Ergocalciferol vs cholecalciferol
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Ergocalciferol vs Cholecalciferol: A Comparative Analysis
Introduction to Vitamin D Forms
Vitamin D is essential for maintaining bone health and calcium homeostasis. The two primary forms of vitamin D are ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). While both forms are used to treat vitamin D deficiency, their efficacy and potency have been subjects of extensive research.
Potency and Efficacy of Cholecalciferol vs Ergocalciferol
Serum 25-Hydroxyvitamin D Levels
Several studies have demonstrated that cholecalciferol is more effective than ergocalciferol in raising serum 25-hydroxyvitamin D [25(OH)D] levels. In a study involving elderly female patients, cholecalciferol increased serum 25(OH)D levels significantly more than ergocalciferol when administered either orally or intramuscularly 1. Another study with older adults found that daily or monthly dosing of cholecalciferol resulted in higher serum 25(OH)D levels compared to ergocalciferol 2. Similarly, in hip fracture patients, cholecalciferol supplementation led to a greater increase in serum 25(OH)D than ergocalciferol 4.
Impact on Parathyroid Hormone (PTH)
Cholecalciferol also appears to be more effective in reducing serum parathyroid hormone (PTH) levels. In elderly patients, cholecalciferol significantly lowered PTH levels compared to ergocalciferol 1. However, some studies have shown that both forms of vitamin D have comparable effects on PTH reduction despite differences in 25(OH)D levels 3.
Bioavailability and Metabolite Concentrations
Free and Bioavailable Vitamin D Metabolites
Research indicates that both cholecalciferol and ergocalciferol have similar effects on free and bioavailable vitamin D metabolite concentrations. In a study with hip fracture patients, both forms of vitamin D increased vitamin D-binding protein (DBP) and free 25(OH)D concentrations comparably, despite cholecalciferol having a greater effect on total 25(OH)D levels 3.
Stability and Breakdown
Cholecalciferol is more stable than ergocalciferol, especially during storage and cooking. Ergocalciferol is more susceptible to breakdown, making cholecalciferol a more reliable option for food fortification and supplementation 9.
Clinical Implications in Specific Populations
Chronic Kidney Disease (CKD) Patients
In patients with chronic kidney disease (CKD), cholecalciferol has been shown to be more effective in raising serum 25(OH)D levels compared to ergocalciferol. A study involving CKD patients found that cholecalciferol therapy resulted in a greater increase in 25(OH)D levels than ergocalciferol 5. Another retrospective analysis confirmed that cholecalciferol was superior in treating vitamin D deficiency in non-dialysis CKD patients 8.
Healthy Individuals with Low UV-B Exposure
In healthy individuals with minimal UV-B exposure, both ergocalciferol and cholecalciferol were found to be equally effective in increasing serum 25(OH)D levels when provided in low doses through fortified drinks 6.
Toxicity and Safety
Comparative Toxicity
Cholecalciferol has been found to be more toxic than ergocalciferol in animal studies. In rhesus monkeys, high doses of cholecalciferol caused hypercalcemia and extensive soft tissue mineralization, whereas ergocalciferol resulted in hypercalcemia without comparable tissue damage 7.
Conclusion
Overall, cholecalciferol is generally more effective than ergocalciferol in increasing serum 25(OH)D levels and reducing PTH levels. It is also more stable and less prone to breakdown, making it a preferable choice for supplementation and fortification. However, cholecalciferol's higher potency also comes with increased toxicity risks, which should be considered in clinical settings. Further research is needed to fully understand the long-term implications of using either form of vitamin D in various populations.
Sources and full results
Most relevant research papers on this topic
Short 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 Journal
Highly CitedEvaluation of ergocalciferol or cholecalciferol dosing, 1,600 IU daily or 50,000 IU monthly in older adults.
Cholecalciferol is slightly more effective than ergocalciferol in increasing serum 25(OH)D levels in older adults, with both showing significant between-individual response.
RCT
Very Rigorous JournalHighly CitedCalculated free and bioavailable vitamin D metabolite concentrations in vitamin D-deficient hip fracture patients after supplementation with cholecalciferol and ergocalciferol.
Both cholecalciferol and ergocalciferol effectively increase vitamin D levels in vitamin D-deficient hip fracture patients, with cholecalciferol showing slightly greater ionized calcium increase.
RCTRigorous JournalSerum 25-hydroxyvitamin D levels in vitamin D-insufficient hip fracture patients after supplementation with ergocalciferol and cholecalciferol.
Cholecalciferol supplementation is more effective in increasing serum 25-hydroxyvitamin D levels than ergocalciferol in vitamin D-insufficient hip fracture patients, but their impact on PTH levels remains unclear.
RCTHighly CitedCholecalciferol v. ergocalciferol for 25-hydroxyvitamin D (25(OH)D) repletion in chronic kidney disease: a randomised clinical trial
Cholecalciferol therapy is more effective than ergocalciferol for raising serum 25(OH)D in non-dialysis-dependent chronic kidney disease patients, but both require maintenance therapy to maintain levels.
RCTVery Rigorous JournalFortified malted milk drinks containing low-dose ergocalciferol and cholecalciferol do not differ in their capacity to raise serum 25-hydroxyvitamin D concentrations in healthy men and women not exposed to UV-B.
Both low-dose ergocalciferol and cholecalciferol in fortified malted milk drinks effectively raise serum 25-hydroxyvitamin D concentrations in healthy men and women with negligible UV-B exposure.
RCTVery Rigorous JournalA comparison of the toxicity of ergocalciferol and cholecalciferol in rhesus monkeys (Macaca mulatta).
Cholecalciferol is significantly more toxic than ergocalciferol in rhesus monkeys, leading to hypercalcemia, death, and extensive soft tissue mineralization.
Non-RCT
Animal StudyErgocalciferol versus Cholecalciferol for Nutritional Vitamin D Replacement in CKD
Cholecalciferol may be superior to ergocalciferol in treating nutritional vitamin D deficiency in non-dialysis chronic kidney disease, with younger females benefiting more.
Observational StudyVitamin D supplementation: cholecalciferol, calcifediol, and calcitriol
Cholecalciferol is the only form of vitamin D that should be considered for fortification and supplementation, as it is more stable, potent, and resistant to breakdown in cooking and baking compared to ergocalciferol.
Cholecalciferol (Vitamin D3) Improves Myelination and Recovery after Nerve Injury
Cholecalciferol (vitamin D3) is more efficient than ergocalciferol in promoting nerve regeneration and recovery after injury, with potential for future clinical trials in peripheral nerve or spinal cord repair.
Rigorous JournalHighly Cited