High-dose vitamin D: helpful or harmful?

Curr Rheumatol Rep. 2011 Jun;13(3):257-64. doi: 10.1007/s11926-011-0175-9.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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*
  • Vitamin D / therapeutic use*

Substances

  • Vitamin D
  • Calcium