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Dietary Reference Intakes for Calcium and Vitamin D (2011)
Food and Nutrition Board (FNB)

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. "Appendix G: Cases Studies of Vitamin D Toxicity." Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press, 2011.

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DRI Dietary Reference Intakes Calcium Vitamin D

Serum Calcium

Serum 25(OH)D

Symptoms/Health Effects

3.5–3.7 mmol/L (~14 mg/dL)

496 ng/ml

Polydypsia, polyuria, anorexia, nausea; tx with IV saline, furosemide; hydrocortisone

3.75 mmol/L (15 mg/dL)

1,171 nmol/L (469.2 ng/ml)

Fatigue, constipation, back pain, forgetfulness, nausea, vomiting; tx with IV saline, furosemide, and pamidronate

3.95 mmol/L (15.8 mg/dL)

58–60 IU/ml (145–150 ng/ml)

Both adults developed renal failure. The female aborted a 10-week fetus at 3 weeks post-diagnosis for hypervitaminosis D. Plasma vitamin D levels were 60 IU/ml 5 weeks post-diagnosis; nephrocalcinosis persisted in the adult male but neither had long-term renal impairment

(mean for adults at 5 weeks post-exposure)

(5 weeks post-exposure)

Renal colic, confusion, lethargy, and weakness; reported passing small stones; tx with IV saline, furosemide, glucocorticoids

15.3 mg/dL

>150 ng/ml

11.3 mg/dL

>150 ng/ml

 

Page
1033
Front Matter (R1-R16)
Summary (1-14)
1 Introduction (15-34)
2 Overview of Calcium (35-74)
3 Overview of Vitamin D (75-124)
4 Review of Potential Indicators of Adequacy and Selection of Indicators: Calcium and Vitamin D (125-344)
5 Dietary Reference Intakes for Adequacy: Calcium and Vitamin D (345-402)
6 Tolerable Upper Intake Levels: Calcium and Vitamin D (403-456)
7 Dietary Intake Assessment (457-478)
8 Implications and Special Concerns (479-512)
9 Information Gaps and Research Needs (513-522)
Appendix A: Acronyms, Abbreviations, and Glossary (523-536)
Appendix B: Issues and Interests Identified by Study Sponsors (537-538)
Appendix C: Methods and Results from the AHRQ-Ottawa Evidence-Based Report on Effectiveness and Safety of Vitamin D in Relation to Bone Health (539-724)
Appendix D: Methods and Results from the AHRQ-Tufts Evidence-Based Report on Vitamin D and Calcium (725-1012)
Appendix E: Literature Search Strategy (1013-1018)
Appendix F: Evidence Maps (1019-1024)
Appendix G: Cases Studies of Vitamin D Toxicity (1025-1034)
Appendix H: Estimated Intakes of Calcium and Vitamin D from National Surveys (1035-1044)
Appendix I: Proportion of the Population Above and Below 40 nmol/L Serum 25-Hydroxyvitamin D Concentrations and Cumulative Distribution of Serum 25-Hydroxyvitamin D Concentrations: United States and Canada (1045-1058)
Appendix J: Workshop Agenda and Open Session Agendas (1059-1064)
Appendix K: Biographical Sketches of Committee Members (1065-1074)
Index (1075-1102)
Summary Tables: Dietary Reference Intakes (1103-1116)