How is vitamin D deficiency treated?

Two forms of vitamin D supplement exist: D2 (ergocalciferol, derived from plants) and D3 (cholecalciferol, derived from mammals). D3 is more rapidly absorbed, but either is sufficient for treatment. Interestingly, small studies showed that sunlight exposure alone is insufficient for treatment. The supplement’s half-life is approximately 2 weeks; maximal clinical response usually is within a month of therapy and may persist for 2 months after stopping therapy.

Controversy exists regarding treatment doses, schedule and duration. A recent report in Pediatrics highlighted several cases of mild hypercalcemia from vitamin D replacement. Thus, take care when choosing a dose and treatment duration. Follow-up is needed to monitor 25-hydroxy vitamin D, calcium and phosphorus levels. Special populations including children with malabsorption or obesity may require 2-3 times higher doses to reach goal 25-hydroxy vitamin D level >30 ng/ml.

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