Safety of calcium and vitamin D supplements, a randomized controlled trial

Abstract

Objective It is anticipated that an intake of vitamin D found acceptable by Endocrine Society Guidelines (10 000 IU/day) with co‐administered calcium supplements may result in frequent hypercalciuria and hypercalcaemia. This combination may be associated with kidney stones. The objective of this study was to compare the episodes of hypercalciuria and hypercalcaemia from calcium supplements co‐administered with 10 000 IU or 600 IU vitamin D daily. This design allows a comparison of the Institute of Medicine recommendation for the RDA of vitamin D along with the upper limit of calcium intake with the high intake of vitamin D suggested by the Endocrine Society. Context Harms of currently recommended high intake of vitamin D have not been studied. Design The design was a randomized controlled trial with 2 groups with evaluation every 3 months for one year: (a) CaCO3 1200 mg/day with 10 000 IU vitamin D3/day or (b) CaCO3 1200 mg/day with 600 IU vitamin D3/day. Patients This study was conducted in an ambulatory research centre in healthy, white postmenopausal women. Measurements Serum and 24‐hour urine calcium were measured. Results Hypercalcaemia and hypercalciuria occurred in both groups. At the final visit, 19/48 in the high dose D group had hypercalciuria. The odds of developing hypercalciuria were 3.6 [OR = 3.6(1.39, 9.3)] times higher in the high dose D group. The odds of developing hypercalcaemia did not differ between groups. Conclusions The safe upper level of vitamin D recommended by the Endocrine Society when accompanied by calcium supplements results in frequent hypercalciuria. The risk of kidney stones at these levels should be investigated.

Vitamin D and Calcium Supplementation Accelerates Randall's Plaque Formation in a Murine Model

“…11 The treatment did not reduce significantly bone fractures but an increased kidney stone risk has been described in women who received calcium and vitamin D. Recent studies confirmed that vitamin D, especially when prescribed in addition to calcium supplementation, increases significantly urine calcium excretion and in some studies the risk to develop kidney stones. 12,13 By contrast, some studies did not identify an increased risk of kidney stone after exposure to vitamin D alone (without calcium supplementation) during a median follow-up of 3.3 years. 25 Interventional studies remain sparse but recent observations show that some kidney stone formers may develop hypercalciuria after vitamin D "repletion".…”

“…11,12 A recent randomized controlled trial has shown that the recommended upper serum level of vitamin D, when associated with calcium supplements, results frequently in hypercalciuria. 13 Vitamin D, with or without calcium supplements, is prescribed to prevent bone mass loss, although randomized and controlled studies failed to evidence a protective role of vitamin D against fractures. 14,15 A few reports suggested that kidney stone formers with Randall's plaques may have an increased biological response to vitamin D but there is little evidence that vitamin D promotes or aggravates Randall's plaque formation to date.…”

Vitamin D and Calcium in Osteoporosis, and the Role of Bone Turnover Markers: A Narrative Review of Recent Data from RCTs

“…In total, 17 studies involving intervention with vitamin D supplements were identified, which are presented in Table 1 . Participants’ (n = 4482) mean age varied from 43 to 75 years, and the durations of the studies ranged from 8 weeks to 3 years [ 18 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. In seven studies, only females were included [ 18 , 32 , 33 , 34 , 35 , 36 , 37 ], in two studies, only males were included [ 38 , 39 ], while in the remaining eight studies, both sexes were included [ 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

Eldecalcitol prevents muscle loss by suppressing PI3K/AKT/FOXOs pathway in orchiectomized mice

“…Vitamin D supplements also present the same confusion. Some studies have also pointed out that vitamin D increases hypercalciuria ( Aloia et al, 2018 ). On the contrary, It is also reported that the increase of urinary calcium is not associated with increased serum vitamin D and may result from other factors, such as dietary factors ( Taheri et al, 2019 ).…”