• J S Adams and G Lee.
• Cedars-Sinal Medical Center, Los Angeles, California, USA.
• Ann. Intern. Med. 1997 Aug 1; 127 (3): 203-6.

BackgroundVitamin D intoxication is associated with the mobilization of skeletal calcium.ObjectiveTo ascertain how the resolution of vitamin D intoxication affects bone density.DesignCase series.SettingReferral service for metabolic bone disease in a tertiary care teaching hospital.PatientsFour patients with osteoporosis who were each using several nonprescription dietary supplements and were found to have fasting hypercalciuria.InterventionDiscontinuation of use of dietary supplements.MeasurementsSerial measurement of serum levels of 25-hydroxyvitamin D, ratio of fasting urinary calcium to creatinine, and bone mineral density for 3 years.ResultsDiscontinuation of use of dietary supplements resulted in the normalization of serum levels of 25-hydroxyvitamin D, the normalization of the ratio of urinary calcium to creatinine, and a mean annual increase in bone mineral density (+/- SD) of 1.9% +/- 0.5%.ConclusionsOccult vitamin D intoxication was detected in patients who were using dietary supplements that contained an unadvertised high level of vitamin D. Resolution of vitamin D intoxication was associated with a rebound in bone mineral density.

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