.

    — 42.0% (84 of 200) of participants were vitamin D replete at baseline (≥20 ng/mL),
    — 58.0% (116 of 200) were vitamin D deficient (<20 ng/mL),
    — 13.0% (26 of 200) were severely deficient (<10 ng/mL).
    — All were mobile and could use public transportation. The exclusion rules are too long to quote.

    Looking at D bar chart, at 12 months the avg D was (some small guessing here):

    Group 1 (24k)– 31 ng/ml

    Group 2 (60k)– 39 ng/ml

    Group 3 (24k plus)– 45 ng/ml

    Outcomes:

    The study divided the population into D scores by quartile.

    a. SPPB score. No statistical difference.

    b. Falls. All the reviews quote the relative risk by D level.

    The actual number of mean self-reported falls in 12 months by group by entry D status (20) varied from 0.78 to 1.65.

    The authors noted that higher D level folks might be more active and therefore have more falls. But, no data.

    • JA Larson

      The actual number of mean self-reported falls in 12 months by treatment group varied from 0.94 to 1.47.(Table 2)

    • JA Larson

      Ignoring the minor outcomes….

      Dr. Hollis, MD, points out that D3 half-life is 24 hours. 25(OH)D half-life is 3-4 weeks.

      Therefore dosing should be daily.

      See also http://www.healio.com/endocrinology/bone-mineral-metabolism/news/online/{d86dcc5c-d6ac-4823-917b-339ad2fd675d}/high-dose-infrequent-vitamin-d-supplementation-reduces-efficacy-in-older-women

      Dr. Heaney points out methodological issues in nutrition research.

      See http://www.ncbi.nlm.nih.gov/pubmed/24330136

  3. rcbaker200@comcast.net

    The beneficial effects if any of giving a bolus of vitamin d3 once a month (in this case an average 2000 units a day) if not really tested. Thousands of people may take 40 mg of Lipitor a day for cholesterol, a total of 1200 mg. a month. But would anyone suggest that a patient be given a bolus of 1200 mg of Lipitor once a month? No, that is insane. Giving a bolus once a month vitamin D and expecting positive results is almost just as insane. In fact one could theorize that a bolus of vitamin D increases metabolic activity in the bone for several days and then by suddenly and totally withdrawing vitamin d for the rest of the month may lead to an accelerated loss of calcium from the bones in spite of the levels. Don’t ask for studies, there are none, just a theory. If the authors really wanted to demonstrate if vitamin D is beneficial, why didn’t they give some subjects 2000 U. every day.

  4. rcbaker200@comcast.net

    By the way, over 80% of Americans get low doses of vitamin D and that results in the billion dollar industry of osteoporosis. So that experiment has already been done.

  5. Rita Celone Umile

    Personally, I would prefer if researchers tested the 25(OH)D levels of subjects and then dosed them daily with an amount of D3 that brought (and maintained) their 25(OH)D level around 50-70 ng/ml. Just my opinion…. 😉

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