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Review Articles |
For adults, the 5-µg (200 IU) vitamin D recommended dietary allowance may prevent osteomalacia in the absence of sunlight, but more is needed to help prevent osteoporosis and secondary hyperparathyroidism. Other benefits of vitamin D supplementation are implicated epidemiologically: prevention of some cancers, osteoarthritis progression, multiple sclerosis, and hypertension. Total-body sun exposure easily provides the equivalent of 250 µg (10000 IU) vitamin D/d, suggesting that this is a physiologic limit. Sailors in US submarines are deprived of environmentally acquired vitamin D equivalent to 20–50 µg (800–2000 IU)/d. The assembled data from many vitamin D supplementation studies reveal a curve for vitamin D dose versus serum 25-hydroxyvitamin D [25(OH)D] response that is surprisingly flat up to 250 µg (10000 IU) vitamin D/d. To ensure that serum 25(OH)D concentrations exceed 100 nmol/L, a total vitamin D supply of 100 µg (4000 IU)/d is required. Except in those with conditions causing hypersensitivity, there is no evidence of adverse effects with serum 25(OH)D concentrations <140 nmol/L, which require a total vitamin D supply of 250 µg (10000 IU)/d to attain. Published cases of vitamin D toxicity with hypercalcemia, for which the 25(OH)D concentration and vitamin D dose are known, all involve intake of 
1000 µg (40000 IU)/d. Because vitamin D is potentially toxic, intake of >25 µg (1000 IU)/d has been avoided even though the weight of evidence shows that the currently accepted, no observed adverse effect limit of 50 µg (2000 IU)/d is too low by at least 5-fold.
Key Words: Calciferol • calcidiol • cholecalciferol • calcitriol • vitamin D • 25-hydroxyvitamin D • 1,25-dihydroxyvitamin D • toxicity • safety • nutrition • environment • ultraviolet light • hyperparathyroidism • osteoporosis • osteomalacia • daily reference intake • 25(OH)D • 1,25(OH)2D • no observed adverse effect level • NOAEL • LOAEL • lowest observed adverse effect level
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D. A. Hanley and K. S. Davison Vitamin D Insufficiency in North America J. Nutr., February 1, 2005; 135(2): 332 - 337. [Abstract] [Full Text] [PDF]
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J. M Pettifor Nutritional rickets: deficiency of vitamin D, calcium, or both? Am. J. Clinical Nutrition, December 1, 2004; 80(6): 1725S - 1729S. [Abstract] [Full Text] [PDF]
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C. M Weaver and J. C Fleet Vitamin D requirements: current and future Am. J. Clinical Nutrition, December 1, 2004; 80(6): 1735S - 1739S. [Abstract] [Full Text] [PDF]
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L. A. G. Armas, B. W. Hollis, and R. P. Heaney Vitamin D2 Is Much Less Effective than Vitamin D3 in Humans J. Clin. Endocrinol. Metab., November 1, 2004; 89(11): 5387 - 5391. [Abstract] [Full Text] [PDF]
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H. L Newmark, R. P Heaney, and P. A Lachance Should calcium and vitamin D be added to the current enrichment program for cereal-grain products? Am. J. Clinical Nutrition, August 1, 2004; 80(2): 264 - 270. [Abstract] [Full Text] [PDF]
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G. de Torrente de la Jara, A. Pecoud, and B. Favrat Musculoskeletal pain in female asylum seekers and hypovitaminosis D3 BMJ, July 17, 2004; 329(7458): 156 - 157. [Full Text] [PDF]
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 J. L. Montgomery, M. B. King, J. G. Gentry, A. R. Barham, B. L. Barham, G. G. Hilton, J. R. Blanton Jr., R. L. Horst, M. L. Galyean, K. J. Morrow Jr., et al. Supplemental vitamin D3 concentration and biological type of steers. II. Tenderness, quality, and residues of beef J Anim Sci, July 1, 2004; 82(7): 2092 - 2104. [Abstract] [Full Text] [PDF]
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