• Users Online: 91
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
LETTER TO EDITOR
Year : 2017  |  Volume : 12  |  Issue : 1  |  Page : 59

Comment on: Supplementing vitamin D: Dangers of too much of a good thing: Reply


1 Department of Medicine, St. John's Medical College, Bengaluru, Karnataka, India
2 Department of Immunology, St. John's Medical College, Bengaluru, Karnataka, India

Date of Web Publication23-Feb-2017

Correspondence Address:
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-3698.199134

Rights and Permissions

How to cite this article:
Fathima S, Thomas K, Shobha V, Idiculla J. Comment on: Supplementing vitamin D: Dangers of too much of a good thing: Reply. Indian J Rheumatol 2017;12:59

How to cite this URL:
Fathima S, Thomas K, Shobha V, Idiculla J. Comment on: Supplementing vitamin D: Dangers of too much of a good thing: Reply. Indian J Rheumatol [serial online] 2017 [cited 2017 May 25];12:59. Available from: http://www.indianjrheumatol.com/text.asp?2017/12/1/59/199134

Dear editor,

We thank Dr. Subramanian for his interest [1] in our case report on Vitamin D toxicity.[2] This was to alert clinicians about the excessive and indiscriminate use of Vitamin D. The patient in the case report underwent a through screen to rule out malignancies of thyroid, breast, uterus, and intestines, which were all negative. On follow-up, she remains normocalcemic and well. If the biochemical parameters derange in future, we shall perform parathyroid hormone-related peptide assay as suggested by you.

The assay method used in our institution for Vitamin D estimation is chemiluminescent immunoassay. We have also observed low levels of Vitamin D even in asymptomatic individuals. The reason for this remains elusive, though studies on Vitamin D receptor polymorphisms and free Vitamin D levels may throw light.

Senior citizens are vulnerable to Vitamin D deficiency and consequent fractures. The Endocrine Society recommends Vitamin D levels above 30 ng/ml, while the Institute of Medicine's suggests levels above 20 ng/ml. The recommendation of the endocrine society is to provide at least 600 IU for those aged 50–70 and 800 IU in those above 70.[3] A dose of 1500–2000 units a day is required to raise the levels to 30 ng/dl, which in turn will prevent fractures. In Indians, a daily dose of 2000 units is recommended.[4] The dangers of over-treatment was reported by a case series from India recently.[5] In order to correct deficiency 50,000 units/week for 8 weeks or equivalent daily doses is suggested.[3] Parenteral administration may also be considered at the same dose as the effectiveness remains mostly similar.[6]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Nallasivan S. Comment on: Supplementing Vitamin D: Dangers of Too Much of a Good Thing. Ind J Rheumatol 2017;12:58.  Back to cited text no. 1
    
2.
Fathima S, Tomas K, Shoba V, Idiculla J. Supplementing Vitamin D: Dangers of too much of a good thing. Indian J Rheumatol 2016;11:226-7.  Back to cited text no. 2
  Medknow Journal  
3.
Evaluation, Treatment and Prevention of Vitamin D Deficiency – Endocrine Society. Available from: http://www.endocrine.org>publications. [Last accessed on 2016 Dec 30].  Back to cited text no. 3
    
4.
Mudur G. Indian endocrinologists set guidance to combat Vitamin D deficiency. BMJ 2015;351:h5997.  Back to cited text no. 4
    
5.
Kaur P, Mishra SK, Mithal A. Vitamin D toxicity resulting from overzealous correction of Vitamin D deficiency. Clin Endocrinol (Oxf) 2015;83:327-31.  Back to cited text no. 5
    
6.
Zabihiyeganeh M, Jahed A, Nojomi M. Treatment of hypovitaminosis D with pharmacologic doses of cholecalciferol, oral vs. intramuscular; an open labeled RCT. Clin Endocrinol (Oxf) 2013;78:210-6.  Back to cited text no. 6
    




 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
References

 Article Access Statistics
    Viewed400    
    Printed2    
    Emailed0    
    PDF Downloaded22    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]