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Two of 6 studies that administered daily doses approximating the Institute of Medicine8217;s Tolerable Upper Intake Level (1000-4000 IU) to vitamin D-deficient populations achieved group 25(OH)D levels gt;30ngdl within 1 month. Nine of 10 studies evaluating loading therapy (gt;50 000 IU) achieved group 25(OH)D levels gt;30ngdlL. Adverse event analysis identified increased hypercalcemia risk with doses gt;400 000 IU, but no increased hypercalcemia or hypercalciuria with loading doses 300 000 IU. CONCLUSIONS: Rapid normalization of vitamin D levels is best achieved by using loading therapy that considers disease status, baseline 25(OH)D, and age (or weight). Loading doses gt;300 000 IU should be avoided until trials are conducted to better evaluate risk and benefit.

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