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ICU patients 6X more likely to die if poor response to 570,000 IU of Vitamin D – RCT April 2025


Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency

J Formos Med Assoc. 2025 Apr;124(4):355-360. doi: 10.1016/j.jfma.2024.05.005
An-Yi Wang 1, Yu-Chang Yeh 2, Kuang-Hua Cheng 3, Yin-Yi Han 4, Ching-Tang Chiu 2, Chai-Chi Chang 2, I-Ting Wang 5, Anne Chao 6

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Background: Vitamin D deficiency is associated with mortality and morbidity in critically ill patients. This study investigated the safety and effectiveness of enteral high-dose vitamin D supplementation in intensive care unit (ICU) patients in Asia.

Methods: This was a multicenter, prospective, randomized-controlled study. Eligible participants with vitamin D deficiency were randomly assigned to the control or vitamin D supplementation group. In the vitamin D supplementation group, the patients received 569,600 IU vitamin D. The primary outcome was the serum 25(OH)D level on day 7.

Results: 41 and 20 patients were included in the vitamin D supplementation and control groups, respectively. On day 7, the serum 25(OH)D level was significantly higher in the vitamin D supplementation group compared to the control group (28.5 [IQR: 20.2-52.6] ng/mL and 13.9 [IQR: 11.6-18.8] ng/mL, p < 0.001).
Only 41.5% of the patients achieved serum 25(OH)D levels higher than 30 ng/mL in the supplementation group. This increased level was sustained in the supplementation group on both day 14 and day 28. There were no significant adverse effects noted in the supplementation group. Patients who reached a serum 25(OH)D level of >30 ng/mL on day 7 had a significantly lower 30-day mortality rate than did those who did not (5.9% vs 37.5%, p < 0.05).

Conclusions: In our study, less than half of the patients reached adequate vitamin D levels after the enteral administration of high-dose vitamin D. A reduction in 30-day mortality was noted in the patients who achieved adequate vitamin D levels.
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A previous study by the same authors found similar benefits to good responders in ICU

Some ICU patients got 540,000 IU of Vitamin D: good responders lived longer than controls or poor responders – RCT June 2024
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VitaminDWiki - Vitamin D is needed before many surgeries – many studies and RCTs


VitaminDWiki - ways to increase the response

The following is derived from: Reasons for low response to vitamin D

ReasonsSolutions
Obese Give more Vitamin D
Dark Skin Give more Vitamin D
Known poor response
Autism, MS, Diabetes, some Cancers
Give more Vitamin D
Fatty liver disease
Anemia
Give more
Give Calcidiol, (does not need the liver))
Gall-bladder removedGive water dispersable Vitamin D
Poor gut
Bariatric Surgery
Give Gut-Friendly Vitamin D
Low Magnesium Give Magnesium Sulfate
(Mg is essential for Vitamin D metabolism)
Consider giving Mg if poor 3 day response
it appears that some people cannot
process a single large dose
Spread out the loading dose
Such as 50,000 IU daily
Poor gene activationsSome supplements re-activate some genes

Attached files

ID Name Comment Uploaded Size Downloads
22458 Poor response, increased death.webp admin 02 Apr, 2025 18.93 Kb 16
22457 Poor response, increased death.webp admin 01 Apr, 2025 19.76 Kb 40
22456 high-dose vitamin D in critically ill patients_CompressPdf.pdf admin 01 Apr, 2025 408.00 Kb 4