Excessive Vitamin D Dietary Supplementation Is Common in the U.S.

Summary and Comment |
July 6, 2017

Excessive Vitamin D Dietary Supplementation Is Common in the U.S.

  1. Thomas L. Schwenk, MD

Almost one fifth of adults took daily supplements ≥1000 IU, and 3% ingested ≥4000 IU.

  1. Thomas L. Schwenk, MD

Known and purported benefits of sufficient vitamin D have caused some patients to believe that taking doses higher than the recommended daily intake (600 IU for adults ≤70, and 800 IU for those >70) adds even more value. In this study, investigators used a national health and nutrition survey database to identify about 5000 participants for each 2-year cycle of dietary assessment (from 1999 to 2014), for a total of 39,243 participants (mean age, 47).

In the 2013–2014 survey, the prevalence of daily supplemental intake ≥1000 IU vitamin D was 18.2%, and prevalence of intake ≥4000 IU was 3.2%. High intake was most common in women (25.9%), non-Hispanic whites (21.8%), and older participants (age, ≥70; 38.5%). Intake of ≥1000 IU increased significantly from the 1999–2000 survey (0.3%) to the 2013–2014 survey.

Comment

Prior studies have suggested several risks associated with high-dose vitamin D, including excess fractures, falls, renal calculi, and all-cause mortality. The increasing prevalence of high supplement intake suggests that clinicians should be asking specifically about supplemental vitamin D use. In fact, as I was preparing this summary, a colleague mentioned that one of his patients was taking 5000 IU of vitamin D daily and had a very high 25-hydroxyvitamin D level (84 ng/mL); my colleague called her, discussed excessive use of vitamin D supplements, and sent her a copy of this JAMA study.

Editor Disclosures at Time of Publication

  • Disclosures for Thomas L. Schwenk, MD at time of publication Editorial boards UpToDate

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