From the Guidelines
For adults with vitamin D deficiency, the recommended treatment dose is typically 50,000 IU of vitamin D once a week for 8 weeks, followed by maintenance therapy of 1500–2000 IU daily, as recommended by the Endocrine Society clinical practice guidelines 1.
Treatment Regimen
The treatment regimen for vitamin D deficiency in adults involves an initial high-dose phase, followed by a maintenance phase.
- The initial phase consists of 50,000 IU of vitamin D once a week for 8 weeks, which effectively and rapidly corrects deficiency.
- After the initial phase, patients should transition to a daily maintenance dose of 1500–2000 IU of vitamin D, which should be continued indefinitely to prevent recurrence of deficiency.
Important Considerations
- Vitamin D is fat-soluble, so it's best absorbed when taken with a meal containing some fat.
- Blood levels should be rechecked after 8-12 weeks of treatment to ensure adequate repletion and prevent potential toxicity.
- The maintenance dose may need to be adjusted based on individual patient needs and serum vitamin D levels, as some patients may require higher or lower doses to maintain optimal levels 1.
Rationale
The recommended treatment regimen is based on the most recent and highest quality evidence, which suggests that this approach is effective in correcting vitamin D deficiency and maintaining optimal levels over time 1.
- The use of high-dose vitamin D in the initial phase allows for rapid correction of deficiency, while the maintenance phase helps to prevent recurrence and maintain optimal levels.
- The Endocrine Society clinical practice guidelines provide a framework for treating vitamin D deficiency in adults, and their recommendations are based on a thorough review of the available evidence 1.
From the FDA Drug Label
Directions As a dietary supplement for adults, take two (2) drops orally once daily, or as directed by a healthcare provider. The recommended dose of Vitamin D for treating deficiency in adults is two (2) drops orally once daily, as per the drug label instructions, however it is also stated or as directed by a healthcare provider. 2
- The dose may vary based on the healthcare provider's direction.
- The label does not provide a specific dose for treating deficiency, only for use as a dietary supplement.
From the Research
Recommended Dose of Vitamin D for Treating Deficiency in Adults
The recommended dose of Vitamin D for treating deficiency in adults varies depending on the severity of the deficiency and individual factors.
- According to 3, treatment may include oral ergocalciferol (vitamin D2) at 50,000 IU per week for eight weeks, followed by maintenance dosages of cholecalciferol (vitamin D3) at 800 to 1,000 IU per day.
- 4 suggests that the required dose may be calculated from predictive equations, with an average daily dose of 4707 IU/day resulting in an increase in serum 25-hydroxyvitamin D level.
- 5 recommends a cumulative dose of at least 600,000 IU administered over several weeks to replenish vitamin D stores in patients with documented deficiency.
- 6 argues for a daily dose of 2000 IU (50 µg) of vitamin D3 to prevent and treat vitamin D deficiency in the general adult population.
- 7 reports on the safety of daily oral dosing of vitamin D3 using 5000 to 50,000 IU per day in long-term hospitalized patients, with no cases of vitamin D3-induced hypercalcemia or adverse events.
Factors Affecting Vitamin D Dosage
Several factors can affect the required dosage of vitamin D, including:
- Starting serum concentration of 25-hydroxyvitamin D 4
- Body mass index (BMI) 4
- Age 4
- Serum albumin concentration 4
- Individual response to vitamin D supplementation 4, 5
Safety and Efficacy
The safety and efficacy of vitamin D supplementation have been extensively studied, with most research suggesting that doses up to 2000 IU/day are safe and effective for preventing and treating vitamin D deficiency 3, 4, 5, 6, 7. However, higher doses may be required to correct severe deficiency or maintain optimal levels in certain individuals 4, 5, 7.