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Response to: Towards an adequate intake of vitamin D. An advisory report of the Health Council of the Netherlands

European Journal of Clinical Nutrition volume 64, page 655 (2010)Cite this article

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Weggemans et al. (2009), on behalf of the Dutch Health Council, reported on their recent advice on the preferable vitamin D status. They conclude that ⩾30 nmol/l 25-hydroxyvitamin D (25(OH)D) is adequate for women aged ⩽50 and men aged ⩽70 years, while >50 nmol/l is adequate at a higher age. The 75–80 nmol/l 25(OH)D limit of adequacy (Heaney et al., 2003) is not advised, because ‘Achieving such levels requires a vitamin D intake that has not been extensively studied and may exceed the tolerable upper intake level of 50 μg/day as defined by the European Food Safety Authority’. The risks are elevated calcium levels in blood and urine, and the formation of kidney stones. Interestingly, however, this 75–80 nmol/l cut-off value is increasingly suggested in papers on vitamin D in nutritional journals, which illustrates the growing gap between the opinions of prominent vitamin D experts and health authorities.

The discrepancy between the 75–80 nmol/l 25(OH)D adequacy level and the 50 μg vitamin D upper tolerable level should rather prompt the authors to question the upper tolerable level than the 75–80 nmol/l cut-off, as 50 μg vitamin D/day will cause 25(OH)D to increase by no more than about 35 nmol/l. The European Scientific Committee on Food has set the ‘no observed adverse effect level’ at 100 μg vitamin D/day, while specialists (Hathcock et al., 2007) advocate a ‘no observed adverse effect level’ and an upper tolerable level of 250 μg/day (10 000 IU). The European Scientific Committee on Food set the ‘no observed adverse effect level’ of the status at 200 nmol/l 25(OH)D and also noted that no hypercalcemia and hypercalciuria occur at the upper reference value of 150 nmol/l. Subjects enjoying abundant sunshine have 100–200 nmol/l 25(OH)D levels without signs of toxicity. Finally, a systematic study indicated that vitamin D toxicity with convincing hypercalcemia occurs at 25(OH)D levels well above 200 nmol/l, most probably from around 375 nmol/l.

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Authors and Affiliations

  1. Department of Laboratory Medicine, University Medical Center, Groningen, The Netherlands

    F A J Muskiet & E van der Veer

  2. Ortho Institute, Gendringen, The Netherlands

    G E Schuitemaker

  3. Department of Clinical Chemistry, Meander Medical Center, Amersfoort, The Netherlands

    J P M Wielders

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  1. F A J Muskiet
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  2. E van der Veer
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  4. J P M Wielders
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Correspondence to F A J Muskiet.

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Competing interests

FAJM, EvdV and JPMW declare no conflict of interest. GES is indirectly involved in a company that sells supplements, but vitamin D is not part of the company activities.

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Muskiet, F., van der Veer, E., Schuitemaker, G. et al. Response to: Towards an adequate intake of vitamin D. An advisory report of the Health Council of the Netherlands. Eur J Clin Nutr 64, 655 (2010). https://doi.org/10.1038/ejcn.2010.48

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