Vitamin D3 Bests Vitamin D2 for Boosting Total Serum Levels

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Vitamin D3 Bests Vitamin D2 for Boosting Total Serum Levels


600 IU of vitamin D3 significantly more effective in wintertime study
by Kristen Monaco, Contributing Writer, MedPage Today
July 06, 2017

This article is a collaboration between MedPage Today® and: Medpage Today

Action Points

Vitamin D3 was more effective at raising serum total 25-hydroxyvitamin D levels in the wintertime than vitamin D2. Note that most current guidelines, including the NIH, consider both forms for vitamin D to be equivalent although there may differences in efficacy between vitamin D3 (cholecalciferol) and D2 (ergocalciferol).

Vitamin D3 was more effective at raising serum total 25-hydroxyvitamin D [25(OH)D] levels in the wintertime than vitamin D2, according to British researchers.

Biscuits and juice fortified with 15 µg (600 IU) of vitamin D3 showed a significantly greater increase in total 25(OH)D levels among women compared those supplemented with 15 µg (600 IU) of vitamin D2 (74% versus 34% biscuit; 75% versus 33% juice), wrote Laura Tripkovic, PhD, of the University of Surrey in England, and colleagues, in the American Journal of Clinical Nutrition.

Compared with the vitamin D2 biscuit group, both groups saw greater absolute incremental changes in total 25(OH)D:

Vitamin D3 biscuit: Δ 6.1 ng/mL (15.3 nmol/L), 95% CI 3.0-9.3 (7.4-23.3), P<0.0003
Vitamin D3 juice: Δ 6.4 ng/mL (16.0 nmol/L), 95% CI 3.2-9.6 (8.0-23.9), P<0.0001

Similarly, compared with the vitamin D2 juice group, both groups showed a significantly greater absolute incremental changes in total 25(OH)D:

Vitamin D3 biscuits: Δ 6.5 ng/mL (16.3 nmol/L), 95% CI 3.4-9.7 (8.4-24.2), P<0.0001
Vitamin D3 juice:Δ 6.8ng/mL (16.9 nmol/L), 95% CI 3.6-9.9 (9.0-24.8), P<0.0001

During the 12-week trial, participants in the placebo group reported a 25% drop in total 25(OH)D levels: Δ baseline to week 12: -4.5 ng/mL (-11.2 nmol/L), 95% CI -6.7 to -2.3 (-16.7 to -5.8), P<0.0001, the authors reported.

"Our findings show that vitamin D3 is twice as effective as D2 in raising vitamin D levels in the body, which turns current thinking about the two types of vitamin D on its head," Tripkovic stated in a press release. "Those who consume D3 through fish, eggs or vitamin D3 containing supplements are twice as more likely to raise their vitamin D status than when consuming vitamin D2 rich foods such as mushrooms, vitamin D2 fortified bread or vitamin D2 containing supplements, helping to improve their long term health."

Most current guidelines, including the NIH, consider both forms for vitamin D to be equivalent. However, it wasn't until the past 2 decades that the differences in efficacy between vitamin D3 (cholecalciferol) and D2 (ergocalciferol) have been suggested, Tripkovic's group noted, adding that there is still a lack of research that has evaluated the extent of these differences at low doses.

The randomized, double-blind study, which was held during the winter to avoid interference from UV exposure, included 335 South Asian and white European women, ages 20 to 64, who resided in the U.K. All participants were randomized into one of five groups: 15 µg (600 IU) vitamin D2 biscuit or juice, 15 µg (600 IU) vitamin D3 biscuit or juice, or placebo.

The researchers collected data on serum 25(OH)D levels at baseline, 6-weeks, and 12-weeks via liquid chromatography-tandem mass spectrometry. Also, measures were collected on calcium, albumin, and parathyroid hormone levels at all visits.

There were no significant differences in absolute change reported between the juice and biscuit vitamin D3 groups (Δ 0.2 ng/mL [0.6 nmol/L], 95% CI -3.0 to 3.4 [-7.4 to 8.6], P<0.34), nor between the vitamin D2 groups (Δ 0.4 ng/mL [0.9 nmol/L], 95% CI -2.8 to 3.5 [-6.9 to 8.7], P<0.25), which the authors noted this indicates "equivalent bioavailability."

There were also no significant interactions regarding ethnicity, although South-Asian women tended to have a slightly greater response to both type of vitamin D, which the researchers noted was most likely attributed to their lower serum levels at baseline.

"This is a very exciting discovery which will revolutionise how the health and retail sector views vitamin D," stated co-author Susan Lanham-New, PhD, of the University of Surrey in a press release. "Vitamin D deficiency is a serious matter, but this will help people make a more informed choice about what they can eat or drink to raise their levels through their diet."

A study limitation was "the lack of opportunity to generate dose-response data [which] would have provided valuable insight into the physiologic response to vitamin D and thus assisted in elucidating the mechanism behind the observed differences seen in the current data," the authors noted.

Among older adults and those getting insufficient amounts of vitamin D, the American Association of Clinical Endocrinologists recommend to increase vitamin D intake from fortified foods or supplements to at least 800 to 1,000 IU daily. People who have osteoporosis or are concerned about bone health may take a vitamin D supplement of 2000 IU daily.

The study was supported by the Biotechnology and Biological Sciences Research Council (BBSRC).

Tripkovic disclosed no relevant relationships with industry. Lanham-New disclosed a relevant relationship with D3Tex.
 
Glad I have been taking cholecalciferol form! (BIotech brand 50,000 IU). It was interesting that they controlled for UV exposure by doing the testing in the winter. I was gardening yesterday and was aware i didn't put on sunscreen and had been out for a half an hour. I thought I should go in and get sunscreen. Then, it occurred to me, maybe not, because sun should help boost my vitamin D levels. Sun gets your body to make its own D3. Then, why aren't vitamin D-deficient DSers told to get sun exposure? It's a natural way to get increased vitamin D3. A certain amount of sun exposure (less than required to get a sunburn) seems like a good idea. I know vitamin D levels in normies are improved in the summer or in geographical areas with greater sun exposure.
I was always too embarrassed to expose my legs and arms, let alone my midriff or back, when I was fat. Now, I'm embarrassed because of all the sharpei skin hanging everywhere. But I am getting old enough to let it all hang out, and it might be good for me to expose more skin to the sun. I don't know what percentage of vitamin D needs I can get from sun, so I would only use it to add to the supplements, not replace any of it. I am also old enough to be less concerned about skin cancer. But I am not sure the neighbors are ready to see me sunbathing!
 
Then, why aren't vitamin D-deficient DSers told to get sun exposure? It's a natural way to get increased vitamin D3. A certain amount of sun exposure (less than required to get a sunburn) seems like a good idea.
My dh (a DSer) has skin cancer and has been told NO exposure to the sun without sunscreen. I was also told the same when a spot came back marginal for skin cancer. But sunscreen doesn't stop the kind of vitamin D the sun gives us. http://www.skincancer.org/healthy-lifestyle/vitamin-d/damage
 
Thanks for the information. I too wondered why we're not told to go outside more after the surgery. I know that sunlight won't replace taking vitamins, but it could definitely help.
 

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