The use of a once oral monthly ergocalciferol supplement to improve serum 25 (OH) D levels in bariatric surgery subjects
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Background: Vitamin D insufficiency is common both before and after bariatric surgery. There are many factors that complicate prevention and treatment of vitamin D insufficiency and only a few studies have evaluated the adequacy of vitamin D supplementation. Methods: A total of 32 severely obese subjects were randomly assigned to receive 100,000 IUs of ergocalciferol monthly after bariatric surgery (vitamin D group; n=10) or no additional vitamin D after bariatric surgery (control group; n=22). All patients received a multivitamin and calcium + vitamin D supplements containing 1600-2000 IUs. The Body Mass Index (BMI) was calculated, by using the subjects measured height and weight, and serum 25 (OH) D, calcium, and hemoglobin A1c levels were measured preoperatively and 1 year after bariatric surgery. Questionnaires were used to assess other information on sun exposure, vitamins, medications, and any other supplement usage before each blood sample was taken. Results: At 1 year after bariatric surgery, a significant increase was seen in mean serum 25 (OH) D levels (26.1 ± 9.23 versus 38.53 ± 16.75 ng/mL; p=0.046) in the vitamin D group receiving additional 100,000 IUs ergocalciferol per month. There was also a significant difference in 1 year post-op mean serum 25 (OH) D levels between the control and vitamin D groups (24.55 ± 8.87 versus 38.53 ± 16.75 ng/mL; p=0.004). No subject had serum calcium levels out of normal reference range and there were no cases of hypercalcemia. Conclusion: The findings of this study showed 100,000 IUs ergocalciferol once a month is a safe and effective treatment for vitamin D deficiency and insufficiency in most patients having bariatric surgery.