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Benefit-risk assessment of vitamin D supplementation Bischoff-Ferrari HA; Shao A; Dawson-Hughes B; Hathcock J; Giovannucci E; Willett WCOsteoporos Int 2010[Jul]; 21 (7): 1121-32Current intake recommendations of 200 to 600 IU vitamin D per day may be insufficient for important disease outcomes reduced by vitamin D. INTRODUCTION: This study assessed the benefit of higher-dose and higher achieved 25-hydroxyvitamin D levels [25(OH)D] versus any associated risk. METHODS AND RESULTS: Based on double-blind randomized control trials (RCTs), eight for falls (n = 2426) and 12 for non-vertebral fractures (n = 42,279), there was a significant dose-response relationship between higher-dose and higher achieved 25(OH)D and greater fall and fracture prevention. Optimal benefits were observed at the highest dose tested to date for 700 to 1000 IU vitamin D per day or mean 25(OH)D between 75 and 110 nmol/l (30-44 ng/ml). Prospective cohort data on cardiovascular health and colorectal cancer prevention suggested increased benefits with the highest categories of 25(OH)D evaluated (median between 75 and 110 nmol/l). In 25 RCTs, mean serum calcium levels were not related to oral vitamin D up to 100,000 IU per day or achieved 25(OH)D up to 643 nmol/l. Mean levels of 75 to 110 nmol/l were reached in most RCTs with 1,800 to 4,000 IU vitamin D per day without risk. CONCLUSION: Our analysis suggests that mean serum 25(OH)D levels of about 75 to 110 nmol/l provide optimal benefits for all investigated endpoints without increasing health risks. These levels can be best obtained with oral doses in the range of 1,800 to 4,000 IU vitamin D per day; further work is needed, including subject and environment factors, to better define the doses that will achieve optimal blood levels in the large majority of the population.|*Dietary Supplements/adverse effects[MESH]|Accidental Falls/prevention & control[MESH]|Aged[MESH]|Calcium/blood[MESH]|Dose-Response Relationship, Drug[MESH]|Fractures, Bone/prevention & control[MESH]|Humans[MESH]|Middle Aged[MESH]|Randomized Controlled Trials as Topic[MESH]|Risk Assessment[MESH]|Vitamin D/*administration & dosage/adverse effects/analogs & derivatives/blood[MESH] |
