Source
Cedars-Sinal Medical Center, Los Angeles, California, USA.
Abstract
BACKGROUND:
Vitamin D intoxication is associated with the mobilization of skeletal calcium.
OBJECTIVE:
To ascertain how the resolution of vitamin D intoxication affects bone density.
DESIGN:
Case series.
SETTING:
Referral service for metabolic bone disease in a tertiary care teaching hospital.
PATIENTS:
Four patients with osteoporosis who were each using several nonprescription dietary supplements and were found to have fasting hypercalciuria.
INTERVENTION:
Discontinuation of use of dietary supplements.
MEASUREMENTS:
Serial measurement of serum levels of 25-hydroxyvitamin D, ratio of fasting urinary calcium to creatinine, and bone mineral density for 3 years.
RESULTS:
Discontinuation of use of dietary supplements resulted in the normalization of serum levels of 25-hydroxyvitamin D, the normalization of the ratio of urinary calcium to creatinine, and a mean annual increase in bone mineral density (+/- SD) of 1.9% +/- 0.5%.
CONCLUSIONS:
Occult vitamin D intoxication was detected in patients who were using dietary supplements that contained an unadvertised high level of vitamin D. Resolution of vitamin D intoxication was associated with a rebound in bone mineral density.