Is there a danger in supplementing vitamin D in the setting of sarcoidosis?

The Bottom Line: In this first published RCT of vitamin D supplementation in sarcoidosis, it was found that patients with sarcoidosis and 25OHD <50 nmol/L, vitamin D supplements did not alter average serum calcium or urine calcium, but had no benefit on surrogate markers of skeletal health and caused one case of significant hypercalcaemia.

Bolland MJ, Wilsher MLGrey AHorne AMFenwick SGamble GDReid IR.  Randomised controlled trial of vitamin D supplementation in sarcoidosis.  BMJ Open. 2013 Oct 23;3(10):e003562.

Setting: Clinical research centre.
Participants: 27 normocalcaemic patients with sarcoidosis and 25-hydroxyvitamin D (25OHD) <50 nmol/L.
Intervention: 50 000 IU weekly cholecalciferol for 4 weeks, then 50 000 IU monthly for 11 months or placebo.

Strengths and limitations: The study had limited power to detect small differences in bone density and bone turnover markers.  Few participants had 25-hydroxyvitamin levels <25 nmol/L, and therefore the findings may not apply to individuals with very low vitamin D levels.

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