Comparison of the effect of daily versus bolus dose maternal vitamin D 3 supplementation on the 24,25-dihydroxyvitamin D 3 to 25-hydroxyvitamin D 3 ratio

• Published in: Bone (New York, N.Y.) Vol. 110; p. 321
• Main Authors: Ketha, Hemamalini, Thacher, Tom D, Oberhelman, Sara S, Fischer, Philip R, Singh, Ravinder J, Kumar, Rajiv
• Format: Journal Article
• Language: English
• Published: United States 01.05.2018
• Subjects: 24,25-Dihydroxyvitamin D 3 - blood; Adult; Calcifediol - blood; Chromatography, Liquid; Dietary Supplements; Female; Humans; Infant; Lactation - drug effects; Tandem Mass Spectrometry; Vitamin D - administration & dosage; Young Adult; LC-MS/MS; Catabolism; Vitamin D metabolism; Safety; Lactation; Nutrition
• ISSN: 1873-2763
• DOI: 10.1016/j.bone.2018.02.024

Supplementing lactating mothers with high doses of vitamin D can adequately meet vitamin D requirements of the breastfed infant. We compared the effect of bolus versus daily vitamin D dosing in lactating mothers on vitamin D catabolism. We hypothesized that catabolism of 25(OH)D to 24,25(OH) D would be greater in the bolus than in the daily dose group. Randomized controlled trial (clinicaltrials.govNCT01240265) in 40 lactating women. Subjects were randomized to receive vitamin D orally, either a single dose of 150,000IU or 5000IU daily for 28days. Vitamin D metabolites were measured in serum and breast milk at baseline, 1, 3, 7, 14 and 28days. Temporal changes in the serum 24,25(OH) D /25(OH)D ratio. The concentration of serum 24,25(OH) D was directly related to that of 25(OH)D in both groups (r =0.63; p<0.001). The mean (±SD) 24,25(OH) D /25(OH)D ratio remained lower at all time points than baseline values in the daily dose group (0.093±0.024, 0.084±0.025, 0.083±0.024, 0.080±0.020, 0.081±0.023, 0.083±0.018 at baseline, 1, 3, 7, 14, and 28days, respectively). In the single dose group, the increase in 24,25(OH) D lagged behind that of 25(OH)D, but the 24,25(OH) D /25(OH)D values (0.098±0.032, 0.067±0.019, 0.081±0.017, 0.092±0.024, 0.103±0.020, 0.106±0.024, respectively) exceeded baseline values at 14 and 28days and were greater than the daily dose group at 14 and 28days (p=0.003). The 24,25(OH) D /25(OH)D ratio remained in the normal range with both dosing regimens. Greater breast milk vitamin D values in the single dose group were inversely associated with the 24,25(OH) D /25(OH)D ratio (r =0.14, p<0.001), but not with daily dosing. After a 14-day lag, a single high dose of vitamin D led to greater production of 24,25(OH) D , presumably via induction of the 24-hydroxylase enzyme (CYP24A1), relative to the 25(OH)D value than did daily vitamin D supplementation, and this effect persisted for at least 28days after vitamin D administration. A daily dose of vitamin D may have more lasting effectiveness in increasing 25(OH)D with lesser diversion of 25(OH)D to 24,25(OH) D than does larger bolus dosing.