Vitamin D Deficiency

  • Author:
    Betty Kovacs, MS, RD

    Betty is a Registered Dietitian who earned her B.S. degree in Food and Nutrition from Marymount College of Fordham University and her M.S. degree in Clinical Nutrition from New York University. She is the Co-Director and Director of nutrition for the New York Obesity Research Center Weight Loss Program.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Quick GuideNutritional Health Pictures Slideshow: Amazing Vitamin D, Nutrition's Newest Star

Nutritional Health Pictures Slideshow: Amazing Vitamin D, Nutrition's Newest Star

What is the treatment for a vitamin D deficiency?

Vitamin D3 has been shown to be the best choice for supplements. Vitamin D2 supplements do not raise your levels the same amount as D3 and, in some cases, they have been shown to decrease levels over long-term use.

The amount of vitamin D that is needed to correct a deficiency will depend on the severity of the deficiency and your individual health risks. The time of year will also matter. For example, if you are on the low end of adequate blood levels and heading in to the winter months you would need a bit more than if you were heading in to the summer months. The goal for everyone is to get your stores to a safe level and prevent them from dropping with a maintenance plan.

What you take is as important as how you take it. Vitamin D supplements should be taken with a meal that contains fat. Studies have shown that when taken on an empty stomach versus with a meal containing fat, there was an average of 32% more vitamin D absorption in the fat-containing meal. This ranged from 11%-52%. Even an 11% reduction is significant and can impact your vitamin level. A recent study instructed people to take their supplement with their largest meal (typically the one with the most fat), and in three months, their blood levels went up an average of 56.7%.

There are supplements that can be taken on a daily, weekly, or monthly basis. It's a matter of preference and, most importantly, which one you will be more likely to take. You may start out at a higher dose and decrease after a month or two. Most experts feel that the goal is to get your level above 30-40 ng/mL, depending on your risk factors, and then take a maintenance amount. When you are deficient, it is recommended to have your blood tested after two to three months of taking the supplement to be sure that your levels are going up. Work with your doctors to find the optimal plan for you.

The task force for the Endocrine Society makes the following recommendations:

  • For children 1-18 years of age who are vitamin D deficient, we suggest treatment with 2,000 IU/d of vitamin D3 for at least six weeks or with 50,000 IU once a week for at least six weeks to achieve a blood level of 25(OH)D above 30 ng/ml, followed by maintenance therapy of 600-1,000 IU/day.
  • We suggest that all adults who are vitamin D deficient be treated with 50,000 IU of vitamin D3 once a week for eight weeks or its equivalent of 6,000 IU of vitamin D3 daily to achieve a blood level of 25(OH)D above 30 ng/ml, followed by maintenance therapy of 1,500-2,000 IU/day.
  • In obese patients, patients with malabsorption syndromes, and patients on medications affecting vitamin D metabolism, we suggest a higher dose (two to three times higher; at least 6,000-10,000 IU/day) of vitamin D to treat vitamin D deficiency to maintain a 25(OH)D level above 30 ng/ml, followed by maintenance therapy of 3,000-6,000IU/day. One study found that for every 33 lbs. of body weight the serum 25(OH)D level was 4 ng/ML lower at the end of one year of monitoring. This could lead to a significant change in the amount required to supplement based on your body weight and starting serum level.
  • African Americans: The population mean serum 25(OH)D level has been shown to be lower in African Americans than whites, but supplementation has been shown to be as effective in this population. A randomized, controlled vitamin D study was on a population of white and African-American women. Continue Reading
Reviewed on 6/9/2016
References
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