Ability of 25-Hydroxyvitamin D3Therapy to Augment Serum 1,25- and 24,25-Dihydroxyvitamin D in Postmenopausal Osteoporosis*

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Abstract
Six women (mean age, 62 yr; range, 48–77 yr) who were considered to have postmenopausal osteoporosis, as demonstrated by radiological evidence of vertebral crush fractures, low intestinal calcium (Ca) absorption, and bone biopsies consistent with this diagnosis, received a pharmacological dose of 25-hydroxyvitamin D3 (25OHD3; 20 µg/day) for 3 months. This treatment increased the serum concentration of 25OHD from 8.7 ± 4.6 to 30.2 ± 9.5 (SD) ng/ml (P < 0.0025), increased the serum concentration of 24,25-dihydroxyvitamin D from 1.2 ± 1.2 to 7.7 ± 2.7 ng/ml (P < 0.025) in three patients, and increased the serum concentration of 1,25-dihydroxyvitamin D from 2.1 ± 1.7 to 4.3 ± 1.5 ng/dl (P < 0.025). Moreover, there were commensurate increases in fractional intestinal Ca absorption from 0.38 ± 0.03 to 0.49 ± 0.06 (P < 0.025) and in urinary Ca from 69 ± 31 to 127 ± 67 mg/day (P < 0.025). There were no significant changes in serum Ca (9.6 ± 0.5 us. 9.5 ± 0.4 mg⁄dl), serum phosphorus (3.4 ± 0.2 us. 3.6 ± 0.4 mg⁄dl) or alkaline phosphatase (87 ± 27 us. 91 ± 30 IU/liter) before or after therapy. It is concluded that orally administered 25OHD3 is not only effective in raising the low intestinal Ca absorption observed in postmenopausal osteoporosis but also in increasing the serum concentrations of 24,25-dihydroxyvitamin D and 1,25-dihydroxyvitamin D.

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