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Vitamin D: Can an Upper Limit be Defined?¹

Department of Pediatrics, College of Medicine, Le Bonheur Children's Medical Center, The University of Tennessee, Memphis, TN 38102

Vitamin D ingested in excess results in hypercalcemia, which is caused by excessive absorption of massive quantities of calcium by the intestine and enhanced bone resorption. The symptoms of this intoxication include feeding difficulties, polydypsia, polyuria, irritability, lassitude and poor weight gain. Because daily intakes of 400 KI (10 µg) of vitamin D₂ or D₃ are completely safe, and because as low as 100 KI (2.5 µg) daily may prevent rickets, it is difficult to justify recent studies that attempt to firmly establish an upper limit of daily vitamin D intake in the normal neonate. Thus, despite efforts to better understand the upper limits of daily vitamin D intake, a concentration of 100 KI (2.5 µg) of vitamin D per 100 kcal ingested, as is currently recommended by the Committee on Nutrition of the American Academy of Pediatrics, seems entirely appropriate.

KEY WORDS: • vitamin D • 25-hydroxyvitamin D • 1,25-dihydroxyvitamin D • hypercalcemia • hypercalciuria • Williams syndrome • hypervitaminosis D

¹ This paper was presented at a symposium, "Upper Limits of Nutrients in Infant Formulas," November 7–8, 1988, in Iowa City, IA.