D3 cholecalciferol
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The Role and Efficacy of Cholecalciferol (Vitamin D3) in Health Management
Cholecalciferol in Multiple Sclerosis (MS) Management
High-Dose Cholecalciferol as Add-On Therapy in RRMS
The SOLAR study explored the impact of high-dose cholecalciferol (14,007 IU daily) as an adjunct to subcutaneous interferon β-1a (scIFNβ-1a) in patients with relapsing-remitting multiple sclerosis (RRMS). Despite no significant differences in disease activity-free status or annual relapse rate (ARR) between the cholecalciferol and placebo groups, cholecalciferol supplementation resulted in a 32% reduction in new combined unique active (CUA) lesions at 48 weeks. This suggests potential benefits in reducing new lesion formation, particularly in younger patients aged 18-30 years.
Cholecalciferol vs. 25-Hydroxycholecalciferol in Serum Vitamin D Levels
Comparative Effectiveness in Older Adults
A study comparing cholecalciferol (D3) and 25-hydroxycholecalciferol [25(OH)D3] found that 25(OH)D3 was approximately three times more effective in raising serum 25-hydroxyvitamin D concentrations. Participants receiving 25(OH)D3 achieved higher steady-state levels more rapidly than those receiving D3, indicating a superior efficacy of 25(OH)D3 in improving vitamin D status.
Cholecalciferol in Chronic Kidney Disease (CKD)
Efficacy in Raising Vitamin D and Reducing PTH Levels
In patients with CKD stages 3 and 4, weekly supplementation with 50,000 IU of cholecalciferol significantly increased serum 25(OH)D levels and showed a trend towards reducing parathyroid hormone (PTH) levels over 12 weeks. This suggests that cholecalciferol is effective in correcting vitamin D insufficiency and may help manage secondary hyperparathyroidism in CKD patients.
Cholecalciferol in Dairy Cows
Impact on Serum Calcium Concentrations
In dairy cows, daily oral administration of cholecalciferol combined with an acidogenic diet and oral calcium post-parturition significantly increased serum calcium concentrations around calving. This strategy effectively mitigates periparturient hypocalcemia, highlighting the role of cholecalciferol in animal health management.
Cholecalciferol in Fracture Prevention
Long-Term Supplementation in the Elderly
A five-year study involving elderly men and women demonstrated that four-monthly supplementation with 100,000 IU of cholecalciferol reduced the incidence of fractures by 22% and fractures at major osteoporotic sites by 33%. This indicates that regular high-dose cholecalciferol supplementation can significantly lower fracture risk in the elderly population.
Stability and Degradation of Cholecalciferol
Analytical Challenges and Solutions
Cholecalciferol is prone to isomerization under various conditions, complicating its analysis. Studies using HPLC-DAD and UHPLC-MS/MS have identified several isomers formed under thermal, acidic, and oxidative conditions. These findings underscore the importance of robust analytical methods to ensure the stability and accurate measurement of cholecalciferol in fortified foods.
Cholecalciferol in Intestinal Calcium Transport
Potent Metabolites
Research has identified a major polar metabolite of cholecalciferol that is significantly more effective than cholecalciferol itself in promoting intestinal calcium transport. This metabolite achieves maximum stimulation of calcium transport much faster than cholecalciferol, suggesting its potential as a highly active form of vitamin D in the intestine.
Combined Vitamin D Therapy in Hemodialysis Patients
Additive Effects on PTH and Vitamin D Levels
In hemodialysis patients with secondary hyperparathyroidism, combined treatment with paricalcitol and cholecalciferol significantly reduced PTH levels and increased serum 25(OH)D and cathelicidin levels. This combination therapy offers a promising approach to managing vitamin D deficiency and hyperparathyroidism in this patient population.
Conclusion
Cholecalciferol (vitamin D3) plays a crucial role in various health conditions, from managing multiple sclerosis and chronic kidney disease to preventing fractures in the elderly and improving calcium transport. Its efficacy, however, can be influenced by the form of vitamin D used, with 25-hydroxycholecalciferol showing superior results in raising serum vitamin D levels. Robust analytical methods are essential for ensuring the stability and accurate measurement of cholecalciferol in fortified products. Combined vitamin D therapies also offer significant benefits in specific patient populations, such as those undergoing hemodialysis.
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