Vitamin D supplementation guidelines

Płudowski, Paweł; Holick, Michael F.; Grant, William B.; Konstantynowicz, Jerzy; Mascarenhas, Mário Rui; Haq, Afrozul; Povoroznyuk, Vladyslav; Balatska, Nataliya; Barbosa, Ana Paula; Karonova, Tatiana; Rudenka, Ema; Misiorowski, Waldemar; Захарова, И. Н.; Rudenka, Alena; Łukaszkiewicz, Jacek; Marcinowska-Suchowierska, Ewa; Łaszcz, Natalia; Abramowicz, Paweł; Bhattoa, Harjit Pal; Wimalawansa, Sunil J.

doi:10.1016/j.jsbmb.2017.01.021

Cited by 521 publications

(511 citation statements)

References 103 publications

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“…Vitamin D 3 is also formed by UV-B mediated conversion of 7-Dehydrocholesterol in the skin. 1 Due to a wide therapeutic index hypervitaminosis D is extremely rare; however, there are a small number of global case studies showing it can occur at excessively high doses of supplementation.…”

Section: Discussionmentioning

confidence: 99%

Risks of the ‘Sunshine pill’ – a case of hypervitaminosis D

2018

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Case presentationA 73-year-old man presented with a 4-week history of diarrhoea and 2-week history of confusion. He was a retired nuclear scientist who was previously fully independent with no history of cognitive impairment. There was no history of smoking, alcohol or substance abuse.His wife reported cognitive disturbances including being unable to use a cassette player or turn on his electric razor and he had started urinating in the sink. He was visited by his GP who found him confused, drowsy and dehydrated. Observations were unremarkable but a rectal examination showed hard stool in the rectum. Presuming a urinary tract infection, laxatives and trimethoprim were prescribed and he was transferred to hospital for further investigations.On admission there were no infective signs or symptoms. His cardiovascular, respiratory and abdominal examinations were unremarkable. He was extremely delirious requiring sedation and occasional reasonable physical restraint. He scored 3/10 on the Abbreviated Mental Test Score (AMTS) but had no other neurological signs. His electrocardiogram (ECG), chest X-ray (CXR) and computed tomography (CT) brain were all normal. Admission blood test results are shown in Table 1 . DiagnosisInvestigations for his hypercalcaemia revealed low parathyroid hormone 0.6 pmol/L and a toxic 25-hydroxyvitamin D (25[OH]D) ABSTRACT concentration 881 nmol/L (normal range 25-100 nmol/L), suggesting a diagnosis of hypervitaminosis D. Other causes of hypercalcaemia such as malignancy, thyroid disease and sarcoidosis were excluded. On further questioning his daughter reported he had been taking 60,000 IU vitamin D capsules per day for the last 2 years having read a book advocating its health benefits.

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Section: Discussionmentioning

confidence: 99%

Risks of the ‘Sunshine pill’ – a case of hypervitaminosis D

2018

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“…National, continental consensus and practical recommendations for prevention of hypovitaminosis D have been adopted and are implemented in North American (USA, Canada) and European countries [11,[22][23][24][25][26][27].…”

Section: David Publishingmentioning

confidence: 99%

Management of Vitamin D Insufficiency in Young Children in the Russian Federation

Захарова¹,

Klimov²,

Мальцев³

et al. 2017

UCMS

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Abstract:The paper presents the results of a multicenter study assessing efficacy and safety of a course-based regimen for hypovitaminosis D management in children under the age of three years. A dose of cholecalciferol was prescribed to children differentially, based on the baseline 25(OH)D levels. The dependence of the baseline vitamin D levels on the pre-test administration of cholecalciferol has been demonstrated. A high efficacy of the proposed management regimen in children, starting from the first 6 months of life, allows to widely recommend it in outpatient clinical practice. The level of calcidiol in children following one-month administration of 1000 to 4000 IU/day increased from 23.7 ng/ml to 45.5 ng/ml (P < 0.001), and the frequency of normal levels increased from 33.3% to 74.5 % (P < 0.001). The median increase in calcidiol levels following the one-month course of 1000 IU/day, 2000 IU/day, 3000 IU/day, and 4000 IU/day was 2.9 ng/ml, 22.3 ng/ml, 22.6 ng/ml, and 32.0 ng/ml, respectively. An increase in 25(OH)D levels closely correlates with the daily dose of cholecalciferol (r = 0.504, P < 0.001). The regimen proposed by the authors demonstrated, along with the efficacy, a high safety profile, the threshold limit of 100 ng/ml being exceeded only in 3.9% of children.

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“…Results pertaining to vitamin D insufficiency were interpreted in accordance with the recommendations of the International Society of Endocrinology (2011): 25(ОН)D concentrations below 10 ng/mL corresponded to severe vitamin D deficiency; levels in the range of 10 to 20 ng/ mL were interpreted as a deficiency; 21-29 ng/mL as an insufficiency; and levels in the range of 30 to 100 mg/mL as a normal vitamin D content [18,22].…”

Section: ключевые слова: холекальциферол недостаточность витамина Dmentioning

confidence: 99%

“…Notwithstanding the growing relevance of this problem, the question of optimal dosing and, which is also important, optimal duration of cholecalciferol supplementation remains unanswered [2,5,11,12,18,20,22]. The choice which, unfortunately, has been dominant in this country to this day, is the so-called «seasonal» vitamin D supplementation method, which involves administration of cholecalciferol only during the autumn and winter period of the year; in the Southern regions, this period often lasts only 5 to 6 months, which is definitely an insufficient time to achieve and maintain an optimal calcifediol concentration [2,5,7,9].…”

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confidence: 99%

“…Vitamin D deficiency is partially compensated (i. e. the 25(OH)D concentration increases to >30 ng/mL) and no hypercalcaemia occurs in children and adolescents given such doses for 6 months. 25(OH)D concentrations of 30 ng/mL or higher are required for manifestation of the extraskeletal effects of vitamin D. Additionally, the upper limit for serum calcifediol was established (30-50 ng/ mL or 75-125 nmol/L) at which a switch to prophylactic cholecalciferol supplementation is recommended, because any levels of calcifediol above 50 ng/mL are considered by the authors to be a «high concentration necessitating a decrease of the therapeutic dose» [14,18,20,22].…”

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confidence: 99%

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Changes in calcifediol concentrations in infants depending on the cholecalciferol dose and duration of therapy

Klimov¹,

Захарова²,

Maltcev³

et al. 2017

Medical news of the North Caucasus

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The paper presents an analysis of the relationship between the duration of cholecalciferol supplementation at different doses and the 25(ОН)D concentration in infants during their first year of life. We evaluated 496 infants aged 1 month to 12 months who were divided into four groups depending on the duration of vitamin D supplementation: up to 8 weeks, 8-15 weeks, 16-24 weeks, and over 24 weeks. original research PediatricsОригинальные исследОвания

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Vitamin D supplementation guidelines

Cited by 521 publications

References 103 publications

Risks of the ‘Sunshine pill’ – a case of hypervitaminosis D

Risks of the ‘Sunshine pill’ – a case of hypervitaminosis D

Management of Vitamin D Insufficiency in Young Children in the Russian Federation

Changes in calcifediol concentrations in infants depending on the cholecalciferol dose and duration of therapy

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