Calcium is the harmful agentBMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4819 (Published 17 November 2009) Cite this as: BMJ 2009;339:b4819
- Helga M Rhein, general practitioner1
Meyer and Köpke urge us to consider the “side effects of vitamin D and its toxicity.”1 But the doses considered (400-1100 IU) in Bischoff-Ferrari and colleagues’ meta-analysis and in the article Meyer and Köpke cite as evidence for side effects are certainly not toxic.2 3 The tolerable upper intake level for vitamin D used to be 2000 IU, but newer evidence suggests that much higher doses, 10 000 IU daily, are safe.4
Furthermore, most of the side effects reported by Avenell et al were gastrointestinal symptoms and renal calculi and are clearly due to the added calcium or the use of calcitriol, not vitamin D.
Cite this as: BMJ 2009;339:b4819
Competing interests: None declared.