What is the Treatment of Vitamin D Deficiency? High-Dose Oral Loading Regimen in Adults
Confirmed vitamin D deficiency in adults requires prompt, structured repletion to restore adequate serum levels. A high-dose oral loading course is the recommended approach, with the specific regimen tailored to patient characteristics.
Treatment Approach
Management centres on a structured course of high-dose oral vitamin D3 (colecalciferol) supplementation, administered over several weeks. The choice of formulation is guided by individual patient factors — including the ability to swallow capsules, dietary requirements, and whether conditions affecting absorption or hepatic metabolism are present. Full regimen details, selection criteria, and sequencing are available in the complete protocol.
Treatment Goal
Target: serum 25[OH]D > 50 nmol/L on re-testing — with re-testing deferred until 3–6 months after completing treatment to allow levels to reach a steady state.
References
- Prescribe a full course of 280,000 to 300,000 units of colecalciferol in total, as weekly split doses, over 6–7 weeks.
- Domnisol® (calcifediol 266 microgram capsules) – not a colecalciferol product but a metabolite of colecalciferol. Preferred for patients with malabsorption, obesity, or impaired hepatic function (if ALT or AST ≥ 2x upper limit of normal).
- If serum vitamin D level is more than 50 nmol/L, advise on the use of lower dose maintenance supplementation with vitamin D (800 units daily).
- In any case, ensure 3–6 months have passed after treatment to allow serum vitamin D levels to reach a steady state before re-testing.
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