![]() ![]() ![]() 2 Those doses and concentrations are not recommended but highlight the fact that at more reasonable doses and concentrations discussed below toxicity is not a big concern for most patients. Risks are minimal, especially at recommended doses and most reports suggest a toxicity threshold for vitamin D of 10,000 to 40,000 International Units per day (IU/d) and serum concentrations of 200-240 ng/mL. The primary toxicity concern is elevated serum calcium concentration which can lead to vascular and tissue calcification with subsequent damage to kidneys, blood vessels and the heart. Toxicity can include non-specific symptoms such as anorexia, weight loss, polyuria and heart arrhythmias. Vitamin D has many therapeutic benefits ranging from maintaining bone metabolism and strength to reducing the prevalence of colon cancer. In the case of vitamin D this risk/benefit ratio is skewed far in favor of benefits. To answer this question, we need to reflect on what is probably the most important principal of drug therapy which is, “the possible risks of therapy must outweigh its possible benefits.” ![]() Should elderly persons take a vitamin D supplement? ![]()
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