What is the significance of a Vitamin D (25-Hydroxyvitamin D [25 OH-Vit D]) level of 32.75?

From the Guidelines

Your vitamin D level of 32.75 ng/mL is considered sufficient but at the lower end of the normal range, and to maintain optimal vitamin D levels, I recommend taking a daily vitamin D3 supplement of 1000-2000 IU. According to the study by 1, a target range of at least 30 to 40 ng/mL is recommended, and testing may be warranted after at least 3 months of supplementation. It's essential to note that response to treatment varies by environmental factors and starting levels of 25(OH)D.

Some key points to consider:

• Vitamin D is essential for calcium absorption, bone health, immune function, and may play a role in mood regulation 1.
• Your body produces vitamin D when exposed to sunlight, but factors like limited sun exposure, darker skin, obesity, and certain medications can reduce levels.
• Include vitamin D-rich foods in your diet such as fatty fish (salmon, mackerel), fortified dairy products, egg yolks, and mushrooms.
• Have your levels rechecked in 3-6 months to ensure your supplementation is effective.
• If you experience symptoms like bone pain, muscle weakness, or fatigue, consult your healthcare provider as these could indicate worsening deficiency.

It's also important to consider the recommendations for clinical practice, as outlined in the study by 1, which suggests that adult patients with or at risk for fractures, falls, cardiovascular or autoimmune diseases, and cancer may benefit from vitamin D supplementation. Additionally, the study by 1 recommends that patients with 25(OH)D levels between 20 and 30 ng/mL may benefit from adding 1000 IU of vitamin D2 or D3 per day to their current intake.

From the Research

Vitamin D Levels

• The provided vitamin D level is 32.75, which can be classified as follows:
  • According to 2, a level of < 20 ng/ml is considered deficient, 20-30 ng/ml is considered insufficient, and 30-80 ng/ml is considered optimal.
  • Based on this, a level of 32.75 falls within the insufficient range.
• Other studies have slightly different classifications:
  • 3 considers a level of < 50 nmol/L (or 20 ng/ml) as deficient, and a level of > 50 nmol/L as optimal.
  • 4 considers a level of < 30 nmol/L as severely deficient, and a level of > 50 nmol/L as optimal for bone health.

Health Effects of Vitamin D Supplementation

• According to 2, vitamin D supplementation can improve musculoskeletal health, reduce the rate of fractures and falls in older adults, and may have other benefits.
• However, 4 found that supplementation of vitamin D-replete individuals does not provide demonstrable health benefits, and that the causal link between vitamin D and many extra-skeletal outcomes remains unclear.
• 5 found that vitamin D3 decreased mortality in all trials analyzed together, but that other forms of vitamin D did not have a significant effect on mortality.

Supplementation Recommendations

• 2 recommends that vitamin D supplementation should not be offered routinely to other patient populations, except for those with documented vitamin D deficiency.
• 3 suggests that a worldwide public health intervention that includes vitamin D supplementation in certain risk groups, and systematic vitamin D food fortification to avoid severe vitamin D deficiency, would be important.
• 5 found that vitamin D3 seemed to decrease mortality in elderly people living independently or in institutional care, but that further placebo-controlled randomized trials are warranted due to risks of attrition bias and outcome reporting bias.