Something missing is how fast did the patient ramp up to that dosage. If you start at a very high dosage, you will mobilize all the stored calcium in the gut and vascular system. It has to go somewhere. As some who is currently at 52k UI's per day, I can say that if I started at that level I would have damaged myself in many ways, not just kidneys. I started at 2k per fatty meal/snack and worked my way up over a few years. The purpose has been to de-calcify my vascular system and gut. I can actually tell when I am near the limit as it induces pain. I back down a few thousand IU's for a couple weeks, then keep working back up. When I first started, I could not exceed 4k per meal without getting blurry vision. Now that happens around 54-56k. I probably will not go much higher. I do not suggest doing this unless you have a good reason to do so. If you must do this, then be sure to include K2 MK-7 and magnesium for each dosage to bind and transport some of the calcium to the bone. I am not a doctor and this is not medical advise, not to mention, only a small percentage of functional medicine doctors use this method of de-calcification. My BP has dropped over 20 points, so I am making some progress. For people just wanting enough 25-hydroxy to fuel their immune system, 2x the RDA is probably fine assuming normal renal health. BTW, measuring 25-hydroxy has little value unless you know your kidney health, as that is the not the final stage of the hormone.
