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Controversy: Too much Calcium if increase Vitamin D

50 percent of elderly got hypercalcimia with 2000 IU of vitamin D – Feb 2011

Evaluation of the effectiveness of cholecalciferol in long-term care elderly patients with hypovitaminosis d.
Consult Pharm. 2011 Feb;26(2):101-7.
Shin M, Minden C.
Sullivan University College of Pharmacy, Louisville, Kentucky.

Objective: To study the efficacy and safety of cholecalciferol (vitamin D3) 2,000 units daily for 12 weeks in elderly patients with hypovitaminosis D. Secondarily, to postulate causes for those patients who did not return to normal 25-hydroxy vitamin D (25-OHD) levels.Design: One-group, pretest post-test. Retrospective chart review. Data collected from Computerized Patient Record System.Setting: Long-term care facility at Central Arkansas Veterans Healthcare System.Patients, Participants: Potential study subjects were elderly patients (? 65 years of age) treated with total daily dose of cholecalciferol 2,000 units daily by mouth, for at least 12 weeks' duration period between July 1, 2007, and July 31, 2009, with documented 25-OHD levels before and after treatment.Interventions: None.Main Outcome Measures: Efficacy of cholecalciferol was assessed by categorizing patients as responders (25-OHD levels ? 30 ng/mL) and nonresponders (25-OHD levels < 30 ng/mL).

Safety of vitamin D3 was determined by measuring prevalence of hypercalcemia. Patient demographics, disease states, and medications that can affect 25-OHD levels between responders and nonresponders of vitamin D treatment were assessed.

Results: 24 patients were included in analysis. 58.3% (14) of patients responded to cholecalciferol treatment and 41.7% (10) of patients did not. The mean 25-OHD level after treatment was 38.7 ng/mL in responders and 26.4 ng/mL in non responders.

Twelve patients (50%) developed hypercalcemia.

Conclusion: The present study has shown that some long-term care elderly patients respond to three months of vitamin D supplementation.
The reason why some patients did not respond cannot be determined from this study. PMID: 21310707

Chart from Overview of IoM

released Nov 30, 2010

See also VitaminDWiki: controversy