5,000 IU Vitamin D daily resulted in many benefits after 3 months (US soldiers) – RCT

A Prospective Cohort Study of Vitamin D Supplementation in AD Soldiers: Preliminary Findings.

Mil Med. 2019 Mar 1;184(Suppl 1):498-505. doi: 10.1093/milmed/usy393.

McCarthy MS1, Elshaw EB2, Szekely BM2, Raju D3.

Responses to constant dosing do not plateau in many people until >3 months Study did manage to document trends at just 3 months Probably would have had statistical significance (not just trends) if either: - Had started with a loading dose - Had the trial last 6 months Average Vitamin D 23 ng ==> 35 ng Note that 42% of the active duty soldiers were non-white, Non-whites would likely have had low levels to start Would have needed more than 5,000 IUs Report of the study to the military - Aug 2019 * *📄 Download the PDF from VitaminDWiki* * Military * Military and Vitamin D - many studies * Trial starting for Vitamin D with US soldiers – 2,000 and 5,000 IU for 3 months – Nov 2016 * Previous publication about this RCT - many problems noted at the time * Need for Routine Vitamin D Screening in Military Personnel – Sept 2016 * US Army learning about benefits of vitamin D to trauma – Matthews Dec 2013 talking with Dr. Matthews * Huge increase in Vitamin D supplementation in the US military (2005-13) – Oct 2016 Many months for Vitamin D level response, and even more for the body to get the benefits * Respond to daily Vitamin D in 2-12 months * Vitamin D response time is 3-6 months, not much benefit in first 4 months – RCT July 2017 * 3 to 6 months to plateau with 4,000 IU vitamin D daily (Cardiac Patients) – June 2017

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PURPOSE: To explore response to vitamin D supplementation in active duty (AD) warfighters and translate findings into evidence-based health policy.

BACKGROUND: Soldiers are at risk for musculoskeletal injuries and metabolic dysfunction that impact physical performance and military readiness; the link with low vitamin D status is unclear.

METHODS:

This prospective trial enrolled 152 soldiers; baseline 25 hydroxyvitamin (OH) D level determined assignment to a no-treatment control (CG) or treatment group (TG) receiving a vitamin D3 supplement for 90 days. Symptoms, diet, sun exposure, and blood biomarkers obtained at baseline (T1) and 3 months (T2).

RESULTS:

Cohort was predominantly white (58%) with a significant difference in racial distribution for vitamin D status. Mean (SD) 25(OH)D levels were 37.8 (5.6) ng/mL, 22.2 (5.0) ng/mL, and 22.9 (4.7) ng/mL for the CG, low dose TG, and high-dose TG at T1, respectively. Following three months of treatment, one-way ANOVA indicated a statistically significant difference between groups (F5,246 = 44.37; p < 0.0001). Vitamin D intake was 44% of Recommended Dietary Allowance throughout the first phase of the trial. Patient-Reported Outcomes Measurement Information System scores improved in TG for fatigue and sleep, p < 0.01.

CONCLUSIONS: Vitamin D deficiency is widespread in AD soldiers. Clinicians must intervene early in preventable health conditions impacting warfighter performance and readiness and recommend appropriate self-care strategies.