Calcium supplements and bone health

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WARNINGS, DISCLAIMERS AND OTHER INTIMIDATING LEGAL STATEMENTS


First the FDA accepted and obligatory statements

RECOMMENDED DOSE: One Capsule WEEKLY for adults.

WARNINGS: Not intended for children, pregnant women, or persons with kidney disease, bone disease, malignancies, or calcium disorders except upon the advice of and under the supervision of a physician. (In fact, cholecalciferol is often recommended for some of the above situations.)
Side effects from too much vitamin D may include persisting nausea, vomiting, poor appetite, constipation, weakness and weight loss.

Toxicity

Vitamin D toxicity is not common and difficult to achieve. This is because: 1) there are few natural dietary sources of vitamin D and even usual fortified sources contain relatively small amounts. 2) 25-OH cholecalciferol (the form stored by the body after conversion in the liver) has only weak hormonal activity. (Again, vitamin D is a hormone, not a vitamin.) The conversion to the active hormone, 1, 25-OH cholecalciferol, is an internally regulated process.

Most recent reported vitamin D toxicity has involved repeated ingestion over significant periods of time of poorly compounded over the counter nutritional supplements:

Critique of the Considerations for Establishing the Tolerable Upper Intake Level for Vitamin D: Critical Need for Revision Upwards
Reinhold Vieth
American Society for Nutrition J. Nutr. 136:1117-1122, April 2006
http://content.nejm.org/cgi/content/full/357/3/308

Vitamin D Intoxication Associated with an Over-the-Counter Supplement
P. Koutkia, T. C. Chen, and M. F. Holick - 5 Jul, 2001
http://content.nejm.org/cgi/content/full/345/1/66-
a?ijkey=cc079da10156cb4274319c9cac72bfa83fa13935&keytype2=tf_ipsecsha

Accidental over fortification of milk has been reported.

An outbreak of hypervitaminosis D associated with the overfortification of milk from a home-delivery dairy.
S Blank, K S Scanlon, T H Sinks, S Lett and H Falk
American Journal of Public Health, Vol. 85, Issue 5 656-659 http://www.ajph.org/cgi/content/abstract/85/5/656

This, although they are available, is why concentrated powders and liquid preparations have been considered prescription products by the FDA.

PLEASE NOTE that each of our production lots is tested prior to distribution. In addition annual testing is done for evidence of contamination or degradation.

 

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