Effect of Vitamin D Supplements on Acute Spinal Cord Injury: A Double-blinded, Randomized Control Trial


  • Nattawut Kittinanon Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand
  • Thanyaphon Sukpongthai Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand


vitamin D supplement, acute spinal cord injury, vitamin D deficiency, Activities of daily living, 25(OH)D


Objectives: To study the effect of vitamin D supplements in acute spinal cord injury patients.

Study design: Double-blind randomized controlled trial.

Settings: Maharat Nakhon Ratchasima Hospital.

Subjects: Acute spinal cord injury patients (onset < 1 month) admitted to Maharat Nakhon Ratchasima Hospital between May 1, 2020 and September, 30, 2021.

Methods: Thirty patients with 25(OH)D vitamin D levels ≥ 20 ng/mL were randomly assigned to one of two groups: intervention or control. The intervention group received one tablet of 20,000 IU  of vitamin D every two weeks for three months. The placebo was  given to the control group. Vitamin D levels, the primary outcome, were measured at baseline and after three months.  At the 3-month follow-up, sun exposure, a food frequency questionnaire, Spinal Cord Independence Measure III (SCIM III), and Leisure Time Physical Activity Questionnaire for People with Spinal Cord Injury (LTPAQ) were all assessed. The proportion test was used to compare the scores of the two groups for secondary outcomes.

Results: There were 13 patients in the intervention group and 17 in the control group. The majority in both groups had paraplegia and both groups had similar sun exposure and vitamin D food intake. Before receiving vitamin D supplementation, the intervention and control groups had mean vitamin D levels of 27.54 (5.23) and 29.11 (7.60) ng/mL, respectively. After the study period, the intervention group had a higher mean vitamin D level of 10.29 (8.59) ng/mL. The mean vitamin D level in the intervention group had increased by 10.29 (8.59) ng/mL, but the level in the control group was slightly decreased. There was also a statistically significant difference in the number of patients with vitamin D insufficiency/deficiency between the intervention group (2 (15.38%)) and the control group (9 (52.94%), but there was no statistically significant difference in SCIM III and LTPAQ between the two groups.

Conclusions:  As a result, patients with acute spinal cord injuries should receive vitamin D supplements to reduce existing vitamin D deficiency


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Javidan AN, Sabour H, Latifi S, Vafa M, Shidfar F, Khazaeipour Z, et al. Calcium and vitamin D plasma concentration and nutritional intake status in patients with chronic spinal cord injury: A referral center report. J Res Med Sci [Internet]. 2014 Sep [cited 2023 Jun 19];19(9):881-884. Available from: https://pubmed.ncbi.nlm.nih.gov/25535504/

Khammeree T, Vichiansiri R, Sawanyawisuth K, Manimmanakorn N. Vitamin D abnormalities in Thai patients with spinal cord injuries. Asian Biomedicine [Internet]. 2016 Dec [cited 2023 Jun 19];10(6):595-601. [Internet]. Available from: https://sciendo.com/article/10.5372/1905-7415.1006.528 doi: 10.1111/j.1365-2265.2006.02683.x

Jiang SD, Jiang LS, Dai LY. Mechanisms of osteoporosis in spinal cord injury. Clin Endocrinol (Oxf) [Internet]. 2006 Nov [cited 2023 Jun 19];65(5):555-565. Available from: https://pubmed.ncbi.nlm.nih.gov/17054455/

Jiang SD, Dai LY, Jiang LS. Osteoporosis after spinal cord injury. Osteoporos Int [Internet]. 2006 Feb [cited 2023 Jun 19];17(2):180-192. 005-2028-8. Available from: https://pubmed.ncbi.nlm.nih.gov/16217589/ doi: 10.1007/s00198-005-2028-8

Benlidayi IC, Basaran S, Seydaoglu G, Guzel R. Vitamin D profile of patients with spinal cord injury and post-stroke hemiplegia: All in the same boat. J Back Musculoskelet Rehabil [Internet]. 2016 Apr 27 [cited 2023 Jun 19];29(2):205-210. Available from: https://pubmed.ncbi.nlm.nih.gov/26406185/ doi: 10.3233/BMR-150615

Barbonetti A, Sperandio A, Micillo A, D’Andrea S, Pacca F, Felzani G, et al. Independent association of vitamin D with physical function in people with chronic spinal cord injury. Arch Phys Med Rehabil [Internet]. 2016 May [cited 2023 Jun 19];97(5):726-732. Available from: https://pubmed.ncbi.nlm.nih.gov/26805770/ doi: 10.1016/j.apmr.2016.01.002

Oleson CV, Patel PH, Wuermser LA. Influence of season, ethnicity, and chronicity on vitamin D deficiency in traumatic spinal cord injury. J Spinal Cord Med [Internet]. 2010 [cited 2023 Jun 19];33(3):202-213. Available from: https://pubmed.ncbi.nlm.nih.gov/20737793/ doi: 10.1080/10790268.2010.11689697

Flueck JL, Perret C. Vitamin D deficiency in individuals with a spinal cord injury: a literature review. Spinal Cord [Internet]. 2017 May [cited 2023 Jun 19];55(5):428-434. Available from: https://pubmed.ncbi.nlm.nih.gov/27824059/ doi: 10.1038/sc.2016.155

Bauman WA, Emmons RR, Cirnigliaro CM, Kirshblum SC, Spungen AM. An effective oral vitamin D replacement therapy in persons with spinal cord injury. J Spinal Cord Med [Internet]. 2011 Sep [cited 2023 Jun 19];34(5):455-460 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184482/ doi: 10.1179/2045772311Y.0000000032

Flueck JL, Schlaepfer MW, Perret C. Effect of 12-Week Vitamin D supplementation on 25[OH]D status and performance in athletes with a spinal cord injury. Nutrients [Internet]. 2016 September 22 [cited 2023 June 19];8(10):586. Available from: https://pubmed.ncbi.nlm.nih.gov/27669288/ doi: 10.3390/nu8100586

Amorim S, Teixeira VH, Corredeira R, Cunha M, Maia B, Margalho P, et al. Creatine or vitamin D supplementation in individuals with a spinal cord injury undergoing resistance training: A double-blinded, randomized pilot trial. J Spinal Cord Med [Internet]. 2018 Jul [cited 2023 Jun 19];41(4):471-478. Available from: https://pubmed.ncbi.nlm.nih.gov/28901216/ doi: 10.1080/10790268.2017.1372058

Marek K, Cichoń N, Saluk-Bijak J, Bijak M, Miller E. The role of vitamin D in stroke prevention and the effects of its supplementation for post-stroke rehabilitation: a narrative review. Nutrients. 2022 Jul;14(13):2761. [Internet]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9268813/ doi: 10.3390/nu14132761

Ghahremani M, Smith EE, Chen HY, Creese B, Goodarzi Z, Ismail Z. Vitamin D supplementation and incident dementia: Effects of sex, APOE, and baseline cognitive status. Alzheimers Dement (Amst). 2023 Mar 1;15(1):e12404. [Internet]. Available from: https://pubmed.ncbi.nlm.nih.gov/36874594/ doi: 10.1002/dad2.12404

Dickson HG. SCIM–Spinal Cord Independence Measure: a new disability scale for patients with spinal cord lesions. Spinal Cord. 1998 Jun;36(10): [Internet]. Available from: https://www.researchgate.net/publication/260176196_SCIM-Spinal_Cord_Independence_Measure_a_new_disability_scale_for_patients_with_spinal_cord_lesions. doi: 10.1038/sj.sc.3100738

Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Ross AC, Taylor CL, Yaktine AL, Del Valle HB, editors. Dietary reference intakes for calcium and vitamin D. Washington (DC): National Academies Press (US); 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56070/

Stalgis-Bilinski KL, Boyages J, Salisbury EL, Dunstan CR, Henderson SI, Talbot PL. Burning daylight: balancing vitamin D requirements with sensible sun exposure. Med J Aust [Internet]. 2011 Apr 4;194(7):345-8. doi: 10.5694/j.1326-5377.2011.tb03003.x. Available from: https://pubmed.ncbi.nlm.nih.gov/21470084/

Lamberg-Allardt C. Vitamin D in foods and as supplements. Prog Biophys Mol Biol [Internet]. 2006 Sep [cited 2023 Jun 19];92(1):33-8. Available from: https://pubmed.ncbi.nlm.nih.gov/16618499/ doi: 10.1016/j.pbiomolbio.2006.02.017.

Özgirgin N, Koyuncu E, Funda G, Nakipoğlu-Yüzer GF, et al. Is spinal cord injury a risk factor for vitamin D deficiency? Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi [Internet]. March 2016 [cited 2023 June 19];1(62):57-63. Available from: https://www.researchgate.net/publication/299397619_Is_spinal_cord_injury_a_risk_factor_for_vitamin_D_deficiency doi: 10.5606/tftrd.2016.39260.

Dlugos DJ, Perrotta PL, Horn WG. Effects of the submarine environment on renal-stone risk factors and vitamin D metabolism. Undersea Hyperb Med [Internet]. 1995 Jun [cited 2023 Jun 19];22(2):145-52. Available from: https://pubmed.ncbi.nlm.nih.gov/7633276/

Kennel KA, Drake MT, Hurley DL. Vitamin D deficiency in adults: when to test and how to treat. Mayo Clin Proc [Internet]. 2010 Aug [cited 2023 Jun 19];85(8):752-7; quiz 757-8. Available from: https://pubmed.ncbi.nlm.nih.gov/20675513/