Vitamin D3 Supplementation for Plantar Fasciitis, Achilles Tendinosis, and Bursitis
Weekly vitamin D3 supplementation of 60,000 IU is not recommended for plantar fasciitis, Achilles tendinosis, or bursitis, as this exceeds safe dosing guidelines and there is no evidence supporting vitamin D specifically for these musculoskeletal conditions. 1
Appropriate Vitamin D Supplementation
The American College of Nutrition and American Heart Association recommend much lower doses of vitamin D:
- Adults (1-70 years): 600-800 IU daily 1
- Adults over 70 years: 800 IU daily 1
- Safe upper limit: 4,000 IU daily 1
A weekly dose of 60,000 IU equals approximately 8,571 IU per day, which exceeds the recommended safe upper limit by more than double.
Special Populations Requiring Higher Doses
Some populations may require higher doses, but still not as high as 60,000 IU weekly:
- Patients with obesity: 2-3 times higher doses (up to 7,000 IU daily) 1
- Patients with malabsorption syndromes: higher doses or weekly regimens 1
- Patients with liver disease: higher doses due to impaired hepatic 25-hydroxylation 1
Safety Considerations
While one study suggests that long-term supplementation with vitamin D3 in doses ranging from 5,000 to 50,000 IU/day appears to be safe in hospitalized patients 2, this contradicts established guidelines and was conducted in a controlled hospital environment with regular monitoring.
For vitamin D deficiency treatment:
- For levels 5-15 ng/mL: 50,000 IU weekly for 4-8 weeks, then maintenance 1
- After reaching target levels, maintenance doses should be reduced to guideline-recommended amounts
Evidence for Musculoskeletal Conditions
There is no evidence supporting vitamin D supplementation specifically for:
- Plantar fasciitis
- Achilles tendinosis
- Bursitis
The standard treatments for these conditions include:
Plantar Fasciitis
- Conservative measures: rest, ice, NSAIDs, stretching exercises, orthotics, night splints 3, 4
- Addressing biomechanical issues: controlling pronation, proper footwear 4
- More advanced treatments: steroid injections, extracorporeal shock wave therapy 5
Achilles Tendinosis and Bursitis
- Rest, ice, NSAIDs, physical therapy 5
- Addressing biomechanical issues and training errors 4
- Novel treatments may include injection therapy for recalcitrant cases 5
Monitoring Recommendations
If vitamin D supplementation is used (at appropriate doses):
- Check vitamin D levels after 3 months to ensure target level has been reached 1
- Monitor annually once stable 1
- Target serum 25(OH)D level: 30-80 ng/mL 1
- Monitor serum calcium and phosphorus with higher doses 1
Bottom Line
The proposed weekly dose of 60,000 IU vitamin D3 is excessive and not indicated for plantar fasciitis, Achilles tendinosis, or bursitis. Focus instead on evidence-based treatments for these specific conditions and consider appropriate vitamin D supplementation only if deficiency is documented.