Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 28;16(1):111.
doi: 10.3390/nu16010111.

Intense Testing and Use of Vitamin D Supplements Leads to Slow Improvement in Vitamin D Adequacy Rates: A Cross-Sectional Analysis of Real-World Data

Rodis D Paparodis  1   2   3   4 , Dimitra Bantouna  3 , Evangelos Karvounis  5 , Ioannis Zoupas  6 , Sarantis Livadas  3   7   8 , Nicholas Angelopoulos  3   9 , Shahnawaz Imam  2 , Dimitrios T Papadimitriou  3   10 , Juan C Jaume  4
Affiliations

Intense Testing and Use of Vitamin D Supplements Leads to Slow Improvement in Vitamin D Adequacy Rates: A Cross-Sectional Analysis of Real-World Data

Rodis D Paparodis et al. Nutrients. .

Abstract

Background: Vitamin D testing (VDT) and supplement use (VDS) are on the rise, but most patients remain deficient (<30 ng/mL-VDD). We designed the present real-world study to assess this paradox.

Methods: We reviewed data from all patients visiting our clinics between 2014 and 2022. We estimated the rate of patients with vitamin D adequacy (≥30 ng/mL) (VDA) by year and month of testing, the dose of VDS (low (≤1200 IU/day), medium (1201-3000 I/day) and high dose (>3000 IU/day)), intake duration (short-term (<12 months) and long-term use (≥12 months)), and timing of use (current use, former use, no use).

Results: We enrolled n = 6912 subjects with vitamin D measurements: n = 5195 females (75.2%), age 44.0 ± 16.8 years, BMI 27.9 ± 6.5 kg/m2; never users: n = 5553 (80.3%), former users: n = 533 (7.7%), current users: n = 826 (12.0%). Current use of VDS was higher in females. VDT rose from 42.1% in 2014 to 92.7% in 2022, and VDA rose from 14.8% to 25.5% for the same time. VDA was found overall in n = 1511 (21.9%); Never users: n = 864 (15.6%), Former users: n = 123 (23.2%); and Current users: n = 370 (44.8%). The maximal VDA (67.9%) was found in subjects using high-dose VDS in the long term.

Conclusions: Despite the significant rise in VDT and VDS use, VDA was found in a minority of patients. Prolonged use of high-dose supplements produces modest improvements in VDA.

Keywords: cholecalciferol; vitamin D adequacy; vitamin D deficiency; vitamin D insufficiency; vitamin D supplementation.

PubMed Disclaimer

Conflict of interest statement

Paparodis has received speaker honoraria and has served as a consultant and/or advisor for the following pharmaceutical companies, which manufacture and/or distribute vitamin D supplements in Greece: ITF, Rafarm, Proton Pharma, Innovis, IBSA, Faran, Isoplus. All other authors have no relevant financial or non-financial interests to disclose.

Figures

Figure 1
Figure 1
A flow diagram of the study enrollment. Legend: NU: never users of vitamin D-containing supplements; FU: former users of vitamin D-containing supplements; CU: current users of vitamin D-containing supplements. H: high dose of vitamin D-containing supplements (>3000 IU daily); M: medium dose of vitamin D-containing supplements (1200–3000 IU daily); L: low dose of vitamin D-containing supplements (≤1200 IU daily); ST: short-term use of vitamin D-containing supplements (<12 months); LT: long-term use of vitamin D-containing supplements (≥12 months).
Figure 2
Figure 2
(A) The monthly rate of vitamin D deficiency (<30 ng/mL) of the entire cohort. (B) The monthly mean serum vitamin D concentration of each subgroup split by the history of vitamin D supplement use: never users (N) (those who never used any vitamin D-containing supplement), former users (F) (those who used vitamin D-containing supplements in the past), and current users (C) (those who currently use vitamin D-containing supplements).
Figure 3
Figure 3
(A) The frequency (%) of available vitamin D measurements in the entire clinic’s patient population each year. (B) The rate (%) of subjects with vitamin D adequacy (>30 ng/mL) per year. (C) The mean serum vitamin D concentration (ng/mL) of the entire cohort per year of study. (D) The rate (%) of subjects with any history of vitamin D-containing supplements use per year.
See this image and copyright information in PMC

References

    1. Holick M.F. The One-Hundred-Year Anniversary of the Discovery of the Sunshine Vitamin D3: Historical, Personal Experience and Evidence-Based Perspectives. Nutrients. 2023;15:593. doi: 10.3390/nu15030593. - DOI - PMC - PubMed
    1. Papadimitriou D.T. The Big Vitamin D Mistake. J. Prev. Med. Public Health = Yebang Uihakhoe Chi. 2017;50:278–281. doi: 10.3961/jpmph.16.111. - DOI - PMC - PubMed
    1. Veugelers P.J., Ekwaru J.P. A statistical error in the estimation of the recommended dietary allowance for vitamin D. Nutrients. 2014;6:4472–4475. doi: 10.3390/nu6104472. - DOI - PMC - PubMed
    1. Giustina A., Adler R.A., Binkley N., Bollerslev J., Bouillon R., Dawson-Hughes B., Ebeling P.R., Feldman D., Formenti A.M., Lazaretti-Castro M., et al. Consensus statement from 2(nd) International Conference on Controversies in Vitamin D. Rev. Endocr. Metab. Disord. 2020;21:89–116. doi: 10.1007/s11154-019-09532-w. - DOI - PMC - PubMed
    1. Roth D.E., Abrams S.A., Aloia J., Bergeron G., Bourassa M.W., Brown K.H., Calvo M.S., Cashman K.D., Combs G., De-Regil L.M., et al. Global prevalence and disease burden of vitamin D deficiency: A roadmap for action in low- and middle-income countries. Ann. N. Y. Acad. Sci. 2018;1430:44–79. doi: 10.1111/nyas.13968. - DOI - PMC - PubMed