Factors affecting the effectiveness of vitamin D supplementation
https://doi.org/10.51793/OS.2024.27.5.011
Abstract
Background. Due to the prevalence of vitamin D insufficient supply of the population and its pleiotropic effect, optimization of vitamin D status is beyond doubt.
Objective. The purpose of the review is to compare the effectiveness of taking different vitamers, doses, regimens and formulations of vitamin D to optimize vitamin status and manifest pleiotropic effects.
Results. An analysis of the literature revealed a general pattern: smaller doses require longer administration to achieve normal blood plasma 25(ОН)D levels. When taken regularly over a period of 3 to 6 months, doses corresponding to physiological needs will provide sufficient blood serum levels of 25(ОН)D. To obtain maximum benefit, a daily, continuous supply of daily vitamin D in doses of 800-1000 IU is preferable to intermittent bolus doses. The effectiveness of vitamin D depends on the form (oil, micellar, liposomes, etc.). After stopping the additional intake, "washing out" occurs, i.e. after 8-12 weeks, return to the original vitamin D supply. To maintain a normal blood serum level of 25(ОН)D and, accordingly, to have a positive effect on metabolic blood parameters, it is sufficient for healthy people to take vitamin D in a dose close to the age-related physiological requirement – 400-1000 IU/day. Persons taking glucocorticoids, suffering from osteoporosis, diabetes mellitus, obesity (especially after bariatric surgery) require higher doses of vitamins from 2000 to 5000 IU/day.
Conclusion. The main parameters influencing the effectiveness of vitamin D are the vitamer used, the dose, duration and regimen of administration, and the form of release. To achieve an adequate supply with vitamin D and the manifestation of pleiotropic effects, patients require higher doses than healthy individuals.
About the Authors
V. M. Kodentsova
Federal State Budgetary Institution of Science Federal Research Center for Nutrition, Biotechnology and Food Safety
Россия
Россия
Vera M. Kodentsova, Dr. of Sci. (Biol.), Сhief researcher, Laboratory of Vitamins and Minerals
2/14 Ustinsky proezd, Moscow, 109240, Russia
D. V. Risnik
Federal State Budgetary Educational Institution of Higher Education Lomonosov Moscow State University
Россия
Россия
Dmitry V. Risnik, Cand. of Sci. (Biol.), Leading researcher, Department of Biophysics, Faculty of Biology
119234, Moscow, Leninskie Gory, 1, p. 12
References
1. Suplotova L. A., Avdeeva V. A., Rozhinskaya L. Ya. Vitamin D status in residents of Tyumen region. Obesity and metabolism. 2019; 16 (2): 69-74. DOI: 10.14341/omet10162. (In Russ.)
2. Kodentsova V. M., Risnik D. V. Provision of children with vitamin D. Comparative analysis of correction methods. Lechaschi Vrach. 2020; 2: 35-43. DOI: 10.26295/OS.2020.95.40.007. (In Russ.)
3. Kodentsova V. M., Beketova N. A., Nikitjuk D. B., Tutelyan V. A. Characteristics of vitamin provision in the adult population of the Russian Federation. The Russian Journal of Preventive Medicine. 2018; 21 (4): 32-37. DOI: 10.17116/profmed201821432. (In Russ.)
4. Odinaeva N. D., Kondratyeva E. I., Loshkova E. V., et al. Seasonal variations in serum vitamin D levels in children and adults with various diseases. Vopr. det. dietol. (Pediatric Nutrition). 2022; 20 (2): 29-37. DOI: 10.20953/1727-5784-2022-2-29-37. (In Russ.)
5. Smirnova D. V., Rehm C. D., Fritz R. D., et al. Vitamin D status of Russian adult population from 2013 to 2018. Sci Rep. 2022; 12 (1): 16604. DOI: 10.1038/s41598-022-21221-4.
6. Giustina A., Adler R. A., Binkley N., et al. Consensus statement from 2nd International Conference on Controversies in Vitamin D. Rev EndocrMetabDisord. 2020; 21 (1): 89-116. DOI: 10.1007/s11154-019-09532-w.
7. Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol. 2017; 13: 466-479. DOI: 10.1038/nrendo.2017.31.
8. Kodentsova V. M., Vrzhesinskaya O. A. Science-based approaches to the selection and dosage of vitamin and mineral complexes. Traditional Medicine. 2011; 5: 351-357. (In Russ.)
9. Jarusriwanna A., Phusunti S., Chotiyarnwong P., Unnanuntana A. High-dose versus low-dose ergocalciferol for correcting hypovitaminosis D after fragility hip fracture: a randomized controlled trial. BMC Geriatr. 2021; 21: 72. DOI: 10.1186/s12877-021-02023-1.
10. Ganie M. A., Sidana S., Baba M. S., et al. Efficacy and safety of various oral regimens (three oral doses) and schedules (daily v. monthly) of cholecalciferol in North Indian adults with low vitamin D status: evidence from a randomized controlled trial. British Journal of Nutrition. 2023; 129 (10): 1732-1739. DOI: 10.1017/S0007114522002641.
11. Mortensen C., Damsgaard C. T., Hauger H., et al. Estimation of the dietary requirement for vitamin D in white children aged 4-8 y: A randomized, controlled, dose-response trial. The American journal of clinical nutrition. 2016; 104 (5): 1310-1317.
12. Ohlund I., Lind T., Hernell O., et al. Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: A double-blind randomized clinical trial. Am J ClinNutr. 2017; 106 (1): 105-112. DOI: 10.3945/ajcn.116.147108.
13. Smith T. J., Tripkovic L., Damsgaard C. T., et al. Estimation of the dietary requirement for vitamin D in adolescents aged 14-18 y: A dose-response, double-blind, randomized placebo-controlled trial. Am. J. Clin. Nutr. 2016; 104: 1301-1309. DOI: 10.3945/ajcn.116.138065.
14. Aghajafari F., Field C. J., Weinberg A. R., et al. Both mother and infant require a vitamin D supplement to ensure that infants’ vitamin D status meets current guidelines. Nutrients. 2018; 10 (4): 429. DOI: 10.3390/nu10040429.
15. Gharibeh N., Razaghi M., Vanstone C. A., et al. Effect of Vitamin D Supplementation on Bone Mass in Infants With 25-Hydroxyvitamin D Concentrations Less Than 50 nmol/L: A Prespecified Secondary Analysis of a Randomized Clinical Trial. JAMA Pediatr. 2023; 177 (4): 353-362. DOI: 10.1001/jamapediatrics.2022.5837.
16. Aglipay M., Birken C. S., Parkin P. C., et al. Effect of High-Dose vs StandardDose Wintertime Vitamin D Supplementation on Viral Upper Respiratory Tract Infections in Young Healthy Children. JAMA. 2017; 318 (3): 245-254. DOI: 10.1001/jama.2017.87.
17. Fantini C., Corinaldesi C., Lenzi A., et al. Vitamin D as a Shield against Aging. Int J Mol Sci. 2023; 24 (5): 4546. DOI: 10.3390/ijms24054546.
18. Kong S. H., Jang H. N., Kim J. H., et al. Effect of vitamin D supplementation on risk of fractures and falls according to dosage and interval: a meta-analysis. Endocrinol Metab (Seoul). 2022; 37 (2): 344-358. DOI: 10.3803/EnM.2021.1374.
19. Rizzoli R. Vitamin D supplementation: upper limit for safety revisited? Aging ClinExp Res. 2021; 33: 19-24. DOI: 10.1007/s40520-020-01678-x.
20. Farahmand M. A., Daneshzad E., Fung T. T., et al. What is the impact of vitamin D supplementation on glycemic control in people with type-2 diabetes: a systematic review and meta-analysis of randomized controlled trails. BMC Endocr Disord. 2023; 23 (1): 15. DOI: 10.1186/s12902-022-01209-x.
21. Pludowski P., Takacs I., Boyanov M., et al. Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement. Nutrients. 2022; 14 (7): 1483. DOI: 10.3390/nu14071483.
22. Schuetz P., Gregoriano C., Keller U. Supplementation of the population during the COVID-19 pandemic with vitamins and micronutrients – how much evidence is needed? Swiss Med Wkly. 2021; 151: w20522. DOI: 10.4414/smw.2021.20522.
23. Kodentsova V. M., Risnik D. V. Vitamin D – an alimentary factor in the prevention of diseases caused by its deficiency. Medical Council. 2022; 16 (6): 70-80. DOI: 10.21518/2079-701X-2022-16-6-181-191. (In Russ.)
24. Balachandar R., Pullakhandam R., Kulkarni B., Sachdev H. S. Relative Efficacy of Vitamin D2 and Vitamin D3 in improving Vitamin D status: Systematic review and meta-Analysis. Nutrients. 2021; 13 (10): 3328. DOI: 10.3390/nu13103328.
25. Bilezikian J. P., Formenti A. M., Adler R. A., et al. Vitamin D: Dosing, levels, form, and route of administration: Does one approach fit all? Rev Endocr Metab Disord. 2021; 22 (4): 1201-1218. DOI: 10.1007/s11154-021-09693-7.
26. Sosa Henríquez M., Gómez de Tejada Romero M. J. Cholecalciferol or calcifediol in the management of vitamin D deficiency. Nutrients. 2020; 12 (6): 1617. DOI: 10.3390/nu12061617.
27. Gromova O. A., Torshin I. Yu., Chuchalin A. G., et al. Roles of active forms of vitamin D in supporting innate immune systems and in reducing excess inflammation in COVID-19. TerapevticheskiiArkhiv (Ter. Arkh). 2021; 93 (8): 948-953. DOI: 10.26442/00403660.2021.08.200918. (In Russ.)
28. Dukhanin A. S. Vitamin D drug formulation: from active substance to therapeutic effects. Lechaschi Vrach. 2022; 9 (25): 66-71. DOI: 10.51793/OS.2022.25.9.001. (In Russ.)
29. Doskina E. V. The role of various forms of vitamin D in the treatment of patients with vitamin D deficiency (clinical case). Endocrinology: News. Opinions. Teaching, 2021; 10 (2): 123-129. DOI: 10.33029/2304-9529-2021-10-2-123-129. (In Russ.)
30. Gromova O. A., Torshin I. Yu., Pronin A. V. Features of the pharmacology of the water-soluble form of vitamin D based on micelles. Pharmateca. 2015; 1 (294): 28-35. (In Russ.)
31. Shah N. D., Limketkai B. N. The use of medium-chain triglycerides in gastrointestinal disorders. Pract. Gastroenterol. 2017; 41: 20-28.
32. Temova Rakuša Ž., Pišlar M., Kristl A., Roškar R. Comprehensive stability study of vitamin D3 in aqueous solutions and liquid commercial products. Pharmaceutics. 2021; 13: 617. DOI: 10.3390/pharmaceutics13050617.
33. Żurek G., Przybyło M., Witkiewicz W., Langner M. Novel Approach for the Approximation of Vitamin D3 Pharmacokinetics from In Vivo Absorption Studies. Pharmaceutics. 2023; 15 (3): 783. DOI: 10.3390/pharmaceutics15030783.
34. Dałek P., Drabik D., Wołczańska H., et al. Bioavailability by design — Vitamin D3 liposomal delivery vehicles. Nanomedicine. 2022; 43: 102552. DOI: 10.1016/j.nano.2022.102552.
35. Šimoliūnas E., Rinkūnaitė I., Bukelskienė Ž., Bukelskienė V. Bioavailability of different vitamin D oral supplements in laboratory animal model. Medicina (Kaunas). 2019; 55 (6): 265. DOI: 10.3390/medicina55060265.
36. Shikh E. V., Tikhomirov S. V., Zaitseva T. A., et al. Analysis of the effectiveness of the use of various dosage regimens and forms of cholecalciferol in patients with impaired reproductive function. Doctor.Ru. 2019; 4 (159): 54-58. DOI: 10.31550 / 1727-2378-2019-159-4-54-58. (In Russ.)
37. Margieva T. V., Zimina E. P., Bakovich E. A., et al. The Efficacy of Preventing Rachitis in Babies by Using Vitamin D SolutioOleosa: the Results of a ShortTerm Comparative Investigation. Pediatricheskayafarmakologiya — Pediatric pharmacology. 2016; 13 (3): 299-302. DOI: 10.15690/pf.v13i3.1581. (In Russ.)
38. Rosendahl J., Valkama S., Holmlund-Suila E., et al. Effect of higher vs standard dosage of vitamin D3 supplementation on bone strength and infection in healthy infants: a randomized clinical trial. JAMA Pediatr. 2018; 172(7): 646-654. DOI: 10.1001/jamapediatrics.2018.0602.
39. Van Helmond N., Brobyn T. L., LaRiccia P. J., et al. Vitamin D3 Supplementation at 5000 IU Daily for the Prevention of Influenza-like Illness in Healthcare Workers: A Pragmatic Randomized Clinical Trial. Nutrients. 2022; 15 (1): 180. DOI: 10.3390/nu15010180.
40. Gu J. C., Wu Y. G., Huang W. G., et al. Effect of vitamin D on oxidative stress and serum inflammatory factors in the patients with type 2 diabetes. J Clin. Lab. Anal. 2022; 36 (5): e24430. DOI: 10.1002/jcla.24430.
41. Wenclewska S., Szymczak-Pajor I., Drzewoski J., et al. Vitamin D Supplementation Reduces Both Oxidative DNA Damage and Insulin Resistance in the Elderly with Metabolic Disorders. Int. J. Mol. Sci. 2019; 20 (12): 2891. DOI: 10.3390/ijms20122891.
42. Khusankhodzhaeva F. T., Salyamova F. E., Akhmadalieva D. T., Kabilova G. A. A new approach to the treatment of urinary tract infections in patients with type 2 diabetes mellitus by the addition of vitamin D. Uzbek Scholar Journal. 2022; 10: 407-417. (In Russ.)
43. Stepanova A. P., Karonova T. L. Effect of vitamin D therapy on the severity of pain in patients with type 2 diabetes mellitus and diabetic peripheral neuropathy. Osteoporosis and Bone Diseases. 2020; 23 (2): 165-166. (In Russ.)
44. Stepanova A. P., Karonova T. L., Galagoudza M. M. Indicators of microcirculation in patients with type 2 diabetes with diabetic peripheral neuropathy during therapy with various doses of vitamin D. Regional hemodynamics and microcirculation. 2019; 18 (4): 19-28. DOI: 10.24884/1682-6655-2019-18-4-19-28. (In Russ.)
45. Ebrahimkhani S., Ghavamzadeh S., Mehdizadeh A. The effects of vitamin D and curcuminoids supplementation on anthropometric measurements and blood pressure in type 2 diabetic patients with coexisting hypovitaminosis D: A double-blind, placebo-controlled randomized clinical trial. Clin Nutr ESPEN. 2020; 37: 178-186. DOI: 10.1016/j.clnesp.2020.02.017.
46. Penckofer S., Ridosh M., Adams W., et al. Vitamin D supplementation for the treatment of depressive symptoms in women with type 2 diabetes: a randomized clinical trial. J Diabetes Res. 2022; 2022: 4090807. DOI: 10.1155/2022/4090807.
47. Johny E., Jala A., Nath B., et al. Vitamin D Supplementation Modulates Platelet-Mediated Inflammation in Subjects With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Trial. Front Immunol. 2022; 13: 869591. DOI: 10.3389/fimmu.2022.869591.
48. Argano C., MallaciBocchio R., Lo Monaco M., et al. An Overview of Systematic Reviews of the Role of Vitamin D on Inflammation in Patients with Diabetes and the Potentiality of Its Application on Diabetic Patients with COVID-19. Int J Mol Sci. 2022; 23 (5): 2873. DOI: 10.3390/ijms23052873.
49. Todd J., McSorley E., Pourshahidi L., et al. Vitamin D3 supplementation in healthy adults: A comparison between capsule and oral spray solution as a method of delivery in a wintertime, randomised, open-label, cross-over study. Br J Nutr. 2016; 116 (8): 1402-1408. DOI: 10.1017/S000711451600347.
50. Jolliffe D. A., Camargo C. A., Sluyter J. D., et al. Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials. The lancet Diabetes & endocrinology. 2021; 9 (5): 276-292. DOI: 10.1016/S2213-8587(21)00051-6.
51. Holick M. F., Binkley N. C., Bischoff-Ferrari H. A., et al. Endocrine Society: Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J ClinEndocrinolMetab. 2011; 96: 1911-30.
52. Kodentsova V. M., Risnik D. V. Micronutrient metabolic networks and multiple micronutrient deficiency: a rationale for the advantages of vitamin-mineral supplements. Microelements in medicine. 2020; 21(4): 3-20. DOI: 10.19112/2413-6174-2020-21-4-3-20. (In Russ.)
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For citations:
Kodentsova V.M., Risnik D.V. Factors affecting the effectiveness of vitamin D supplementation. Lechaschi Vrach. 2024;(5):62-70. (In Russ.) https://doi.org/10.51793/OS.2024.27.5.011
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