4,000 IU of Vitamin D - many pages

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111+ VitaminDWiki pages with 4,000 or 4000 in the title

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4000 IU daily - rare risk of hypercalcemia - meta-analysis Feb 2023 (can reduce risk by subtracting Calcium or adding Vitamin K2)

Long-term supplementation with 3200 to 4000 IU of vitamin D daily and adverse events: a systematic review and meta-analysis of randomized controlled trials
European Journal of Nutrition February 2023
Armin Zittermann, Christian Trummer, Verena Theiler-Schwetz & Stefan Pilz

Note: No indication of how much Calcium (food or supplement) each group was taking
Nor if any vitamin K2 was taken (which reduces Calcium in the blood)

Purpose
The upper tolerable intake level for vitamin D in the general population has been set at 4000 international units (IU) daily, but considerable uncertainty remains. We summarized the reported harmful effects of a daily vitamin D supplement of 3200–4000 IU in trials lasting ≥ 6 months.

Methods
We performed a systematic review and meta-analysis of randomized controlled trials in several databases and identified 22 trials reporting safety data. Parameters of calcium metabolism, falls, hospitalization, and mortality were assessed.

Results
The selected trials comprised a total number of 12,952 participants. All trials used supplemental vitamin D3. The relative risk (RR) of hypercalcemia in the vitamin D vs. control arm was 2.21 (95%CI: 1.26–3.87; 10 studies), with a vitamin D-induced frequency of hypercalcemia of 4 cases per 1000 individuals. Subgroup analysis in trials with > 100 and ≤ 100 study participants revealed an RR of 2.63 (95%CI: 1.30–5.30; 7 studies) and 0.80 (95%CI: 0.24–2.62; 3 studies), respectively (Pinteraction = 0.06). Risks of falls and hospitalization were also significantly increased in the vitamin D arm with an RR of 1.25 (95%CI: 1.01–1.55; 4 studies) and 1.16 (95%CI: 1.01–1.33; 7 studies), respectively. Risks of hypercalciuria, kidney stones, and mortality did not differ significantly between study arms. The quality assessment revealed a high risk of incomplete reporting of safety-related outcome data.

Conclusion
Supplemental vitamin D doses of 3200–4000 IU/d appear to increase the risk of hypercalcemia and some other adverse events in a small proportion of individuals, indicating that this dose is not completely safe. In future studies, rigorous reporting of safety-related outcomes is needed when using moderately high doses of vitamin D.
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VitaminDWiki – Consensus Vitamin D category contains:

71 Vitamin D consensus publications

• French pediatric consensus: 30 – 60 ng of Vitamin D – Feb 2022
• 15 Clinical guidelines now recommend vitamin D – Nov 2021
• 34 clinical practice Vitamin D guidelines, huge diversity – Nov 2021
• Minimum National Vitamin D recommendations range from 200 to 4,000 IU – July 2021
• Controversies and consensus in Vitamin D – 3rd Conference Sept 2019
• Vitamin D Consensus 4,000 to 10,000 IU, upper limit 100 ng – Italy 2018
• 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018 six say 10,000 IU is OK
• 17 reasons why are doctors reluctant to accept vitamin D
  • Doctors and medical communities appear to be poor audiences to convince that vitamin D is good

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Charts from Overview Vitamin D Dose-Response 4,000 IU ==> 50-55 ng

• Same dose of vitamin D for everyone is virtually impossible - Dec 2015 has the following, from 36 studies

See also VitaminDWiki

Is 50 ng of vitamin D too high, just right, or not enough