title: Vitamin D supplementation versus combined calcium and vitamin D in older female patients - an observational study.
abstract: BACKGROUND
  In most developed countries overt vitamin D deficiency, characterized by rickets or osteomalacia, is now uncommon. However, subclinical vitamin D insufficiency is extremely common and may contribute to the development of skeletal and non-skeletal problems. Standard practice involves supplementation with a combination of vitamin D and calcium although the benefit of adding calcium to vitamin D supplements has not been fully established and may reduce adherence due to its bulky and chalky consistency.
  
  
  OBJECTIVE
  To compare the effects of vitamin D alone versus vitamin D/calcium supplements on vitamin D levels, bone profile and parathyroid hormone level.
  
  
  METHODS
  Older (> 65 years) female patients living in the community and long term care institutions.
  
  
  METHODS
  Either 800 iu of vitamin D3 or a composite supplement of 800 iu vitamin D3 and 1000 mg calcium were given to patients in an open-labelled observational study. Serum 25-hydroxy-vitamin D, parathyroid hormone, calcium, phosphate and alkaline phosphatase levels were assessed at baseline and after 3 months of treatment.
  
  
  RESULTS
  Serum 25-hydroxy-vitamin D levels rose from baseline levels of 25 ± 16 to 79 ± 16 in those treated with vitamin D alone and from 35 ± 24 nmol/L to 70 ± 24 nmol/L in those treated with vitamin D and calcium. Serum PTH levels fell by similar amounts in both groups. In both community dwellers and institutionalised patients, those treated with vitamin D alone were at least as likely to achieve normalisation of serum vitamin D levels as those on combined calcium/vitamin D treatment.
  
  
  CONCLUSIONS
  Vitamin D alone appears as effective as combined calcium/vitamin D treatment in restoring serum vitamin D levels in older community dwelling and institutionalised patients. A prospective randomised trial would help confirm these findings.
authors.affiliation: Department of Medicine for the Elderly, University Hospital Galway.
authors.forename: T
authors.initials: T
authors.lastname: Dinizulu
authors.forename: D
authors.initials: D
authors.lastname: Griffin
authors.forename: J
authors.initials: J
authors.lastname: Carey
authors.forename: E
authors.initials: E
authors.lastname: Mulkerrin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000494:pharmacology / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000494:pharmacology / Q000627:therapeutic use*; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D018977:Micronutrients / Q000494:pharmacology / Q000627:therapeutic use*; D010281:Parathyroid Hormone / Q000097:blood*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy*
chemical_list: D018977:Micronutrients; D010281:Parathyroid Hormone; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D; D002118:Calcium