Short- and long-term safety of weekly high-dose vitamin D3 supplementation in school children.

BACKGROUND Hypovitaminosis D is prevalent in youth worldwide, but the safety of vitamin D at doses exceeding 200 IU/d is unknown in this age group. We assessed the safety of high doses of vitamin D(3) administered to apparently healthy schoolchildren. METHODS To assess short-term safety, 25 subjects randomly received placebo or vitamin D(3) at doses of 14,000 IU/wk for 8 wk. To assess long-term safety, 340 subjects randomly received placebo, vitamin D(3) as 1,400 IU/wk or 14,000 IU/wk for 1 yr. Biochemical variables were monitored at 0, 2, 4, 6, and 8 wk and 8 wk off therapy in the short-term study and at 0, 6, and 12 months in the long-term study. RESULTS In both the short- and long-term studies, mean serum calcium and 1,25-hydroxyvitamin levels did not change in any group. In the short-term study, mean 25-hydroxyvitamin concentrations increased from 44 (+/- 11) to 54 (+/- 19) ng/ml in the treated groups (P = 0.033). In the long-term study, mean 25-hydroxyvitamin D levels increased from 15 +/- 8 to 19 +/- 7 ng/ml (P < 0.0001) in subjects receiving 1,400 IU/wk and from 15 +/- 7 to 36 +/- 22 ng/ml (P < 0.0001) in the group receiving 14,000 IU/wk. No subject developed vitamin D intoxication. CONCLUSION Vitamin D(3) at doses equivalent to 2000 IU/d for 1 yr is safe in adolescents and results in desirable vitamin D levels.

[1]  J. Smit,et al.  Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents , 2007, Osteoporosis International.

[2]  M. Holick Vitamin D deficiency. , 2007, The New England journal of medicine.

[3]  G. Fuleihan,et al.  Vitamin D insufficiency and musculoskeletal health in children and adolescents , 2007 .

[4]  J. Knight,et al.  Vitamin D and Reduced Risk of Breast Cancer: A Population-Based Case-Control Study , 2007, Cancer Epidemiology Biomarkers & Prevention.

[5]  W. Willett,et al.  The urgent need to recommend an intake of vitamin D that is effective. , 2007, The American journal of clinical nutrition.

[6]  A. Shao,et al.  Risk assessment for vitamin D. , 2007, The American journal of clinical nutrition.

[7]  R. Vieth,et al.  The case against ergocalciferol (vitamin D2) as a vitamin supplement. , 2006, The American journal of clinical nutrition.

[8]  H. Dahifar,et al.  Impact of dietary and lifestyle on vitamin D in healthy student girls aged 11-15 years. , 2006, The journal of medical investigation : JMI.

[9]  C. Mølgaard,et al.  A Positive Dose–Response Effect of Vitamin D Supplementation on Site‐Specific Bone Mineral Augmentation in Adolescent Girls: A Double‐Blinded Randomized Placebo‐Controlled 1‐Year Intervention , 2006, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[10]  J. Manson,et al.  Vitamin D and calcium intake in relation to type 2 diabetes in women. , 2006, Diabetes care.

[11]  M. Holick High prevalence of vitamin D inadequacy and implications for health. , 2006, Mayo Clinic proceedings.

[12]  R. Vieth,et al.  Effect of vitamin D replacement on musculoskeletal parameters in school children: a randomized controlled trial. , 2006, The Journal of clinical endocrinology and metabolism.

[13]  P. Lips,et al.  Estimates of optimal vitamin D status , 2005, Osteoporosis International.

[14]  T. Hangartner,et al.  Calcium supplementation and bone mineral density in females from childhood to young adulthood: a randomized controlled trial. , 2005, The American journal of clinical nutrition.

[15]  B. Hollis,et al.  Vitamin D2 is much less effective than vitamin D3 in humans. , 2004, The Journal of clinical endocrinology and metabolism.

[16]  R. Vieth,et al.  Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients , 2004, Nutrition journal.

[17]  B. Hollis Editorial: The determination of circulating 25-hydroxyvitamin D: no easy task. , 2004, The Journal of clinical endocrinology and metabolism.

[18]  M. Drezner,et al.  Assay variation confounds the diagnosis of hypovitaminosis D: a call for standardization. , 2004, The Journal of clinical endocrinology and metabolism.

[19]  S. Emans,et al.  Prevalence of vitamin D deficiency among healthy adolescents. , 2004, Archives of pediatrics & adolescent medicine.

[20]  P. Lips Which circulating level of 25-hydroxyvitamin D is appropriate? , 2004, The Journal of Steroid Biochemistry and Molecular Biology.

[21]  R. Vieth Why the optimal requirement for Vitamin D3 is probably much higher than what is officially recommended for adults , 2004, The Journal of Steroid Biochemistry and Molecular Biology.

[22]  R. Heaney,et al.  Long-latency deficiency disease: insights from calcium and vitamin D. , 2003, The American journal of clinical nutrition.

[23]  F. Greer,et al.  Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. , 2003, Pediatrics.

[24]  R. Strange,et al.  Exposure to ultraviolet radiation: association with susceptibility and age at presentation with prostate cancer , 2001, The Lancet.

[25]  G. Fuleihan,et al.  Hypovitaminosis D in Healthy Schoolchildren , 2001, Pediatrics.

[26]  R. Vieth,et al.  Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. , 2001, The American journal of clinical nutrition.

[27]  M. Kosorok,et al.  Early diagnosis of cystic fibrosis through neonatal screening prevents severe malnutrition and improves long-term growth. Wisconsin Cystic Fibrosis Neonatal Screening Study Group. , 2001, Pediatrics.

[28]  G. Peres,et al.  Wintertime Vitamin D Deficiency in Male Adolescents: Effect on Parathyroid Function and Response to Vitamin D3 Supplements , 2001, Osteoporosis International.

[29]  M. Georgieff,et al.  Calcium Requirements of Infants, Children, and Adolescents , 1999, Pediatrics.

[30]  C. Weaver,et al.  Adolescent nutrition in the prevention of postmenopausal osteoporosis. , 1999, The Journal of clinical endocrinology and metabolism.

[31]  P. Lips,et al.  An International Comparison of Serum 25-Hydroxyvitamin D Measurements , 1999, Osteoporosis International.

[32]  R. Vieth,et al.  Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. , 1999, The American journal of clinical nutrition.

[33]  G. Peres,et al.  Vitamin D Status During Puberty in French Healthy Male Adolescents , 1999, Osteoporosis International.

[34]  R. Vieth,et al.  Evidence that vitamin D3 increases serum 25-hydroxyvitamin D more efficiently than does vitamin D2. , 1998, The American journal of clinical nutrition.

[35]  J. Riancho,et al.  Seasonal Deficiency of Vitamin D in Children: A Potential Target for Osteoporosis‐Preventing Strategies? , 1998, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[36]  V. Matkovic,et al.  Calcitriol and Bone Mass Accumulation in Females During Puberty , 1997, Calcified Tissue International.

[37]  C. Mautalen,et al.  Vitamin D prophylaxis in children with a single dose of 150000 IU of vitamin D. , 1996, European journal of clinical nutrition.

[38]  G. Peres,et al.  Vitamin D-dependent seasonal variation of PTH in growing male adolescents. , 1995, Bone.

[39]  C. Mautalen,et al.  Seasonal variations of 25 hydroxyvitamin D and parathyroid hormone in Ushuaia (Argentina), the southernmost city of the world. , 1993, Bone and mineral.

[40]  K. Norwich,et al.  Role of 25-hydroxyvitamin D3 dose in determining rat 1,25-dihydroxyvitamin D3 production. , 1990, The American journal of physiology.

[41]  P. Delmas,et al.  Measurement of bone mineral content of the lumbar spine by dual energy x-ray absorptiometry in normal children: correlations with growth parameters. , 1990, The Journal of clinical endocrinology and metabolism.

[42]  G. Lockitch,et al.  Age- and sex-specific pediatric reference intervals for biochemistry analytes as measured with the Ektachem-700 analyzer. , 1988, Clinical chemistry.

[43]  L. Aksnes,et al.  Plasma concentrations of vitamin D metabolites in puberty: effect of sexual maturation and implications for growth. , 1982, The Journal of clinical endocrinology and metabolism.