Vitamin D Deficiency Clinical Trial
Circa-annual variations in 25-hydroxyvitamin D [25(OH)D] levels have been well established,
and there also seems to be an effect of season on bone turnover and bone mass. been shown
that bone turnover follows a circa-annual rhythm. On the basis of human clinical results, it
was suggested that adipose tissue functions as a vitamin D buffering system that to a
certain extent prevents uncontrolled synthesis of 25(OH)D in the liver. Directly related to
this issue is the question of how much vitamin D is needed to ensure target serum
25-hydroxyvitamin D [25(OH)D] concentrations. According to the recommended dietary
allowances, persons should achieve "levels of intake of essential nutrients considered to be
adequate to meet the known nutritional needs of practically all healthy persons" Moreover it
is important to note that the significant percentage of the population is temporarily of
continuously deficient in vitamin D. In the similar condition of vitamin D deficiency, the
aetiology is very different since only as almost exclusively as a consequence of a primary
disease in children it is manifested: hypovitaminosis D is highly prevalent among children
on renal substitution therapy, regardless of the type of therapy used and the stage of renal
failure.
The rationale providing high dose strengths of vitamin D based on an assumption of better
compliance especially in adult with senior age patients; also a potential for faster
resolution of vitamin D deficiency, since utilization of cholecalciferol is higher when
patients had low levels of 25(OH)D, and vice versa, there is a plateau phase when close to
normal range (Vieth 2001).
According to clinical data, a doses equivalent of daily 1000 IU, (7000 IU per week, or 30000
IU per month) is considered as a minimal effective dose to treat vitamin D deficiency. The
treatment of vitamin D with a duration of 30 days may result and increase of 6-12.5 nmol/L.
With the deficiency criteria considered as <20 ng/ml, the vitamin supplementation is
indicative, the treatment dosages should be adjusted to the increase planned to achieve the
mid-normal range.
As the base of calculations, the doses of 40 IU results in an increase of 0.4 ng/ml in a
period of 60 days. Accordingly 1000 IU in a period of 2-5 month resulted in an increase of
approx 10 ng/ml. The risk of overdose in relatively low, since the absorption and the
metabolic path is well controlled: automatic mechanisms downregulation at normal ranges.
In this study the there are three groups in the similar daily dose equivalent of 1000
IU/day. The absorption of daily , weekly and monthly dosing should have a buffered effect
due to the body adipose tissues, balancing the daily 1,25(OH)D levels, and moreover to
provide a biological reservoir. The three doses are considered as comparable in efficacy and
safety.
The fourth group is intended to utilize the expanded dose range of 4286 IU/ day, using the
30.000 IU tablets on a weekly dosing schedule. This group is to demonstrate the efficacy of
higher doses to normalize the vitamin D levels, within a reasonable timeframe of 60-90 days.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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