Impact of oral vitamin D supplementation on serum 25-hydroxyvitamin D levels in oncology
Pankaj G Vashi email, Kristen Trukova email, Carolyn A Lammersfeld email, Donald P Braun email and Digant Gupta email
Nutrition Journal 2010, 9:60doi:10.1186/1475-2891-9-60, 23 November 2010
Background
Serum 25-hydroxyvitamin D [25(OH)D] is the major circulating form of vitamin D and a standard indicator of vitamin D status. Emerging evidence in the literature suggests a high prevalence of suboptimal vitamin D (as defined by serum 25(OH)D levels of <32 ng/ml) as well as an association between lower serum levels and higher mortality in cancer. We investigated the effect of oral vitamin D supplementation as a means for restoring suboptimal levels to optimal levels in cancer.
Methods
This is a retrospective observational study of 2198 cancer patients who had a baseline test prior to initiation of cancer therapy at our hospital to evaluate serum 25(OH)D levels between Jan 08 and Dec 09 as part of their initial nutritional evaluation. Patients with baseline levels of <= 32 ng/ml (n=1651) were considered to have suboptimal serum 25(OH)D levels and were supplemented with 8000 IU of Vitamin D3 (four 2000 IU D3 capsules) daily as part of their nutritional care plan. The patients were retested at their first follow-up visit. Of 1651 patients, 799 were available for follow up assessment. The mean serum 25(OH)D levels were compared in these 799 patients across the 2 time points (baseline and first follow-up) using paired sample t-test. We also investigated the factors associated with response to vitamin D supplementation.
Results
Of 2198 patients, 814 were males and 1384 females. 1051 were newly diagnosed and treated at our hospital while 1147 were diagnosed and treated elsewhere. The mean age at presentation was 55.4 years. The most common cancer types were breast (500, 22.7%), lung (328, 14.9%), pancreas (214, 9.7%), colorectal (204, 9.3%) and prostate (185, 8.4%). The mean time duration between baseline and first follow-up assessment was 14.7 weeks (median 10.9 weeks and range 4 weeks to 97.1 weeks). The mean serum 25(OH)D levels were 19.1 ng/ml (SD = 7.5) and 36.2 ng/ml (SD = 17.1) at baseline and first follow-up respectively; p <0.001. Patients with prostate and lung cancer had the highest percentage of responders (70% and 69.2% respectively) while those with colorectal and pancreas had the lowest (46.7% each). Similarly, patients with serum levels 20-32 ng/ml at baseline were most likely to attain levels >32 ng/ml compared to patients with baseline levels <20 ng/ml.
Conclusions
The response to supplementation from suboptimal to optimal levels was greatest in patients with prostate and lung cancer as well as those with baseline levels between 20-32 ng/ml. Characteristics of non-responders as well as those who take longer to respond to supplementation need to be further studied and defined. Additionally, the impact of improved serum 25(OH)D levels on patient survival and quality of life needs to be investigated.
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Giving 8000 IU to Cancer patients got about half back up to 32 ng/ml level in 8 weeks
The following table shows the detailed response vs cancer type.
A patient = responder if they got up to 32 ng/ml in 8 weeks
As would be expected, many (65%) of those with <12 ng did not respond/replete to 32 ng/ml in the 8 weeks
It is interesting to see the vitamin D levels before and after the 8 week supplementation vs cancer type
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It will be interesting in the future to see results of the next 8 weeks & 8,000 IU -as well as possible death rates of those who got the 8,000 IU vs standard death rates for those cancers
It seems clear, in hindsight, that they should have given more than 8,000 IU daily to those who were initially < 16 ng, or have started with a 50,000 or 100,000 IU repletion dose.
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See also at VitaminDWiki
- Restoring vitamin D levels to Pancreatic patients required up to 20000 IU daily – May 2012
- How I Treat Vitamin D Deficiency - for Cancer Mar 2010
- Is there an optimal level of vitamin D to prevent cancer – Sept 2010 not too little, and not too much
- Mechanisms of the Anticancer and Anti-Inflammatory Actions of Vitamin D – 2010
- Meta-analysis reduction in 3 cancers by adding 10 ng of vitamin D – May 2010
- Overview Cancer and vitamin D
- Cancer survivors helped with lots of Vitamin D – Aug 2010
- Metastatic Cancer is maybe reduced by vitamin D - 5 articles
- Is vitamin D the only supplement which consistently helps cancer survivors – Aug 2010
Possible concern: Might get too much Chemotherapy if not adjust it down when increase vitamin D
See also at VitaminDWiki: BREAST CANCER
- Women with breast cancer safely take 10,000 IU daily – Jan 2010
- Breast cancer survivors should take vitamin D – Mar 2010
- Vitamin D3 sensitizes breast cancer to radiation treatment - increasing cancer cell death – May 2010
See also at VitaminDWiki: LUNG CANCER
- Use Google to search site for "lung Cancer"
- Does Vitamin D Treat Cancer Vitamin D Council 2008
- Lung cancer and vitamin D many items
- Vitamin D might not TREAT lung cancer – Nov 2010
See all files tagged with various kinds of cancer
Cancer - Bladder
Cancer – Breast
Cancer – Colon
Cancer – Melanoma
Cancer – Pancreatic
Cancer – Prostate
Cancer – General, others
Cancer - After
Following graph from the CDC August 2010
Imagine how many fewer cancers there could have been if the vitamin D levels were 50 ng instead of 20 ng