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The case against ergocalciferol (vitamin D₂) as a vitamin supplement^1,2

¹ From the School of Nutrition and Dietetics, Acadia University, Wolfville, Canada (LAH); the Department of Nutritional Sciences, University of Toronto, Toronto, Canada (RV); and the Mount Sinai Hospital, Toronto, Canada (RV)

Supplemental vitamin D is available in 2 distinct forms: ergocalciferol (vitamin D₂) and cholecalciferol (vitamin D₃). Pharmacopoeias have officially regarded these 2 forms as equivalent and interchangeable, yet this presumption of equivalence is based on studies of rickets prevention in infants conducted 70 y ago. The emergence of 25-hydroxyvitamin D as a measure of vitamin D status provides an objective, quantitative measure of the biological response to vitamin D administration. As a result, vitamin D₃ has proven to be the more potent form of vitamin D in all primate species, including humans. Despite an emerging body of evidence suggesting several plausible explanations for the greater bioefficacy of vitamin D₃, the form of vitamin D used in major preparations of prescriptions in North America is vitamin D₂. The case that vitamin D₂ should no longer be considered equivalent to vitamin D₃ is based on differences in their efficacy at raising serum 25-hydroxyvitamin D, diminished binding of vitamin D₂ metabolites to vitamin D binding protein in plasma, and a nonphysiologic metabolism and shorter shelf life of vitamin D₂. Vitamin D₂, or ergocalciferol, should not be regarded as a nutrient suitable for supplementation or fortification.

Key Words: Vitamin D₂ • vitamin D₃ • ergocalciferol • cholecalciferol • vitamin supplement

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