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.
How much Vitamin D supplementation is enough? How much is too much? “The input needed for efficacy, in addition to typical food and cutaneous inputs, will usually be 1000-2000 IU/day” and “toxicity is associated only with excessive supplemental intake (usually well above 20,000 IU/day).” This paragraph from the article on toxicity and safety is particularly relevant:
Both the intoxication literature and the recent controlled dosing studies have been reanalyzed by Hathcock et al. These authors show that essentially no cases of confirmed intoxication have been reported at serum 25(OH)D levels below 500 nmol/L. Correspondingly, the oral intakes needed to produce such levels are in excess of 20,000 IU/day in otherwise healthy adults and, more usually, above 50,000 IU/day. These findings led Hathcock et al to select 10,000 IU/day as the tolerable upper intake level (TUIL, or UL), with considerable confidence. It is likely that a higher intake could be defended, but little good would be served by doing so, as 10,000 IU/day is substantially more than is apparently needed for any recognized efficacy endpoint.
original abstract†Abstracts 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.
The functional status indicator for vitamin D, for both safety and efficacy, is serum 25-hydroxyvitamin D concentration. Efficacy for several health endpoints requires levels of 80 nmol/L or higher. Toxicity occurs at levels of 500 nmol/L or higher. The input needed for efficacy, in addition to typical food and cutaneous inputs, will usually be 1000-2000 IU/day of supplemental cholecalciferol. Toxicity is associated only with excessive supplemental intake (usually well above 20,000 IU/day).
These two articles on PainScience.com cite Heaney 2008 as a source:
- PS Trigger Points & Myofascial Pain Syndrome — A guide to the unfinished science of muscle pain, with reviews of every theory and self-treatment and therapy option
- PS Vitamin D for Pain — Is it safe and reasonable for chronic pain patients to take higher doses of Vitamin D? And just how high is safe?
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:
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.