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  3. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial
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Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7387.469 (Published 01 March 2003) Cite this as: BMJ 2003;326:469

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Level of vitamin D (3) supplementation 100,000IU

I am writing about the daily supplementation of 100,000IU of oral
Vitamin D3 (cholecalciferol).

Please comment on the potential of a toxicity problems with a 100,000
IU vitamin D3 taken on a daily basis for 4 months.

Thank you.

Competing interests:  
None declared

Competing interests: No competing interests

01 March 2003
Anne Woo
Sr. Market Development Officer,
Agriculture and Agri-Food Canada, 930 Carling Ave, 5th floor, Ottawa, Ontario, K1S 5A5

Vitamin D deficiency, lack of sunlight, multiple sclerosis

Four monthly oral Vitamin D3 (cholecalciferol), 100,000 IU over 5
years reduced fractures in over 65 year-olds by 20% in your study is very
encouraging.

There have been an epidemiological evidence that multiple sclerosis
(MS) is unknown in equator regions and uncommon in the tropics; MS
prevalence increases outside 40 degrees latitude. In Switzerland MS is
more prevalent in the valleys and less on mountain tops. MS is rare among
Eskimos and people living in coastal fishing villages, possibly due to
vitamin D in fish oils. Vitamin D absoprtion is reduced by phytic acid in
cereals like wheat, oat, barley, corn. The only cereal without phytic acid
is rice.

Vitamin D not only have effect on the bone but also has an immuno-
modulatory effect.

A recent study from Germany showed seasonal variation in the number
of MS plaques on magnetic resonance imaging MRI scans, 2 months after
change in season; i.e. an increase in late winter and a decrease in mid
summer.

Growing up in the tropics (first 15 years of life) gives partial
protection against MS. People who migrated to northern Australia, even at
a later age, have less MS than those in Southern Australia.

A longterm prospective double blind controlled study of the effect of
vitamin D3 supplementation on MS will be most valuable among the high risk
population.

Competing interests:  
None declared

Competing interests: No competing interests

01 March 2003
Peter K. Tun
Staff Grade Physician, Neurorehabilitation Medicine
Royal Berkshire & Battle Hospitals, Reading, RG30 1AG

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