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. 2010 Feb;95(2):471–478. doi: 10.1210/jc.2009-1773

Figure 3.

Figure 3

A, Proposed schema linking low serum 25D levels and secondary hyperparathyroidism with 1,25-dihydroxyvitamin D (1,25D)-driven fat accumulation amplifying the state of vitamin D depletion, while at the same time generating an increase in the serum leptin concentration, which exerts feedback inhibition on the synthesis of 1,25D. B, Schematic of the regimen for vitamin D replacement and maintenance therapy in subjects with serum 25D levels less than 30 ng/ml. The regimen calls for: 1) delivery of 500,000 to 1,000,000 IU vitamin D (see Footnote 1) orally over 4–5 wk; 2) a similarly timed period of no vitamin D to permit ascertainment and confirmation of steady-state 25D levels; and 3) maintenance therapy of 50,000 IU vitamin D orally every month thereafter to maintain a vitamin D sufficiency.