Treatment For Vitamin D Deficiency

Understanding the importance of vitamin D for health at any age is crucial. Since low levels of vitamin D are common, it is important to know how to treat it. We will discuss various ways to improve health through sunlight exposure, proper nutrition, and the use of vitamin D supplements as part of the treatment for vitamin D deficiency. Additionally, we will explore how individual characteristics can influence the success of achieving healthy vitamin D levels, as well as determine safe dosages for its maintenance.

This article was last reviewed by Svetlana Baloban, Healsens, on October 24, 2020. This article was last modified on 29 October 2020.

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It is also noted that the impact of ultraviolet radiation can suppress clinical symptoms of multiple sclerosis independently of vitamin D synthesis ⁵. Sunlight is also beneficial for maintaining healthy erectile function. However, it is worth remembering that UV radiation remains a proven carcinogen. What to do in this situation? It is recommended to consider the option of “healthy sun exposure”, when you are in the sun during the safest times – before 10 in the morning and after 4 in the evening. It is important to remember that sunscreen with a sun protection factor of 30 can reduce vitamin D synthesis in the skin. Additionally, people with naturally dark skin have built-in sun protection and require at least three to five times longer exposure to produce the same amount of vitamin D⁶. Choose the safest times for sunbathing without sunscreen.

Food

Another way to increase the level of vitamin D in the body is through the consumption of food products. Very few foods naturally contain or are enriched with vitamin D. However, in combination with sunbathing, food products can also be beneficial. Pay attention to foods such as fatty fish (salmon, mackerel, tuna), egg yolks, cheese, liver, and vitamin D-fortified dairy products and cereals – they can become a good source of this vitamin.

In addition to sunbathing, in case of vitamin D deficiency (especially at critical levels when the level of 25(OH)D is less than 20 ng/ml), it is advisable to take vitamin D in the form of supplements. It is worth noting that the increase in the level of 25(OH)D when taking vitamin D supplements is highly individual. In the next chapter, we will delve into the issue of vitamin D dosages through supplements recommended at present.

Vitamin D Deficiency Treatment Using Supplements

Vitamin D deficiency is defined when the level of 25(OH)D is below 20 ng/mL. It is important to realize that unprotected sun exposure is the primary source of vitamin D for both children and adults. Vitamin D synthesized in the skin can remain in the blood at least twice as long as vitamin D obtained from external sources. However, if opportunities for sunbathing are unavailable, considering vitamin D supplementation becomes advisable. The amount of vitamin D needed to treat deficiency largely depends on the degree of deficiency and key risk factors. Let’s delve into clinical recommendations for treating vitamin D deficiency using supplements.

Research findings indicate a rate of increase in the level of 25(OH)D in serum of approximately 0.4 ng/mL/μg/day⁷. This means that intake of 100 IU/day of vitamin D increases the level of 25(OH)D in serum by less than 1 ng/mL. For instance, if your level of 25(OH)D in serum is 15 ng/mL, an additional daily intake of about 1500 IU of vitamin D2 or vitamin D3 is required to achieve and maintain a level of 30 ng/mL. However, to achieve a similar increase in the level of 25(OH)D in serum among individuals with obesity, two to three times more vitamin D is required.

Vitamin D can be taken on an empty stomach or with meals, and dietary fats are not required. Taken three times a year, weekly, or daily, vitamin D can be effective in maintaining the level of 25(OH)D in serum for both children and adults.

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How much vitamin D should I take if I’m deficient?

So, the amount of vitamin D needed to treat a deficiency depends largely on the degree of the deficiency and the underlying risk factors.

Initial supplementation with Vitamin D3 for 8 weeks, either 6,000 IU daily or 50,000 IU weekly, can be considered⁸⁹. When the vitamin level exceeds 30 ng/ml, the daily maintenance dose will be 1500 to 2000 IU.

If after 8 weeks your level of 25(OH)D in the blood has not increased, it is recommended to undergo testing for celiac disease or hidden cystic fibrosis.

Higher-risk adults may require higher starting doses of vitamin D3. These people include African Americans, Hispanics, people with obesity, chronic illness, and taking certain medications. Typically, your doctor may prescribe 10,000 IU of vitamin per day. For such people, maintenance doses can range from 3000 to 6000 IU / day. So if you are at risk, it is better to discuss the treatment with your doctor. This is due to the fact that for some diseases, an individual approach to the dosage of vitamin D is required.

It is recommended that both D2 and D3 be taken with a diet containing fat to ensure maximum absorption.

Don’t be surprised if it will take you half a year or more to achieve the optimum levels of this vitamin. Furthermore, when the desired level of vitamin D is achieved, to sustain it you will need to take 1000-2000 ME a day and regularly control its level to prevent its overaccumulation in your body. Vitamin D3 (cholecalciferol) is considered to be more effective than vitamin D2 (ergocalciferol), although some recent studies have proven them equally effective.  

The dosage of vitamin D to correct severe vitamin D deficiency (<10 ng/mL)

Although not validated by clinical trials, a commonly applied strategy is to prescribe a “loading dose”. For example, 50,000 IU of vitamin D orally once weekly for 2-3 months, or 3 times weekly for 1 month¹⁰.

On the other hand, treatment regimen studies have shown that a minimum total dose of 600,000 IU was most effective in achieving vitamin D sufficiency¹¹.

The study examined the following common treatment regimens, namely:

• 50,000 IU of D2 once weekly for 4 weeks followed by 50,000 IU once monthly for 5 months;
• D2 50,000 IU once monthly for 6 months;
• D2 50,000 IU 3 times weekly for 6 weeks.

Regimens where vitamin D2 intake> 600,000 IU administered over an average of 60 +/- 40 days provided the best option without vitamin D toxicity.

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Maintenance Dose of Vitamin D

It is recommended to maintain the concentration of 25(OH)D in the range of 30 to 60 ng/mL.

For all adults aged 19-50 years, at least 600 IU of vitamin D per day is required for maximal improvement in bone and muscle health. For sustained elevation of 25(OH)D levels in the blood above 30 ng/mL, at least 1500-2000 IU/day of vitamin D may be needed.

For all adults aged 50-70 and 70+ years, at least 600 and 800 IU/day of vitamin D, respectively, is required for maximal bone and muscle health. For sustained elevation of 25(OH)D levels in the blood above 30 ng/mL, at least 1500-2000 IU/day of vitamin D may be needed.

Pregnant and lactating women require at least 600 IU/day of vitamin D, and at least 1500-2000 IU/day of vitamin D may be necessary to maintain 25(OH)D levels in the blood above 30 ng/mL.

The tolerable upper intake level of vitamin D, which should not be exceeded without medical supervision, is 4000 IU/day for children aged 1-18 years and 10,000 IU/day for adults aged 19 years and older. This is due to the toxicity of this vitamin when accumulated in adipose tissue.

Currently, there is no evidence that values of 61-100 ng/mL confer health benefits.

Monitoring Vitamin D Levels

If you adhere to preventive or maintenance doses of vitamin D, it is recommended to test your vitamin D levels every 6-12 months. This is primarily due to concerns about potential declines below desired levels. Studies indicate that a dose of 2000 IU of vitamin D for maintenance may be insufficient.

By using the Healsens app, you can more effectively monitor the achievement of your target vitamin D levels. Healsens is focused not only on maintaining health and early detection of risks for chronic diseases but also provides a personalized health plan. You can discover natural methods to normalize your biomarkers, ensuring a healthier future without resembling an advertising pitch.

Ordering Blood Tests in the Netherlands

If you are interested in checking your vitamin D level, you can easily purchase a blood test kit from Healsens.

FURTHER READING

1. Recognition and Management of Vitamin D Deficiency
2. How I Treat Vitamin D Deficiency
3. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline
4. How I Treat Vitamin D Deficiency
5. Beneficial effects of UV radiation other than via vitamin D production
6. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline
7. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline
8. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline
9. Vitamin D Deficiency
10. Vitamin D Deficiency in Adults: When to Test and How to Treat
11. Evaluation of vitamin D repletion regimens to correct vitamin D status in adults