Stoss therapy is safe for treatment of vitamin D deficiency in pediatric patients undergoing HSCT
Bone Marrow Transplant. 2021 Apr 19. doi: 10.1038/s41409-021-01294-x
Jessica Bodea 1, Kristen Beebe 2 3, Courtney Campbell 2, Dana Salzberg 2, Holly Miller 2, Roberta Adams 2 3, Lucia Mirea 2, Paul Castillo 4, Biljana Horn 4, Sandhya Bansal 5, Thalachallour Mohanakumar 5, Alexander Ngwube 6 7
Study used 100,000 to 600,000 IU
Vitamin D deficiency remains common among pediatric patients undergoing hematopoietic stem cell transplant (HSCT) despite both aggressive and standard of care strategies. This study examined the safety and efficacy of single high-dose oral vitamin D therapy (Stoss therapy) for treatment of vitamin D deficiency in HSCT recipients. Patients ages 1-21 years presenting for HSCT were randomized to receive either Stoss regimen plus weekly/daily supplementation or standard of care, per US Endocrine Society guidelines. Among the total 48 subjects, 22 (46%) were randomized to Stoss and 26 (54%) to control arms. Baseline 25-hydroxyvitamin D (25-OHD) levels were insufficient/deficient in total of 34 (71%) patients, without difference between treatment groups. The Stoss regimen was well tolerated and no toxicity was observed. At Day +30, mean 25-OHD levels were significantly higher (P = 0.04) with Stoss (42.3 ± 12 μg/l) compared to controls (35.6 ± 14.3 μg/l), and a higher proportion of Stoss patients had adequate vitamin D levels than controls (85% vs 65%). Stoss therapy is a safe and efficacious treatment option for vitamin D deficiency in children undergoing HSCT and may achieve sufficient levels more rapidly than standard of care.
This trial was registered at www.clinicaltrials.gov as NCT03176849.
- Vitamin D for infants – 100,000 IU monthly is better than 400 IU daily – RCT Oct 2020
- 44 percent of successful RCTs in VitaminDWiki used non-daily dosing - Nov 2020
- Monthly 100,000 IU of vitamin D is safe (and may be better than daily) – RCT Aug 2018
- Monthly vitamin D dosing is better than daily dosing for children and elderly (more likely to be taken) – June 2017
- One pill every two weeks gives you all the vitamin D most adults need
Loading Dose of Vitamin D category has the following
see also Overview Loading of vitamin D Overview Toxicity of vitamin D
Better than Daily 1: Fewer chances to forget, 2) Gets past receptor barrier
Injection category has
It appears that over 1 million Vitamin D loading doses have been taken
Doses ranged from 100,000 to 600,000 IU over a period of a day to a month
No reports of serious adverse reactions
Many studies report on the benefits resulting from loading doses
TOP articles in Loading Dose of Vitamin D
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Better than Daily has the following
Non-daily (Bolus) is better:
- Better compliance for everyone
- Fewer opportunities to forget.
- If happen to forget, just take the pill days or weeks later
- Fewer times to have to take a pill - for those who dislike doing so
- Non-daily is better the ~20% who have a poor Vitamin D Receptor
- A high concentration gradient is one of 14 ways to get past Vitamin D Receptor limitations
- So, while 80% get no extra benefit from non-daily dosing, 20% will get an extra benefit
- Vitamin D given daily, weekly, or monthly has similar response (116 RCTs) – meta-analysis Aug 2023
- 44 percent of successful RCTs in VitaminDWiki used non-daily dosing - Nov 2020
- Monthly vitamin D dosing better for children than daily (again) - Oct 2023
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