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Current Rheumatology Reports

, Volume 13, Issue 3, pp 257–264 | Cite as

High-Dose Vitamin D: Helpful or Harmful?

  • Karen E. Hansen
Article

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.

Keywords

Calcium absorption Vitamin D Fractures Falls Institute of medicine Meta-analysis 

Notes

Acknowledgments

Dr. Hansen acknowledges salary support from the National Institutes of Health (no. R01 AG028739) and the American College of Rheumatology/Research Education Foundation and American Society for Specialty Physicians through the Hartford Foundation and Atlantic Philanthropies (Junior Career Development Award in Geriatric Medicine).

Disclosure

No potential conflict of interest relevant to this article was reported.

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© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Rheumatology DivisionUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

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