While the full scope of vitamin D’s effects on areas such as cardiovascular and mental health remains unclear, it has long been established that the nutrient is essential in maintaining strong bones and muscles. But a recent study published in JAMA revealed that taking too much vitamin D may be harmful.
“Our study showed that for healthy, vitamin D–sufficient adults, there is no evidence of further bone benefit in pushing the dose of vitamin D any higher [than the recommended dose]. There may even be a potential for harm to the skeleton,” said coprincipal investigator David A. Hanley, MD, FRCPC, professor emeritus of medicine, community health sciences, and oncology at the University of Calgary in Alberta, Canada.
In this 3-year, double-blind, randomized clinical trial, Canadian researchers studied the effects of different daily doses of vitamin D3 on bone health in 311 community-dwelling healthy adults with normal baseline levels of vitamin D and without osteoporosis. The study participants, who were aged 55 to 70 years, 53% male, and 95% white, were randomly assigned to receive 400 IU, 4,000 IU, or 10,000 IU of vitamin D3 supplements every day from August 2013 to December 2017 in addition to the estimated 200 IU they consumed from their daily diet.
While a small degree of BMD loss is normal for the age group studied, by the end of the study, radius volumetric BMD significantly decreased by 2.4% and 3.5% among those treated with 4,000 and 10,000 IU per day of vitamin D3, respectively, compared with a 1.2% decrease in those who received 400 IU per day. Tibial volumetric BMD also significantly decreased by 1.7% among those assigned to the 10,000 IU group.
In other words, patients given high doses of vitamin D3 experienced greater bone loss than those who received a modest dose.
This reduction in BMD was not linked to significant differences between the groups in bone strength, however.
The National Academy of Medicine (NAM) recommends that individuals up to age 70 should receive a recommended dietary allowance of vitamin D of at least 600 IU per day. Those older than 70 should receive at least 800 IU per day.
For most healthy individuals, NAM set the tolerable upper intake level of vitamin D at 4,000 IU per day. Some experts have suggested extending this to 10,000 IU. Levels surpassing this threshold increase the risk of harm, with doses above 20,000 IU per day associated with vitamin D toxicity, including high blood and urinary calcium, which cause kidney and tissue damage.
Providers should exercise caution when prescribing high doses of vitamin D, said Hanley. “Our results raise the concern that overaggressive supplementation might, in fact, be harmful for bone health. For the average, healthy American or Canadian, more modest recommendations for supplementation would be advised.”
For the full article, please visit www.pharmacytoday.org for the December 2019 issue of Pharmacy Today.
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December 11, 2019 at 10:25PM
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Too much vitamin D may cause bone harm, study finds - Pharmacy Today, American Pharmacists Association, pharmacist.com
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