Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol

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Abstract
Background: The cholecalciferol inputs required to achieve or maintain any given serum 25-hydroxycholecalciferol concentration are not known, particularly within ranges comparable to the probable physiologic supply of the vitamin. Objectives: The objectives were to establish the quantitative relation between steady state cholecalciferol input and the resulting serum 25-hydroxycholecalciferol concentration and to estimate the proportion of the daily requirement during winter that is met by cholecalciferol reserves in body tissue stores. Design: Cholecalciferol was administered daily in controlled oral doses labeled at 0, 25, 125, and 250 μg cholecalciferol for ≈20 wk during the winter to 67 men living in Omaha (41.2° N latitude). The time course of serum 25-hydroxycholecalciferol concentration was measured at intervals over the course of treatment. Results: From a mean baseline value of 70.3 nmol/L, equilibrium concentrations of serum 25-hydroxycholecalciferol changed during the winter months in direct proportion to the dose, with a slope of ≈0.70 nmol/L for each additional 1 μg cholecalciferol input. The calculated oral input required to sustain the serum 25-hydroxycholecalciferol concentration present before the study (ie, in the autumn) was 12.5 μg (500 IU)/d, whereas the total amount from all sources (supplement, food, tissue stores) needed to sustain the starting 25-hydroxycholecalciferol concentration was estimated at ≈96 μg (≈3800 IU)/d. By difference, the tissue stores provided ≈78–82 μg/d. Conclusions: Healthy men seem to use 3000–5000 IU cholecalciferol/d, apparently meeting > 80% of their winter cholecalciferol need with cutaneously synthesized accumulations from solar sources during the preceding summer months. Current recommended vitamin D inputs are inadequate to maintain serum 25-hydroxycholecalciferol concentration in the absence of substantial cutaneous production of vitamin D.