Vitamin D Toxicity: A 16-Year Retrospective Study at an Academic Medical Center

John P. Lee, DO; Michael Tansey, MD; Jennifer G. Jetton, MD; Matthew D. Krasowski, MD, PhD


Lab Med. 2018;49(2):123-129. 

In This Article


We report that symptomatic vitamin D toxicity is quite rare. We investigated a large cohort of patients with vitamin D levels characterized as elevated by current guidelines; however, most of these patients did not show untoward effects from the elevated levels. Further, we did not observe a strong correlation between elevated 25(OH)D levels and elevated total calcium levels. Irrespective of what constitutes vitamin D toxicity, we observed that certain formulations were common in patients with high 25(OH)D levels, including high-concentration doses (eg, 50,000 IU) and liquid preparations. We advocate for standardized droppers for pediatric vitamin D supplementation. Further study is required regarding vitamin D supplementation guidelines and vitamin D toxicity definitions.