Mayo Clinic Proceedings Home

Vitamin D Is Not as Toxic as Was Once Thought: A Historical and an Up-to-Date Perspective

  • Michael F. Holick
    Correspondence
    Correspondence: Michael F. Holick, PhD, MD, Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University Medical Center, Boston, MA 02118.
    Affiliations
    Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University Medical Center, Boston, MA
    Search for articles by this author
      In the current issue of Mayo Clinic Proceedings, Dudenkov et al
      • Dudenkov D.V.
      • Yawn B.P.
      • Oberhelman S.S.
      • et al.
      Changing incidence of serum 25-hydroxyvitamin D values above 50 ng/mL: a 10 year population-based study.
      report on a retrospective study of serum 25-hydroxyvitamin D (25(OH)D) values in patients registered in the Rochester Epidemiology Project. The article reported that although serum 25(OH)D values of more than 50 ng/mL increased over the 10-year study period, vitamin D toxicity and hypercalcemia were exceedingly rare. To understand the importance of this finding as it relates to clinical care, it is useful to begin with a review of the history of hypovitaminosis D diagnosis and vitamin D replacement, followed by new insights into vitamin D offered in the recent literature.
      To read this article in full you will need to make a payment

      References

        • Dudenkov D.V.
        • Yawn B.P.
        • Oberhelman S.S.
        • et al.
        Changing incidence of serum 25-hydroxyvitamin D values above 50 ng/mL: a 10 year population-based study.
        Mayo Clin Proc. 2015; 90: 577-586
        • Wacker M.
        • Holick M.F.
        Sunlight and vitamin D: a global perspective for health.
        Dermatoendocrinol. 2013; 5: 51-108
        • Stapleton T.
        • MacDonald W.B.
        • Lightwood R.
        The pathogenesis of idiopathic hypercalcemia in infancy.
        Am J Clin Nutr. 1957; 5: 533-542
        • Palermo N.E.
        • Holick M.F.
        Vitamin D, bone health, and other health benefits in pediatric patients.
        J Pediatr Rehabil Med. 2014; 7: 179-192
        • Samuel H.S.
        Infantile hypercalcaemia, nutritional rickets, and infantile scurvy in Great Britain: a British Paediatric Association report.
        Br Med J. 1964; 1: 1659-1661
        • Friedman W.F.
        • Roberts W.C.
        Vitamin D and the supravalvular aortic stenosis syndrome: the transplacental effects of vitamin D on the aorta of the rabbit.
        Circulation. 1966; 34: 77-86
        • Pober B.R.
        Williams-Beuren syndrome.
        N Engl J Med. 2010; 362: 239-252
        • Taylor A.B.
        • Stern P.H.
        • Bell N.H.
        Abnormal regulation of circulating 25-hydroxyvitamin D in the Williams syndrome.
        N Engl J Med. 1982; 306: 972-975
        • Schlingmann K.P.
        • Kaufman M.
        • Weber S.
        • et al.
        Mutations in CYP24 A1 and idiopathic infantile hypercalcemia.
        N Engl J Med. 2011; 365: 410-421
        • Jackson R.D.
        • LaCroix A.Z.
        • Gass M.
        • et al.
        Calcium plus vitamin D supplementation and the risk of fractures.
        N Engl J Med. 2006; 354: 669-683
        • Ross A.C.
        • Manson J.E.
        • Abrams S.A.
        • et al.
        The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know.
        J Clin Endocrinol Metab. 2011; 96: 53-58
        • Hossein-nezhad A.
        • Holick M.F.
        Vitamin D for health: a global perspective.
        Mayo Clin Proc. 2013; 88: 720-755
        • Looker A.C.
        • Johnson C.L.
        • Lachner D.A.
        • Pfeiffer C.M.
        • Schleicher R.L.
        • Sempos C.T.
        Vitamin D Status: United States, 2001-2006.
        NCHS Data Brief. 2011; : 1-8
        • Biancuzzo R.M.
        • Clarke N.
        • Reitz R.E.
        • Travison T.G.
        • Holick M.F.
        Serum concentrations of 1,25-dihydroxyvitamin D2 and 1,25-dihydroxyvitamin D3 in response to vitamin D2 and vitamin D3 supplementation.
        J Clin Endocrinol Metab. 2013; 98: 973-979
        • Holick M.F.
        • Binkley N.C.
        • Bischoff-Ferrari H.A.
        • et al.
        Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.
        J Clin Endocrinol Metab. 2011; 96: 1911-1930
        • Ekwaru J.P.
        • Zwicker J.D.
        • Holick M.F.
        • Giovannucci E.
        • Veugelers P.J.
        The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers.
        PLoS One. 2014; 9: e111265
        • Kroll M.H.
        • Bi C.
        • Garber C.C.
        • et al.
        Temporal relationship between vitamin D status and parathyroid hormone in the United States.
        PLoS One. 2015; 10: e0118108

      Linked Article