Safety and effectiveness of vitamin D mega-dose: A systematic review

Clin Nutr ESPEN. 2021 Dec:46:115-120. doi: 10.1016/j.clnesp.2021.09.010. Epub 2021 Sep 25.

Abstract

Introduction: Supplementation with high doses of vitamin D, known as mega-dose or "stoss therapy," refers to administering high doses of vitamin D by oral or intramuscular route in short periods of time. In this sense, conducting a review to organize this knowledge in a single article will generate a helpful instrument for researchers working in this area and for health professionals who use this therapeutic tool.

Objective: To carry out a literature review on safety and efficacy (normalization of serum vitamin D level, and changes in the clinical picture) of vitamin D mega-dose use.

Methodology: This is a systematic review of the literature searching data through the electronic banks of PubMed, Scielo, and LILACS, using the following keywords: "vitamin D," "mega-dose," "stoss therapy," "cholecalciferol," in different combinations. CONSORT questionnaire was used to assess the quality of the included studies.

Results: Of the 59 articles screened for this review, 10 were included in the review, studying patients with rickets, osteoporosis, and critically ill patients. Two studies compared the exact dosage of vitamin D by different routes of administration, and three studies compared different doses by the same route. All others studied vitamin D mega-dose versus placebo. Adverse effects were observed through the presence of hypercalcemia/hypercalciuria. Serum vitamin D levels were normalized between 70 and 100% of patients, and adverse effects ranged between 1.9 and 18.5%.

Conclusion: The study demonstrated that vitamin D mega-dose therapy is effective in normalizing serum vitamin levels, and the toxicity assessed through adverse effects was low, with no expressive clinical significance. Despite this, there is still a need for further studies in the area to confirm the results found.

Keywords: D vitamin; High dose; Mega-dose.

Publication types

  • Systematic Review

MeSH terms

  • Cholecalciferol
  • Humans
  • Rickets*
  • Vitamin D
  • Vitamin D Deficiency* / diagnosis
  • Vitamin D Deficiency* / drug therapy
  • Vitamins / adverse effects

Substances

  • Vitamins
  • Vitamin D
  • Cholecalciferol