Author Affiliations: Department of Neurology, University of California, San Francisco.
We thank Hanwell and Kimball1 for their interest in our case report.2 Recently, the Institute of Medicine recommended that individuals aged 51 to 70 years (our patient's age bracket) have a daily intake level of 1200 mg of calcium and 600 IU of vitamin D.3 It also suggested tolerable daily upper intake levels of 2000 mg and 4000 IU for calcium and vitamin D, respectively.3
Marcus JF, Goodin DS, Harris CA, Josephson SA. Acute Hypercalcemia Following Excessive Calcium Supplementation in a Dehydrated Patient With Progressive Multiple Sclerosis: Vitamin D Supplementation Is a Red Herring—Reply. Arch Neurol. 2012;69(6):793–794. doi:10.1001/archneurol.2012.203