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Comparison of Daily, Weekly, and Monthly Vitamin D3 in Ethanol Dosing Protocols for Two Months in Elderly Hip Fracture Patients

Metabolic Bone Diseases Unit (S.I.-S., E.S., T.S., B.R.), Rambam Health Care Campus, Haifa 31096, Israel; Bruce Rappaport Faculty of Medicine (S.I.-S.), Technion, Haifa 31096, Israel; University of Toronto (I.L.B., R.V.), Toronto M5S 1A7 Ontario, Canada; and Mount Sinai Hospital (I.L.B., R.V.), Toronto, M5G 1X5 Ontario, Canada

Address all correspondence and requests for reprints to: S. Ish-Shalom, Metabolic Bone Diseases Unit, Rambam Medical Center, P.O. Box 9602, Haifa 31096, Israel. E-mail: s_ish_shalom{at}rambam.health.gov.il.

Background: Different dosing protocols have been used for vitamin D supplementation, but there has been a lack of comparative data among them.

Objective: Our objective was to determine whether the same cumulative dose of vitamin D3 produces different effects if it is given daily, weekly, or monthly.

Design: Women, age 81 ± 8 yr (± SD, n = 48), who had undergone surgery to repair hip fracture were randomized to vitamin D3-supplementation protocols at 1,500 IU daily, or 10,500 IU once weekly, or 45,000 IU once every 28 d. The primary outcome measure was the serum 25-hydroxyvitamin D [25(OH)D] concentration attained.

Results: Initially, serum 25(OH)D concentrations for daily, weekly, and monthly groups were, respectively, 15.13 ± 6.9, 15.7 ± 10.1, and 16.2 ± 10.1 ng/ml. By d 7, these had increased significantly in all the groups (P < 0.001). On the first day after the monthly dose, both serum 25(OH)D and serum 1,25-dihydroxyvitamin D had increased significantly (P < 0.012 each), whereas these did not change significantly on the day after daily or weekly doses. After 2 months, serum 25(OH)D with daily, weekly, and monthly dosing were, respectively, 33.2 ± 8.5, 29.2 ± 8.9, and 37.1 ± 10.3 ng/ml; there were no significant differences among these values.

Conclusions: Supplementation with vitamin D can be achieved equally well with daily, weekly, or monthly dosing frequencies. Therefore, the choice of dose frequency can be based on whichever approach will optimize an individual’s adherence with long-term vitamin D supplementation.

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