Vitamin D Therapy in Clinical Practice: One Dose Does Not Fit All

P. J. Ryan

Disclosures

Int J Clin Pract. 2007;61(11):1894-1899. 

In This Article

Results

There were a total of 1028 patients in the database of average age 62 years (SD 13.9). The mean vitamin D level of the whole 1028 patients was 48 nmol/l (SD 26) with those without supplements 42 nmol/l (SD 22) and those on supplements 64 nmol/l. One hundred patients had preclinic and follow-up vitamin D levels. They were of average age 61 years (SD 12) with a mean baseline vitamin D of 26 nmol/l. The mean posttreatment level was 58 nmol/l (SD 25). Posttreatment vitamin D levels are shown below of these 100 patients is shown in Table 1 .

The average increase in vitamin D levels was 32 nmol/l but with a wide variation and an SD of 26 nmol/l. The greatest increase in vitamin D level was 124 nmol/l on Calichew D3 Forte two tablets a day. Four patients had lower levels posttreatment than pretreatment. Patients were treated with a variety of supplements but the largest subgroup were treated with Calcichew D3 Forte two tablets per day with each tablet containing 500 mg calcium and 400 IU vitamin D3. Patients were instructed to take medication with food preferably their evening meal if given a single tablet and one at lunch and one in the evening if given two. In the subgroup of 41 patients on Calcichew D3 Forte two tablets per day pretreatment vitamin D was 24 nmol/l (SD 16) and posttreatment 62 nmol/l (SD 28). Posttreatment vitamin D levels on Calcichew D3 Forte two tablets per day are shown in Table 2 . The lowest value was 12 nmol/l. The range of increases in vitamin D in response to Calcichew D3 Forte is set out in Table 3 .

Two hundred and ten patients already on vitamin D treatment preclinic had a mean age of 64 years and a mean vitamin D level of 64 nmol/l (SD 28). The distribution of the results is set out in Table 4 . The largest group of 124 patients on two tablets of Calcichew D3 Forte per day average age 66 years had a mean vitamin D of 68 nmol/l (SD 27). The distribution of results for these patients is set out in Table 5 .

The mean vitamin D level of those on vitamin D at presentation age over 65 years was 64.2 nmol/l and under 65 years 63.7 nmol/l. For those on Calcichew D3 Forte two tablets per day the values were 67.6 and 62.7 nmol/l respectively. Separate examination of those with a vitamin D level of < 40 nmol/l showed an average age of 65 years and for those > 40 nmol/l, 63 years. Further analysis of the 100 patients who commenced treatment showed an average increase in vitamin D of 38 nmol/l for those with a baseline of < 26 nmol/l (n = 60) and 24 nmol/l for those with a baseline of > 26 nmol/l.

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