From the Guidelines
A vitamin D level of 20 ng/mL is considered insufficient, and taking 50,000 IU of vitamin D weekly is an appropriate treatment regimen to correct this deficiency, as recommended by the NCCN task force report 1. This high-dose therapy is typically prescribed for 8 weeks, after which you should have your levels rechecked. Once your vitamin D reaches a normal range (generally 30-50 ng/mL), you'll likely switch to a lower maintenance dose of 1,000-2,000 IU daily. During treatment, take the vitamin D with food containing some fat to improve absorption. This high-dose regimen works quickly to replenish your body's vitamin D stores, which is important because vitamin D is essential for calcium absorption, bone health, immune function, and other bodily processes. Some people may experience mild side effects like nausea or headache. If you have certain conditions like kidney stones, sarcoidosis, or take medications that affect calcium levels, consult your healthcare provider before starting this regimen. It's also important to note that vitamin D toxicity is uncommon but may occur with daily doses of more than 50,000 IU per day that produce 25(OH)D levels larger than 150 ng/mL, as stated in the NCCN task force report 1. Additionally, a serum vitamin D level of 20 ng per mL (50 nmol per L) is recommended for good bone health, according to the American College of Obstetricians and Gynecologists 1. However, the most recent and highest quality study on this topic is not available, but based on the available evidence, taking 50,000 IU of vitamin D weekly for 8 weeks is a reasonable approach to correct vitamin D deficiency. Key points to consider:
- Vitamin D is essential for calcium absorption, bone health, immune function, and other bodily processes
- A vitamin D level of 20 ng/mL is considered insufficient
- Taking 50,000 IU of vitamin D weekly for 8 weeks is an appropriate treatment regimen to correct this deficiency
- Maintenance dose of 1,000-2,000 IU daily after correction of deficiency
- Potential side effects like nausea or headache
- Importance of consulting a healthcare provider before starting this regimen, especially if you have certain conditions or take medications that affect calcium levels.
From the Research
Vitamin D Supplementation
- The use of vitamin D supplements has increased substantially over the last decade, with epidemiologic evidence linking vitamin D deficiency to various illnesses, including autoimmune disease, cancer, and cardiovascular disease 2.
- The adequacy of vitamin D stores is determined by measuring 25-hydroxyvitamin D serum concentrations, with demarcations between deficiency (< 20 ng/ml), insufficiency (20-30 ng/ml), and optimal (30-80 ng/ml) serum concentrations being controversial 2.
Dosage and Administration
- Vitamin D in doses of 800-5000 IU/day can improve musculoskeletal health, such as reducing the rate of fractures and falls in older adults 2.
- A cumulative dose of at least 600,000 IU administered over several weeks appears to be necessary to replenish vitamin D stores in patients with documented vitamin D deficiency 2.
- Single large doses of 300,000-500,000 IU should be avoided, and vitamin D supplementation should not be offered routinely to other patient populations 2.
Safety and Efficacy
- Long-term vitamin D supplementation can result in increased risks of hypercalcemia and hypercalciuria, but does not increase the risk of kidney stones 3.
- A daily vitamin D supplementation with 2000 IU (50 µg) may be considered a simple, effective, and safe dosage to prevent and treat vitamin D deficiency in the adult general population 4.
- Vitamin D plays a crucial role in kidney function and metabolism, and its deficiency can lead to kidney dysfunction and further renal disorder 5.
Treatment of Vitamin D Deficiency
- A 25(OH)D level of >50 nmol/L or 20 ng/ml is the primary treatment goal for vitamin D deficiency, although some data suggest a benefit for a higher threshold 6.
- Severe vitamin D deficiency with a 25(OH)D concentration below <30 nmol/L (or 12 ng/ml) dramatically increases the risk of excess mortality, infections, and many other diseases, and should be avoided whenever possible 6.
- For a vitamin D level of 20 ng/ml, a weekly dose of 50,000 units may be necessary to replenish vitamin D stores, but this should be done under medical supervision to avoid adverse effects such as hypercalcemia and hypercalciuria 2, 3.