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
Saba Fathima1, Kurian Thomas1, Vineeta Shobha2, Jyothi Idiculla1,
1 Department of Medicine, St. John's Medical College, Bengaluru, Karnataka, India
2 Department of Immunology, St. John's Medical College, Bengaluru, Karnataka, India
|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;12:59-59
|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 2023 Feb 2 ];12:59-59
Available from: https://www.indianjrheumatol.com/text.asp?2017/12/1/59/199134
We thank Dr. Subramanian for his interest  in our case report on Vitamin D toxicity. 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. 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. The dangers of over-treatment was reported by a case series from India recently. In order to correct deficiency 50,000 units/week for 8 weeks or equivalent daily doses is suggested. Parenteral administration may also be considered at the same dose as the effectiveness remains mostly similar.
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Conflicts of interest
There are no conflicts of interest.
|1||Nallasivan S. Comment on: Supplementing Vitamin D: Dangers of Too Much of a Good Thing. Ind J Rheumatol 2017;12:58.|
|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.|
|3||Evaluation, Treatment and Prevention of Vitamin D Deficiency – Endocrine Society. Available from: http://www.endocrine.org>publications. [Last accessed on 2016 Dec 30].|
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