Vitamin D loading doses quickly and safely raise levels – meta-analysis

Safety and effectiveness of vitamin D mega-dose: A systematic review

Clin Nutr ESPEN. 2021 Dec;46:115-120. doi: 10.1016/j.clnesp.2021.09.010

Fernanda Lauar Ataide 1, Larissa Matos Carvalho Bastos 2, Matheus Franklin Vicente Matias 2, Thelma Larocca Skare 3, Jozélio Freire de Carvalho 4

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Hyper: calcemia, calciuria

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Introduction: Supplementation with high doses of vitamin D, known as mega-dose or "stoss therapy," refers to administering high doses of vitamin D by oral or intramuscular route in short periods of time. In this sense, conducting a review to organize this knowledge in a single article will generate a helpful instrument for researchers working in this area and for health professionals who use this therapeutic tool.

Objective: To carry out a literature review on safety and efficacy (normalization of serum vitamin D level, and changes in the clinical picture) of vitamin D mega-dose use.

Methodology: This is a systematic review of the literature searching data through the electronic banks of PubMed, Scielo, and LILACS, using the following keywords: "vitamin D," "mega-dose," "stoss therapy," "cholecalciferol," in different combinations. CONSORT questionnaire was used to assess the quality of the included studies.

Results: Of the 59 articles screened for this review, 10 were included in the review, studying patients with rickets, osteoporosis, and critically ill patients. Two studies compared the exact dosage of vitamin D by different routes of administration, and three studies compared different doses by the same route. All others studied vitamin D mega-dose versus placebo. Adverse effects were observed through the presence of hypercalcemia/hypercalciuria. Serum vitamin D levels were normalized between 70 and 100% of patients, and adverse effects ranged between 1.9 and 18.5%.

Conclusion: The study demonstrated that vitamin D mega-dose therapy is effective in normalizing serum vitamin levels , and the toxicity assessed through adverse effects was low, with no expressive clinical significance. Despite this, there is still a need for further studies in the area to confirm the results found.


VitaminDWiki observations

  • Vitamin d is perhaps the only nutrient that can be restored via a loading dose

  • Loading doses have beenin use around the world for >50 years

  • Loading doses can quickly raise Vitamin D Levels

  • Injection loading provides the slowest rise - many weeks

  • Oral loading is most frequently used - response peaks in 3-10 days

  • Sublingual loading may have the fastest response time - 1 day not delayed by gut)

  • Loading doses can be made in a single session, or across many days

    • France, for example, has >200 loading dose protocols
  • Many groups have found that the loading doses should be smaller for humans with lower weight

  • People with poor guts should use gut-friendly forms of Vitamin D


VitaminDWiki - Loading Dose of Vitamin D category

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VitaminDWiki - Injection category contains

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VitaminDWiki - Children and Loading dose studies

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VitaminDWiki pages with HIGH-DOSE in title (65 as of Nov 2022)

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VitaminDWiki - Calcium and Vitamin D category contains

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