title: Evaluation of ergocalciferol or cholecalciferol dosing, 1,600 IU daily or 50,000 IU monthly in older adults.
abstract: BACKGROUND
  Whether ergocalciferol (D(2)) and cholecalciferol (D(3)) are equally effective to increase and maintain serum 25-hydroxyvitamin D [25(OH)D] concentration is controversial.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the effect of daily and once monthly dosing of D(2) or D(3) on circulating 25(OH)D and serum and urinary calcium.
  
  
  METHODS
  In a university clinical research setting, 64 community dwelling adults age 65+ were randomly assigned to receive daily (1,600 IU) or once-monthly (50,000 IU) D(2) or D(3) for 1 yr.
  
  
  METHODS
  Serum 25(OH)D, serum calcium, and 24-h urinary calcium were measured at months 0, 1, 2, 3, 6, 9, and 12. Serum PTH, bone-specific alkaline phosphatase, and N-telopeptide were measured at months 0, 3, 6, and 12.
  
  
  RESULTS
  Serum 25(OH)D was less than 30 ng/ml in 40% of subjects at baseline; after 12 months of vitamin D dosing, levels in 19% of subjects (n = 12, seven receiving daily doses and five monthly doses) remained low, despite compliance of more than 91%. D(2) dosing increased 25(OH)D(2) but produced a decline (P < 0.0001) in 25(OH)D(3). Substantial between-individual variation in 25(OH)D response was observed for both D(2) and D(3). The highest 25(OH)D observed was 72.5 ng/ml. Vitamin D administration did not alter serum calcium, PTH, bone-specific alkaline phosphatase, N-telopeptide, or 24-h urine calcium.
  
  
  CONCLUSIONS
  Overall, D(3) is slightly, but significantly, more effective than D(2) to increase serum 25(OH)D. One year of D(2) or D(3) dosing (1,600 IU daily or 50,000 IU monthly) does not produce toxicity, and 25(OH)D levels of less than 30 ng/ml persist in approximately 20% of individuals. Substantial between-individual response to administered vitamin D(2) or D(3) is observed.
authors.affiliation: Osteoporosis Clinical Center and Research Program,University of Wisconsin, Madison, Wisconsin 53705, USA. nbinkley@wisc.edu
authors.forename: N
authors.initials: N
authors.lastname: Binkley
authors.forename: D
authors.initials: D
authors.lastname: Gemar
authors.forename: J
authors.initials: J
authors.lastname: Engelke
authors.forename: R
authors.initials: R
authors.lastname: Gangnon
authors.forename: R
authors.initials: R
authors.lastname: Ramamurthy
authors.forename: D
authors.initials: D
authors.lastname: Krueger
authors.forename: M K
authors.initials: MK
authors.lastname: Drezner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D002118:Calcium / Q000097:blood / Q000652:urine; D002762:Cholecalciferol / Q000008:administration & dosage*; D002940:Circadian Rhythm; D004304:Dosage Forms; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004872:Ergocalciferols / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D010919:Placebos; D014807:Vitamin D / Q000097:blood
chemical_list: D050071:Bone Density Conservation Agents; D004304:Dosage Forms; D004872:Ergocalciferols; D010919:Placebos; D014807:Vitamin D; D002762:Cholecalciferol; D002118:Calcium