PainScience.com Sensible advice for aches, pains & injuries
 
 
bibliography * The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Heaney 2008.

A comfortable margin of safety in Vitamin D dosing

updated
Heaney RP. Vitamin D in health and disease. Clin J Am Soc Nephrol. 2008 Sep;3(5):1535–41. PubMed #18525006.
Tags: chronic pain, vitamin D, muscle pain, etiology, treatment, self-treatment, nutrition, pain problems, muscle, pro

PainSci summary of Heaney 2008?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★☆☆?3-star ratings are for typical studies with no more (or less) than the usual common problems. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

“The safest and most economical way to ensure adequate vitamin D status is to use oral dosing of native vitamin D,” and “the safe upper intake level for vitamin D(3) is 10,000 IU/day.” More detail from the paper:

Vitamin D, particularly its active hormonal form, calcitriol, is a highly potent molecule, capable of producing serious toxic effects, including death, at milligram intake levels. There is thus a healthy fear of the compound relating in part to cases of sporadic poisoning (49) as well as to medical misadventure 70 yr ago, involving administration of millions of units per day of the vitamin. Nevertheless, despite these appropriate concerns, there is, in fact, a comfortable margin of safety between the intakes required for optimization of vitamin D status and those associated with toxicity.

original abstractAbstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Vitamin D functions in the body through both an endocrine mechanism (regulation of calcium absorption) and an autocrine mechanism (facilitation of gene expression). The former acts through circulating calcitriol, whereas the latter, which accounts for more than 80\% of the metabolic utilization of the vitamin each day, produces, uses, and degrades calcitriol exclusively intracellularly. In patients with end-stage kidney disease, the endocrine mechanism is effectively disabled; however, the autocrine mechanism is able to function normally so long as the patient has adequate serum levels of 25(OH)D, on which its function is absolutely dependent. For this reason, calcitriol and its analogs do not constitute adequate replacement in managing vitamin D needs of such patients. Optimal serum 25(OH)D levels are greater than 32 ng/mL (80 nmol/L). The consequences of low 25(OH)D status include increased risk of various chronic diseases, ranging from hypertension to diabetes to cancer. The safest and most economical way to ensure adequate vitamin D status is to use oral dosing of native vitamin D. (Both daily and intermittent regimens work well.) Serum 25(OH)D can be expected to rise by about 1 ng/mL (2.5 nmol/L) for every 100 IU of additional vitamin D each day. Recent data indicate that cholecalciferol (vitamin D(3)) is substantially more potent than ergocalciferol (vitamin D(2)) and that the safe upper intake level for vitamin D(3) is 10,000 IU/d.

related content

One article on PainScience.com cites Heaney 2008 as a source:


This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights: