An effective oral vitamin D replacement therapy in persons with spinal cord injury

• Published in: The journal of spinal cord medicine 2011-09, Vol.34 (5), p.455-460
• Main Authors: Bauman, William A., Emmons, Racine R., Cirnigliaro, Christopher M., Kirshblum, Steven C., Spungen, Ann M.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adult; Analysis of Variance; Bone loss; Calcium; Calcium - blood; Calcium - urine; Cholecalciferol; Collagen Type I - urine; Female; Humans; Male; Middle Aged; Nutritional supplementation; Osteoporosis; Paraplegia; Parathyroid Hormone - blood; Parathyroid Hormone - urine; Peptides - urine; Prospective Studies; Spinal cord injuries; Spinal Cord Injuries - drug therapy; Spinal Cord Injuries - urine; Tetraplegia; Time Factors; Veterans; Vitamin D; Vitamin D - administration & dosage; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D - urine; Vitamin D deficiency; Vitamin D Deficiency - drug therapy; Vitamin D Deficiency - urine
• ISSN: 1079-0268; 2045-7723
• DOI: 10.1179/2045772311Y.0000000032

Background/objective Vitamin D deficiency is prevalent in chronic spinal cord injury (SCI). A 3-month course of oral vitamin D 3 to 'normalize' serum vitamin D levels was investigated. Design Prospective drug-intervention study. Setting VA Medical Center; private rehabilitation facility. Methods Seven individuals with chronic SCI and vitamin D deficiency completed 3 months of oral vitamin D 3 (i.e. cholecalciferol) supplementation. At screening, baseline, and months 1 and 3, blood was collected for serum calcium, 25 hydroxyvitamin D [25(OH)D], intact parathyroid hormone (iPTH), and N-telopeptide (NTx); 24-hour urine for calcium, creatinine, and NTx was performed. Oral vitamin D 3 (2000 IU daily) and elemental calcium (1.3 g daily) were prescribed for 90 days. The results are expressed as mean ± standard deviation (SD). Analysis of variance with a Fisher's post-hoc analysis was performed to test for differences between study visits. Subjects were classified as deficient (30 ng/ml) in 25(OH)D. Results Serum 25(OH)D levels were greater at months 1 and 3 than at baseline (26 ± 6 and 48 ± 17 vs. 14 ± 2 ng/ml; P = 0.005). Six of seven subjects were no longer deficient [25(OH)D >30 ng/ml] by month 3. Serum iPTH levels were significantly decreased at month 1 and month 3; serum NTx levels were significantly lower at month 3 than at baseline. Serum and urinary calcium levels remained within the normal range. Conclusion A daily prescription of 2000 IU of oral vitamin D 3 for 3 months safely raised serum 25(OH)D levels into the normal range in persons with chronic SCI on calcium supplementation.