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Rapid correction of low vitamin D status in nursing home residents

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Abstract

Summary

This prospective study finds that ergocalciferol 50,000 IU three times weekly for four weeks effectively and safely corrects vitamin D inadequacy in nursing home residents.

Introduction

Low vitamin D status is common among nursing home residents and contributes to bone loss, falls and fractures. The objective of this study was to evaluate the efficacy and safety of short course, high dose, oral vitamin D2 (ergocalciferol) treatment.

Methods

This prospective study included 63 nursing home residents. The 25 with low vitamin D status (serum 25(OH)D ≤ 25 ng/ml) received oral ergocalciferol 50,000 IU three times weekly for four weeks; the others received no change to their routine care. Serum total 25(OH)D, 25(OH)D2, 25(OH)D3, calcium, parathyroid hormone (PTH), bone turnover markers and neuro-cognitive assessments were obtained at baseline and four weeks.

Results

Mean total 25(OH)D concentration increased (p < 0.0001) from 17.3 to 63.8 ng/ml in the treated group and remained unchanged in the comparison group. Serum 25(OH)D3 remained stable in the comparison group, but declined (p < 0.0001) with D2 treatment from 15.4 to 9.1 ng/ml. Serum PTH trended down in the treatment group (p = 0.06). No treatment-induced improvement in ambulation, cognition or behavior was observed. No hypercalcemia or other adverse effects were observed with ergocalciferol treatment.

Conclusion

Four weeks of oral vitamin D2 supplementation effectively and safely normalizes serum 25(OH)D in nursing home residents.

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Acknowledgements

The authors thank Thomas Zenner, MD, Thomas Flygt, MD, Wendy Jobe, RN, Jane Belongie, RN, Jamie Hendrix, RN, Monica Montgomery, RN, Patty Hoeffel, MSSW, Kathy DeNiel, RN and Pamela Przybelski, BS, without whose assistance this work would not have been possible.

Conflicts of interest

All authors (Przybelski, Agrawal, Krueger, Engelke, Walbrun and Binkley) have no conflicts of interest relevant to this work.

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Authors and Affiliations

  1. University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA

    R. Przybelski, S. Agrawal, D. Krueger, J. A. Engelke & N. Binkley

  2. Green Bay, WI, USA

    F. Walbrun

  3. University of Wisconsin Osteoporosis Research Program, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA

    R. Przybelski

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  1. R. Przybelski
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  2. S. Agrawal
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  3. D. Krueger
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  4. J. A. Engelke
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  6. N. Binkley
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Correspondence to R. Przybelski.

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Przybelski, R., Agrawal, S., Krueger, D. et al. Rapid correction of low vitamin D status in nursing home residents. Osteoporos Int 19, 1621–1628 (2008). https://doi.org/10.1007/s00198-008-0619-x

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  • DOI: https://doi.org/10.1007/s00198-008-0619-x

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