Pharmacological doses of vitamin

VII.a.2.2. Treatment. Treatment of established vitamin D deficiency requires much larger doses of vitamin D, such as calciferol tablets of 1 mg (40,000 units) daily. Newer but more expensive preparations such as alfa-calcidol and calcitriol are very effective, and are particularly valuable in patients with renal failure who are unable to hydroxylate calciferol. Patients treated with pharmacological doses of vitamin D preparations must be monitored by checking serum calcium at regular intervals because of the risk of inducing hypercalcaemia. This should always be suspected if patients develop thirst, nausea or vomiting. The newer hydroxylated preparations have a shorter effective half-life, and therefore problems of overdosage are quicker to resolve once identified. 

Holmberg I, Aksnes L, Berlin T, et al. Absorption of a pharmacological dose of vitamin D3 from two different lipid vehicles in man comparison of peanut oil and a medium chain triaglyceride. Biopharm Drug Dispos 1990 11 807-815. 

Paolisso, G., D Amore, A., Giugliano, D., Ceriello, A., Varricchio, M., and D Onofrio, F. 1993. Pharmacologic Doses of Vitamin E Improve Insulin Action in Healthy Subjects and Non-Insulin-Dependent Diabetic Patients. Am. J. Clin. Nutr. 57 650-656. 

Genetic Disorders That Respond Favorably to Treatment with Pharmacological Doses of Vitamins ... 

Inborn errors in the synthesis of adenosylcobalamin or of both adenosyl- and methylcobalamins have been described. They cause, respectively, methylmalonic aciduria alone or combined with homocystinuria (Table 38-1). These disorders respond to treatment with pharmacological doses of vitamin B12. Methylmalonic aciduria that does not respond to vitamin B12 is probably due to an abnormal methylmalonyl-CoA mutase. 

Pretreatment with cromolyn, anticholinergics, and cyanocobal-amin have protected sulfite-sensitive patients.Presumably, pharmacologic doses of vitamin B12 catalyze the nonenzymatic oxidation of sulfite to sulfate. 

Moderate pharmacologic doses of vitamin E (150 lU/d) improved some of the psychoneurologic accompaniments of the premenstrual syndrome (London et al, 1983). But there is no known role of vitamin E in cognition. 

Patients diagnosed by neonatal screening should be placed on a low-methionine diet. Methionine restriction may not be acceptable to many patients diagnosed after infancy. While awaiting confirmation of the diagnosis by enzyme assay or DNA analysis, such patients can be given pharmacological doses of vitamin Bs to test for biochemical responsiveness to this cofactor [1]. 

AL Bernstein, JS Dinesen. Brief communication effects of pharmacologic doses of vitamin Be on carpal tunnel syndrome, eleciroencephalographic results, and pain. J Am Coll Nutr 12 73-76, 1993. 

Hypercalcemia in three children receiving pharmacologic doses of vitamin D has been described [82 ]. 

Vanstone MB, Oberfield SE, Shader L, Ardeshirpour L, Carpenter TO. H)fpercalcemia in children receiving pharmacologic doses of vitamin... 

The present report is restricted to a review on the effect of such large, pharmacological doses of vitamin E, administered either as a dietary supplement or as a parenteral injection, on immune responses and disease resistance. 

Both vitamin Bi2-responsive and non-responsive forms appear to be inherited in an autosomal recessive mode, males and females being equally affected. Treatment includes trials of pharmacological doses of vitamin B12 (1 mg per day intramuscularly, initially) together with reduced protein intake (1-1.5 mg per kg of body weight), the latter being increased if the patient responds well to cofactor therapy. Once controlled, the patient may be maintained on oral vitamin B12 (10-15 mg day ) (Gordon et aL, 1976). In... 

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