| Abstract | Any benefit of vitamin D needs to be balanced against the risk of toxicity, which is characterized by hypercalcemia. Daily brief, suberythemal exposure of a substantial area of the skin to ultraviolet light, climate allowing, provides adults with a safe, physiologic amount of vitamin D, equivalent to an oral intake of about 10,000 IU vitamin D(3) per day, with the plasma 25-hydroxyvitamin D (25(OH)D) concentration potentially reaching 220 nmol/L (88 ng/mL). The incremental consumption of 40 IU/d of vitamin D(3) raises plasma 25(OH)D by about 1 nmol/L (0.4 ng/mL). High doses of vitamin D may cause hypercalcemia once the 25(OH)D concentration is well above the top of the physiologic range. The physiological buffer for vitamin D safety is the capacity of plasma vitamin D-binding protein to bind the total of circulating 25(OH)D, vitamin D, and 1,25-dihydroxyvitamin D [1,25(OH)2D]. Hypercalcemia occurs when the free concentration is inappropriately high because vitamin D and its other metabolites have displaced 1,25(OH)2D from vitamin D-binding protein. Evidence from clinical trials shows, with a wide margin of confidence, that a prolonged intake of 10,000 IU/d of vitamin D(3) poses no risk of adverse effects for adults, even if this is added to a rather high physiologic background level of vitamin D. |
| Authors | Reinhold Vieth
(Affiliation: Department of Nutritional Sciences, University of Toronto, and Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada. rvieth at mtsinai.on.ca)
|
| Journal | Annals of epidemiology
(Ann Epidemiol)
Vol. 19
Issue 7
Pg. 441-5
(Jul 2009)
ISSN: 1873-2585 [Electronic] United States |
| PMID | 19364661
(Publication Type: Journal Article, Review)
|
| Chemical References |
- Vitamin D-Binding Protein
- Vitamins
- Vitamin D
- 25-hydroxyvitamin D
|
| Topics |
- Adult
- Congresses as Topic
- Humans
- Hypercalcemia
(chemically induced)
- Neoplasms
(etiology)
- Risk Assessment
- Vitamin D
(administration & dosage, adverse effects, analogs & derivatives, blood, contraindications, pharmacology)
- Vitamin D-Binding Protein
(metabolism)
- Vitamins
(administration & dosage, pharmacology)
|