Efficacy of weekly versus daily cholecalciferol for repleting serum vitamin D (25(OH)D) deficiency: A systematic review and meta-analysis of randomized controlled trials
Basic Clin Pharmacol Toxicol. 2024 Oct 13. doi: 10.1111/bcpt.14092. DOI: 10.1111/bcpt.14092
Émilie Bortolussi-Courval 1, Connor Prosty 2, Jimin J Lee 1, Lisa M McCarthy 3 4, Emily G McDonald 1 2 5, Todd C Lee 1 2 6
Background/rationale: Weekly cholecalciferol can replace daily supplementation to reduce pill burden in patients with complex medication regimens and hypovitaminosis D, but evidence supporting this switch is unclear.
Objective: We aimed to determine whether weekly cholecalciferol was superior to daily cholecalciferol to replete patients with hypovitaminosis D.
Methods: We conducted a systematic review of randomized controlled trials involving participants with baseline hypovitaminosis D (<30 ng/ml) comparing weekly versus daily cholecalciferol dosing and where serum cholecalciferol was measured within 120 days of starting treatment. We searched MEDLINE, CINAHL and EMBASE from inception to 7 May 2024. A random-effects meta-analysis evaluated the odds ratio for repletion of serum vitamin D levels.
Findings: Eight trials involving 542 patients were included in the analysis. Weekly and daily cholecalciferol were not significantly different in correcting hypovitaminosis D (OR = 1.5, 95% CI = 0.3-6.9, p = 0.6, favouring weekly dosing, I2 = 85.3%). A sensitivity analysis excluding otherwise healthy patients had similar findings (OR = 0.8, 95% CI = 0.3-2.1, p = 0.6). Most studies were at risk of bias; the different doses being compared increased the heterogeneity.
Conclusions: Limited direct evidence supports a switch from daily to weekly cholecalciferol dosing; however, weekly supplementation was not demonstrably worse at repleting levels and decreased a patient's daily pill burden.
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Vitamin D Life – Better than Daily contains:
Non-daily (Bolus) is better:
- Better compliance for everyone
- Fewer opportunities to forget.
- If happen to forget, just take the dose many days later
- Fewer times to have to take a pill - for those who dislike doing so
- Non-daily gets more vitamin D to the cells for the ~20% who have a poor Vitamin D Receptor
- A high concentration gradient is one of 14+ ways to get past Vitamin D Receptor limitations
- So, while 80% get no extra benefit from non-daily dosing, 20% will get an extra benefit
- Weekly Vitamin D better than daily – lower cost, less pill burden, perhaps 1.5X better response – meta-analysis Oct 2024
- Vitamin D given daily, weekly, or monthly has similar response (116 RCTs) – meta-analysis Aug 2023
- 44 percent of successful RCTs in Vitamin D Life used non-daily dosing - Nov 2020
- Monthly vitamin D dosing better for children than daily (again) - Oct 2023
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