High-dose vitamin D: helpful or harmful?

Abstract

If the optimal serum 25(OH)D level for skeletal health is 30 ng/mL or greater, then vitamin D insufficiency is widespread, affecting about 75% of adults based on a recent survey of more than 20,000 Americans. However, after a comprehensive analysis of existing research studies, the Institute of Medicine recently concluded that nearly all individuals are vitamin D replete when their 25(OH)D levels are 20 ng/mL or greater. Furthermore, two recent publications challenge the belief that 25(OH)D levels greater than 30 ng/mL are optimal for bone health. In a randomized, placebo-controlled trial, high-dose, once-yearly vitamin D therapy increased the incidence of fractures and falls. The second study reported that high-dose vitamin D did not reduce levels of parathyroid hormone or bone resorption among adults with 25(OH)D levels less than 32 ng/mL at baseline. It is time to question whether serum 25(OH)D levels of 30 ng/mL or greater are necessary for all individuals.

• Authors: Karen E Hansen
• Journal: Current rheumatology reports (Curr Rheumatol Rep) Vol. 13 Issue 3 Pg. 257-64 (Jun 2011) ISSN: 1534-6307 [Electronic] United States
• PMID: 21369796 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Vitamin D
• Calcium

Topics

• Bone Density (drug effects)
• Bone Resorption (drug therapy)
• Calcium (administration & dosage)
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Female
• Fractures, Bone (prevention & control)
• Humans
• Male
• Meta-Analysis as Topic
• Nutrition Policy
• Randomized Controlled Trials as Topic
• Vitamin D (adverse effects, therapeutic use)