Spinal Cord injury outcome was better if got Vitamin D and progesterone within 4 hours – RCT 2016

Created January 2018

Effects of progesterone and vitamin D on outcome of patients with acute traumatic spinal cord injury; a randomized, double-blind, placebo controlled study.

J Spinal Cord Med. 2016 May;39(3):272-80. doi: 10.1080/10790268.2015.1114224. Epub 2015 Dec 17.

Aminmansour B1, Asnaashari A1, Rezvani M1, Ghaffarpasand F2, Amin Noorian SM3, Saboori M1, Abdollahzadeh P4.

* Intramuscular injection of 0.5 mg/kg progesterone twice daily * 5µg/kg oral vitamin D3 twice daily up to 5 days* = 32,000 IU daily for 80 kg (176 lbs) person (400 IU/day/kg) = total of 160,000 IU*     many other vitamin D studies use loading doses of 300,000 to 800,000 IU*     Some of the study participants might have achieved a useful level of vitamin D by day 5A single loading dose of Vitamin D would have resulted in good level in 3 rather than 5 days---* Search Vitamin D Life for PROGESTERONE 372 items as of Jan 2018* Traumatic Brain Injuries routinely treated by Vitamin D, Omega-3, Progesterone and Gluatmine* Traumatic brain injury treated by Vitamin D Progesterone Omega-3 and glutamine – May 2013* Progesterone activates vitamin D receptor - many studies*     It appears that Progesterone improves the Vitamin D Receptor* Spinal cord injuries 2.8 X more likely to get worse in 1 year if low vitamin D – Jan 2018 1. Overview Loading of vitamin D contains the following{include}

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BACKGROUND:

Steroid hormones offer promising therapeutic perspectives during the acute phase of spinal cord injury (SCI) while the role of progesterone and vitamin D remain controversial. The aim of the current study was to investigate the effects of progesterone and vitamin D on functional outcome of patients with acute traumatic SCI.

METHODS:

This was a randomized clinical trial including 64 adult patients with acute traumatic SCI admitted within 8 hours of injury. All the patients received methylprednisolone on admission according to standard protocol (30 mg/kg as bolus dose and 15 mg/kg each 3 hours up to 24 hours). Patients were randomly assigned to receive intramuscular injection of 0.5 mg/kg progesterone twice daily and 5µg/kg oral vitamin D3 twice daily up to 5 days (n = 32) or placebo (n = 32). Patients were visited 6 days, 3 and 6 months after injury and motor and sensory function was assessed according to American Spinal Injury Association (ASIA) score.

RESULTS:

There was no significant difference between two study groups regarding age (P = 0.341), sex (P = 0.802) and therapy lag (P = 0.609). The motor powers and sensory function increased significantly after 6 months in both study groups. Those who received progesterone and vitamin D had significantly higher motor powers and sensory function after 6 months of therapy.

Those who received the therapy within 4 hours of injury, had significantly higher motor powers and sensory function 6 months after treatment in progesterone and vitamin D group. Therapy lag was negatively associated with 6-month motor powers and sensory function in progesterone and vitamin D group.

CONCLUSIONS:

Administration of progesterone and vitamin D in acute phase of traumatic SCI is associated with better functional recovery and outcome.

PMID: 26832888 PMCID: PMC5073761 DOI: 10.1080/10790268.2015.1114224

Tags: Loading dose Spinal Cord