X-Message-Number: 31728
Date: Sun, 7 Jun 2009 09:45:10 -0700 (PDT)
From: 
Subject: 5000 IU vitamin D daily for centenarians

[Since most centenarians are grossly deficient in vitamin D, supplementation
would likely lower their elevated mortality rates. In this population a
daily dosage of 5000 IU would appear to be indicated.]

Snip> "Serum 25-hydroxyvitamin D was undetectable in 99 of 104
centenarians"

J Clin Endocrinol Metab. 2003 Nov;88(11):5109-15.
Comment in:  J Clin Endocrinol Metab. 2003 Nov;88(11):5107-8.
Low vitamin D status, high bone turnover, and bone fractures in
centenarians.
    Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi
P, Delsignore R, Pedrazzoni M, Franceschi C. Department of Internal Medicine
and Biomedical Sciences, University of Parma, 43100 Parma, Italy.
    The oldest olds, including centenarians, are increasing worldwide and,
in the near future, will represent a consistent part of the population. We
have studied bone status and metabolism in 104 subjects over 98 yr of age to
evaluate possible interventions able to avoid fragility fractures and
disability. Ninety females and 14 males not affected by any acute disease
were considered. After a complete clinical assessment, blood was drawn for
evaluating bone turnover markers, and performance tests together with
skeletal ultrasonography (either at the phalanges or at the heel) were
performed. We found that 38 subjects had sustained a total of 55 fractures
throughout their lives, and 75% of these were fragility fractures.
Twenty-eight fractures occurred at the proximal femur, with 14 after the age
of 94 yr. Serum 25-hydroxyvitamin D was undetectable in 99 of 104
centenarians. PTH and serum C-terminal fragment of collagen type I were
elevated in 64 and 90% of centenarians, respectively, with a trend toward
hypocalcemia. Bone alkaline phosphatase levels were close to the upper
limit. Serum IL-6 was elevated in 81% of centenarians and was positively
correlated with PTH and negatively correlated with serum calcium. Serum
creatinine was not correlated with PTH. Bone ultrasonography showed that
most centenarians had low values, and ultrasonographic parameters were
correlated with resorption markers. We conclude that the extreme decades of
life are characterized by a pathophysiological sequence of events linking
vitamin D deficiency, low serum calcium, and secondary hyperparathyroidism
with an increase in bone resorption and severe osteopenia. These data offer
a rationale for the possible prevention of elevated bone turnover, bone
loss, and consequently the reduction of osteoporotic fractures and
fracture-induced disability in the oldest olds through the supplementation
with calcium and vitamin D.
PMID: 14602735

Am J Clin Nutr. 2008 Jun;87(6):1952-8.
Vitamin D intake to attain a desired serum 25-hydroxyvitamin D
concentration.
    Aloia JF, Patel M, Dimaano R, Li-Ng M, Talwar SA, Mikhail M, Pollack S,
Yeh JK. Bone Mineral Research Center, Winthrop University Hospital, Mineola,
NY, USA.
    BACKGROUND: Indirect evidence suggests that optimal vitamin D status is
achieved with a serum 25-hydroxyvitamin D [25(OH)D] concentration >75
nmol/L. OBJECTIVE: We aimed to determine the intake of vitamin D(3) needed
to raise serum 25(OH)D to >75 nmol/L. DESIGN: The design was a 6-mo,
prospective, randomized, double-blinded, double-dummy, placebo-controlled
study of vitamin D(3) supplementation. Serum 25(OH)D was measured by
radioimmunoassay. Vitamin D(3) intake was adjusted every 2 mo by use of an
algorithm based on serum 25(OH)D concentration. RESULTS: A total of 138
subjects entered the study. After 2 dose adjustments, almost all active
subjects attained concentrations of 25(OH)D >75 nmol/L, and no subjects
exceeded 220 nmol/L. The mean (+/-SD) slope at 9 wk [defined as 25(OH)D
change/baseline dose] was 0.66 +/- 0.35 (nmol/L)/(microg/d) and did not
differ statistically between blacks and whites. The mean daily dose was 86
microg (3440 IU). The use of computer simulations to obtain the most
participants within the range of 75-220 nmol/L predicted an optimal daily
dose of 115 microg/d (4600 IU). No hypercalcemia or hypercalciuria was
observed. CONCLUSIONS: Determination of the intake required to attain serum
25(OH)D concentrations >75 nmol/L must consider the wide variability in the
dose-response curve and basal 25(OH)D concentrations. Projection of the
dose-response curves observed in this convenience sample onto the population
of the third National Health and Nutrition Examination Survey suggests a
dose of 95 microg/d (3800 IU) for those above a 25(OH)D threshold of 55
nmol/L and a dose of 125 microg/d (5000 IU) for those below that threshold.
PMID: 18541590

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