Gains in bone mineral density with resolution of vitamin D intoxication
Abstract
BACKGROUND: Vitamin D intoxication is associated with the mobilization of skeletal calcium.
OBJECTIVE: To ascertain how the resolution of vitamin D intoxication affects bone density.
DESIGN: Case series.
SETTING: Referral service for metabolic bone disease in a tertiary care teaching hospital.
PATIENTS: Four patients with osteoporosis who were each using several nonprescription dietary supplements and were found to have fasting hypercalciuria.
INTERVENTION: Discontinuation of use of dietary supplements.
MEASUREMENTS: Serial measurement of serum levels of 25-hydroxyvitamin D, ratio of fasting urinary calcium to creatinine, and bone mineral density for 3 years.
RESULTS: Discontinuation of use of dietary supplements resulted in the normalization of serum levels of 25-hydroxyvitamin D, the normalization of the ratio of urinary calcium to creatinine, and a mean annual increase in bone mineral density (+/- SD) of 1.9% +/- 0.5%.
CONCLUSIONS: Occult vitamin D intoxication was detected in patients who were using dietary supplements that contained an unadvertised high level of vitamin D. Resolution of vitamin D intoxication was associated with a rebound in bone mineral density.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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