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This version published online on May 20, 2008
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2008-0350
A more recent version of this article appeared on August 1, 2008
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Right arrow Calcium and Bone Metabolism

Submitted on February 12, 2008
Accepted on May 12, 2008

Short and Long Term Variations in Serum Calciotrophic Hormones after a Single Very Large Dose of Ergocalciferol (Vitamin D2) or Cholecalciferol (Vitamin D3) in the Elderly

Elisabetta Romagnoli*, Maria Lucia Mascia, Cristiana Cipriani, Valeria Fassino, Franco Mazzei, Emilio D'Erasmo, Vincenzo Carnevale, Alfredo Scillitani, and Salvatore Minisola

Department of Clinical Sciences (E.R., M.L.M., C.C., V.F., E.D.E., S.M.) and Department of Chemistry and Technology of Biologically Active Substances (F.M.), University of Rome "Sapienza", 00161 Rome, Italy; Department of Internal Medicine (V.C.) and Department of Endocrinology (A.S.), "Casa Sollievo della Sofferenza" Hospital, 71013 San Giovanni Rotondo, Italy

* To whom correspondence should be addressed. E-mail: romagnoli.elisabetta{at}fastwebnet.it.

Context: In humans, few studies have compared the potencies of ergocalciferol and cholecalciferol in improving and maintaining vitamin D status.

Objective: To evaluate the effects of a single very large dose of both calciferols on serum changes of 25-hydroxyvitamin D (25OHD), 1,25-dihydroxyvitamin D (1,25(OH)2D), ionised calcium and parathyroid hormone (PTH) at baseline, and at 3, 7, 30 and 60 days.

Design: This was a prospective randomized intervention study.

Setting: The study was performed in a nursing-home residence.

Participants: Thirty-two elderly female patients (age range 66–97 years), with vitamin D deficiency.

Intervention: Participants were randomized into 4 groups of eight to receive a single dose of 300,000 IU of ergocalciferol or cholecalciferol by oral (os) or intramuscular (im) route.

Results: 25(OH)D levels sharply increased at day 3 only when vitamins were given orally. The 30 day-basal difference in serum 25(OH)D was significantly greater after cholecalciferol oral administration (47.8±7.3 ng/ml) compared with other forms (D3 im: 15.9±11.3; D2 os:17.3±4.7; D2 im: 5±4.4; all p<0.001). The AUC of the serum 25(OH)D against time (AUC60) was: D3 os: 3193±759 ng x d/mL vs D2 os: 1820±512, p<0.001; D3 im: 1361±492 vs D2 im 728±195, p<0.01. 25(OH)D significantly influences PTH levels at 3 (p<0.03), 7 (p<0.01), 30 (p<0.01) and 60 (p<0.05). At 60 days, the form of vitamin (cholecalciferol), significantly lowers PTH levels (p=0.037).

Conclusions: Cholecalciferol is almost twice as potent as ergocalciferol in raising serum 25(OH)D, when administered either by mouth or im. 25(OH)D plays a role in modulating serum PTH.
Key words: ergocalciferol • cholecalciferol • calcitriol • parathyroid hormone




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