Ergocalciferol side effects
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Ergocalciferol Side Effects: A Comprehensive Review
Introduction to Ergocalciferol
Ergocalciferol, also known as vitamin D2, is commonly used to treat vitamin D deficiency. It is particularly important for patients with chronic kidney disease (CKD) and those undergoing hemodialysis. While ergocalciferol is effective in increasing serum 25-hydroxyvitamin D levels, its side effects and overall impact on health parameters are crucial to understand.
Common Side Effects of Ergocalciferol
Mineral Homeostasis and Hypercalcemia
One of the primary concerns with ergocalciferol supplementation is its impact on mineral homeostasis. Studies have shown that short-term high-dose ergocalciferol treatment does not significantly alter levels of creatinine, phosphate, ionized calcium, parathyroid hormone (PTH), or fibroblast growth factor 23 (FGF23) in CKD patients 2. Additionally, no severe hypercalcemia or serious side effects were noted in patients receiving ergocalciferol, even at high doses 79.
Cardiovascular and Infection-Related Outcomes
In hemodialysis patients, ergocalciferol supplementation did not significantly affect rates of all-cause, cardiovascular, or infection-related hospitalizations 1. This suggests that ergocalciferol does not exacerbate these conditions, although the statistical power for these outcomes was limited.
Pruritus and Skin Conditions
Ergocalciferol has been investigated for its potential to alleviate uremic pruritus in hemodialysis patients. However, studies indicate that ergocalciferol is not effective in reducing pruritus severity compared to placebo 3. This suggests that while ergocalciferol is safe, it may not provide relief for pruritus associated with kidney disease.
Specific Populations and Ergocalciferol Effects
Children with CKD
In children with CKD stages 2-4, ergocalciferol supplementation has been shown to delay the onset of secondary hyperparathyroidism without causing adverse effects 4. This indicates a beneficial role of ergocalciferol in managing bone health in pediatric CKD patients.
Elderly and Postmenopausal Women
In elderly institutionalized women, high-dose ergocalciferol was more effective than standard doses in achieving optimal 25(OH)D levels without causing significant side effects 9. This suggests that higher doses may be necessary for severe vitamin D deficiency in this population.
Insulin Sensitivity and Metabolic Health
In healthy adults with low vitamin D levels, ergocalciferol administration did not improve insulin secretion, insulin sensitivity, or other markers of metabolic health 6. This indicates that while ergocalciferol is effective in normalizing vitamin D levels, it may not have significant metabolic benefits.
Conclusion
Ergocalciferol is generally safe and effective in increasing serum 25-hydroxyvitamin D levels across various populations, including CKD patients, children, and the elderly. It does not significantly impact mineral homeostasis, cardiovascular outcomes, or pruritus severity. However, its benefits on metabolic health and insulin sensitivity are limited. Overall, ergocalciferol remains a valuable treatment for vitamin D deficiency with a favorable safety profile.
Sources and full results
Most relevant research papers on this topic
Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D Deficiency: A Randomized Clinical Trial.
Ergocalciferol supplementation increased serum 25(OH)D levels in hemodialysis patients with vitamin D deficiency, but did not affect epoetin utilization or secondary biochemical and clinical outcomes.
RCTErgocalciferol treatment and aspects of mineral homeostasis in patients with chronic kidney disease stage 4–5
High-dose ergocalciferol treatment showed no harmful effects on mineral homeostasis markers or FGF23 in chronic kidney disease stage 4-5 patients.
RCTThe effect of ergocalciferol on uremic pruritus severity: a randomized controlled trial.
Ergocalciferol did not show a significant reduction in uremic pruritus severity compared to placebo in hemodialysis patients.
RCTErgocalciferol supplementation in children with CKD delays the onset of secondary hyperparathyroidism: a randomized trial.
Ergocalciferol supplementation effectively delays the development of secondary hyperparathyroidism in children with CKD stages 2-4.
RCT
Highly CitedShort and long-term variations in serum calciotropic hormones after a single very large dose of ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) in the elderly.
Cholecalciferol is nearly twice as potent as ergocalciferol in increasing serum 25(OH)D levels and modulating serum PTH in elderly female patients with vitamin D deficiency.
RCT
Rigorous JournalHighly CitedInsulin secretion and sensitivity in healthy adults with low vitamin D are not affected by high-dose ergocalciferol administration: a randomized controlled trial.
Ergocalciferol administration for 12 weeks normalizes vitamin D levels in healthy adults with low levels, but does not improve insulin secretion, sensitivity, or other metabolic health markers.
RCT
Very Rigorous JournalA double-blind, randomized, placebo-controlled trial of combined calcitriol and ergocalciferol versus ergocalciferol alone in chronic kidney disease with proteinuria
Ergocalciferol effectively lowers proteinuria in chronic kidney disease patients with vitamin D deficiency, but adding calcitriol supplement does not have additional effects on proteinuria.
RCTRigorous JournalErgocalciferol in New-onset Type 1 Diabetes: A Randomized Controlled Trial
Ergocalciferol supplementation significantly reduces serum TNF- concentration and the rate of increase in A1c and IDAA1c, suggesting protection of residual -cell function and partial clinical remission in youth with newly diagnosed type 1 diabetes.
RCTRigorous JournalA randomized double-blinded placebo controlled trial of ergocalciferol 40,000 versus 100,000 IU per week for vitamin D inadequacy in institutionalized postmenopausal women
High dose ergocalciferol is more effective than standard dose in achieving optimal vitamin D levels in institutionalized postmenopausal women, especially for those with severe deficiency.
RCTRigorous JournalChanges in serum 25-hydroxyvitamin D and plasma intact PTH levels following treatment with ergocalciferol in patients with CKD.
Ergocalciferol administration improves vitamin D levels and reduces plasma intact PTH levels in patients with chronic kidney disease, particularly in those with stage 3.
Non-RCTHighly Cited