Efficacy of Vitamin D3 versus Vitamin D2 in deficient and insufficient patients: An open-label, randomized controlled trial

Background: Vitamin D deficiency is very common worldwide but highly prevalent in the Gulf region. The clinical manifestations of Vitamin D deficiency vary depending on the severity and duration of the deficiency. Effective treatment should correct the vitamin D levels and improve other metabolic markers. Objectives: We aimed to (1) compare the efficacy of Vitamin D3 and Vitamin D2 in terms of raising serum 25(OH) total Vitamin D levels, (2) evaluate the time of its attainment, and (3) demonstrate the effect of replacement with either preparation on serum markers of bone or calcium metabolism. Patients and Methods: We conducted a randomized controlled study involving 250 adults with Vitamin D deficiency or insufficiency, assigned into 1:1 ratio to receive weekly capsules of either 50,000 IU of D2 or 50,000 IU of D3 for up to 12 weeks. Serum total Vitamin D level, calcium, phosphorus, alkaline phosphatase, and parathyroid hormone (PTH) levels were measured at 0, 8, and 12 weeks. Analysis of variance and nonparametric test Kruskal–Wallis were used for the comparison of quantitative values and the Chi-square test for comparison of categorical variables. Results: After 8 weeks of treatment, the improvement in Vitamin D level was greater for patients in the D3 group (mean = 18.74, standard error [SE] = 1.08) than that for D2 group (mean = 5.88, SE = 0.65), F (1, 240) = 113.840; P < 0.0005. Similarly after 12 weeks, the improvement in Vitamin D levels was greater for those in the D3 group (mean = 20.76, SE = 1.14) than that for the D2 group (mean = 7.93, SE = 0.79), F (1, 224) = 90.78; P < 0.0005. At 12 weeks, serum calcium, phosphorus, alkaline phosphatase, and PTH levels were not significantly different between the D3 and D2 treatment groups. Conclusions: Vitamin D3 is more efficacious and faster in increasing the level of total Vitamin D than Vitamin D2. However, no significant differences were evident on calcium, phosphorus, alkaline phosphatase, or PTH levels between groups.

Key-words:

Deficiency - efficacy - Vitamin D2 - Vitamin D3

Financial support and sponsorship

Nil.

Publication History

Received: 19 January 2019

Accepted: 27 January 2019

Article published online:
07 July 2022

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