High-dose intramuscular vitamin D provides long-lasting moderate increases in serum 25-hydroxyvitamin D levels and shorter-term changes in plasma calcium

Shelley Gorman, Mark Zafir, Ee Mun Lim, Michael W. Clarke, Gursimran Dhamrait, Naomi Fleury, John P. Walsh, Martin Kaufmann, Glenville Jones, Robyn M. Lucas

Research output: Contribution to journalArticle

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Abstract

The best management of Vitamin D deficiency, defined as a 25-hydroxyVitamin D [(25(OH)D] level <50 nM, is unclear. Intramuscular (IM) injection of a large bolus of Vitamin D (≥100 000 IU) is used, but its safety is uncertain. In 10 adults given an IM injection of 600 000IU Vitamin D3, we measured at baseline and at 1, 2, 3, and 4 weeks postinjection the serum levels of Vitamin D3, 25(OH)D3, 25(OH)D2, total 25(OH)D, 3-epi-25(OH)D3, and 24,25-dihydroxyVitamin D3 [24,25(OH)2D3] using a standardized LC with tandem MS (MS/MS) assay; serum levels of 25(OH)D using the Abbott ARCHITECT i2000 immunoassay; and markers of bone metabolism. Bone markers and 25(OH)D (immunoassay) were remeasured at 24 weeks. All participants had baseline total 25(OH)D levels >50 nM. Serum 25(OH)D levels increased at 3, 4, and 24 weeks postinjection, peaking at 4 weeks [mean ± SEM of 126 ± 7.9 nM (immunoassay) and 100 ± 5.5 nM (LC-MS/MS)] but generally remained <125 nM, the upper limit recommended by the U.S. Institute of Medicine. Serum 24,25(OH)2D3 levels increased at 3 and 4 weeks postinjection. Serum ionized calcium levels were higher than baseline at 1, 3, and 4 weeks postinjection but remained within the clinically normal range. Other biochemical parameters, including other Vitamin D metabolites, plasma alkaline phosphatase, and parathyroid hormone levels, were unchanged. IM injection of a large bolus of Vitamin D effectively increases serum 25(OH)D levels without evidence of metabolic abnormality.

Original languageEnglish
Pages (from-to)1337-1344
JournalJournal of AOAC International
Volume100
Issue number5
DOIs
Publication statusPublished - 1 Sep 2017

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vitamin
vitamin D
Vitamin D
serum
calcium
Calcium
Plasmas
plasma
vitamin D deficiency
parathyroid hormone
dosage
Serum
immunoassays
alkaline phosphatase
medicine
metabolites
Metabolites
injection
Parathyroid Hormone
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division

Cite this

Gorman, Shelley ; Zafir, Mark ; Lim, Ee Mun ; Clarke, Michael W. ; Dhamrait, Gursimran ; Fleury, Naomi ; Walsh, John P. ; Kaufmann, Martin ; Jones, Glenville ; Lucas, Robyn M. / High-dose intramuscular vitamin D provides long-lasting moderate increases in serum 25-hydroxyvitamin D levels and shorter-term changes in plasma calcium. In: Journal of AOAC International. 2017 ; Vol. 100, No. 5. pp. 1337-1344.
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abstract = "The best management of Vitamin D deficiency, defined as a 25-hydroxyVitamin D [(25(OH)D] level <50 nM, is unclear. Intramuscular (IM) injection of a large bolus of Vitamin D (≥100 000 IU) is used, but its safety is uncertain. In 10 adults given an IM injection of 600 000IU Vitamin D3, we measured at baseline and at 1, 2, 3, and 4 weeks postinjection the serum levels of Vitamin D3, 25(OH)D3, 25(OH)D2, total 25(OH)D, 3-epi-25(OH)D3, and 24,25-dihydroxyVitamin D3 [24,25(OH)2D3] using a standardized LC with tandem MS (MS/MS) assay; serum levels of 25(OH)D using the Abbott ARCHITECT i2000 immunoassay; and markers of bone metabolism. Bone markers and 25(OH)D (immunoassay) were remeasured at 24 weeks. All participants had baseline total 25(OH)D levels >50 nM. Serum 25(OH)D levels increased at 3, 4, and 24 weeks postinjection, peaking at 4 weeks [mean ± SEM of 126 ± 7.9 nM (immunoassay) and 100 ± 5.5 nM (LC-MS/MS)] but generally remained <125 nM, the upper limit recommended by the U.S. Institute of Medicine. Serum 24,25(OH)2D3 levels increased at 3 and 4 weeks postinjection. Serum ionized calcium levels were higher than baseline at 1, 3, and 4 weeks postinjection but remained within the clinically normal range. Other biochemical parameters, including other Vitamin D metabolites, plasma alkaline phosphatase, and parathyroid hormone levels, were unchanged. IM injection of a large bolus of Vitamin D effectively increases serum 25(OH)D levels without evidence of metabolic abnormality.",
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High-dose intramuscular vitamin D provides long-lasting moderate increases in serum 25-hydroxyvitamin D levels and shorter-term changes in plasma calcium. / Gorman, Shelley; Zafir, Mark; Lim, Ee Mun; Clarke, Michael W.; Dhamrait, Gursimran; Fleury, Naomi; Walsh, John P.; Kaufmann, Martin; Jones, Glenville; Lucas, Robyn M.

In: Journal of AOAC International, Vol. 100, No. 5, 01.09.2017, p. 1337-1344.

Research output: Contribution to journalArticle

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T1 - High-dose intramuscular vitamin D provides long-lasting moderate increases in serum 25-hydroxyvitamin D levels and shorter-term changes in plasma calcium

AU - Gorman, Shelley

AU - Zafir, Mark

AU - Lim, Ee Mun

AU - Clarke, Michael W.

AU - Dhamrait, Gursimran

AU - Fleury, Naomi

AU - Walsh, John P.

AU - Kaufmann, Martin

AU - Jones, Glenville

AU - Lucas, Robyn M.

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N2 - The best management of Vitamin D deficiency, defined as a 25-hydroxyVitamin D [(25(OH)D] level <50 nM, is unclear. Intramuscular (IM) injection of a large bolus of Vitamin D (≥100 000 IU) is used, but its safety is uncertain. In 10 adults given an IM injection of 600 000IU Vitamin D3, we measured at baseline and at 1, 2, 3, and 4 weeks postinjection the serum levels of Vitamin D3, 25(OH)D3, 25(OH)D2, total 25(OH)D, 3-epi-25(OH)D3, and 24,25-dihydroxyVitamin D3 [24,25(OH)2D3] using a standardized LC with tandem MS (MS/MS) assay; serum levels of 25(OH)D using the Abbott ARCHITECT i2000 immunoassay; and markers of bone metabolism. Bone markers and 25(OH)D (immunoassay) were remeasured at 24 weeks. All participants had baseline total 25(OH)D levels >50 nM. Serum 25(OH)D levels increased at 3, 4, and 24 weeks postinjection, peaking at 4 weeks [mean ± SEM of 126 ± 7.9 nM (immunoassay) and 100 ± 5.5 nM (LC-MS/MS)] but generally remained <125 nM, the upper limit recommended by the U.S. Institute of Medicine. Serum 24,25(OH)2D3 levels increased at 3 and 4 weeks postinjection. Serum ionized calcium levels were higher than baseline at 1, 3, and 4 weeks postinjection but remained within the clinically normal range. Other biochemical parameters, including other Vitamin D metabolites, plasma alkaline phosphatase, and parathyroid hormone levels, were unchanged. IM injection of a large bolus of Vitamin D effectively increases serum 25(OH)D levels without evidence of metabolic abnormality.

AB - The best management of Vitamin D deficiency, defined as a 25-hydroxyVitamin D [(25(OH)D] level <50 nM, is unclear. Intramuscular (IM) injection of a large bolus of Vitamin D (≥100 000 IU) is used, but its safety is uncertain. In 10 adults given an IM injection of 600 000IU Vitamin D3, we measured at baseline and at 1, 2, 3, and 4 weeks postinjection the serum levels of Vitamin D3, 25(OH)D3, 25(OH)D2, total 25(OH)D, 3-epi-25(OH)D3, and 24,25-dihydroxyVitamin D3 [24,25(OH)2D3] using a standardized LC with tandem MS (MS/MS) assay; serum levels of 25(OH)D using the Abbott ARCHITECT i2000 immunoassay; and markers of bone metabolism. Bone markers and 25(OH)D (immunoassay) were remeasured at 24 weeks. All participants had baseline total 25(OH)D levels >50 nM. Serum 25(OH)D levels increased at 3, 4, and 24 weeks postinjection, peaking at 4 weeks [mean ± SEM of 126 ± 7.9 nM (immunoassay) and 100 ± 5.5 nM (LC-MS/MS)] but generally remained <125 nM, the upper limit recommended by the U.S. Institute of Medicine. Serum 24,25(OH)2D3 levels increased at 3 and 4 weeks postinjection. Serum ionized calcium levels were higher than baseline at 1, 3, and 4 weeks postinjection but remained within the clinically normal range. Other biochemical parameters, including other Vitamin D metabolites, plasma alkaline phosphatase, and parathyroid hormone levels, were unchanged. IM injection of a large bolus of Vitamin D effectively increases serum 25(OH)D levels without evidence of metabolic abnormality.

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