What is the equivalent of 46.4 nmol/L (nanomoles per liter) in ng/mL (nanograms per milliliter) for Vitamin D3 (Cholecalciferol)?

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Vitamin D3 Conversion: 46.4 nmol/L to ng/mL

46.4 nmol/L equals 18.6 ng/mL 1

Conversion Formula

  • The standard conversion for 25-hydroxyvitamin D [25(OH)D] is: 1 nmol/L = 0.4 ng/mL 1
  • Therefore: 46.4 nmol/L × 0.4 = 18.6 ng/mL
  • The reverse conversion is: 1 ng/mL = 2.5 nmol/L 1

Clinical Interpretation of This Level

This level (18.6 ng/mL) represents vitamin D deficiency requiring treatment 2, 3

  • Vitamin D deficiency is defined as serum 25(OH)D below 20 ng/mL 2
  • Your level of 18.6 ng/mL falls just below this threshold and requires active supplementation 2, 3
  • The target level for optimal health is at least 30 ng/mL for anti-fracture efficacy and musculoskeletal health 2, 3
  • Severe deficiency (below 10-12 ng/mL) dramatically increases risk for osteomalacia and rickets, but your level does not meet this threshold 1

Recommended Treatment Protocol

The standard loading regimen is 50,000 IU of vitamin D3 (cholecalciferol) once weekly for 8-12 weeks 2, 3

  • Cholecalciferol (D3) is strongly preferred over ergocalciferol (D2) because it maintains serum levels longer and has superior bioavailability 2, 4
  • After the loading phase, transition to maintenance therapy with 800-2,000 IU daily 2, 3
  • Ensure adequate calcium intake of 1,000-1,500 mg daily from diet plus supplements if needed 2, 3
  • Recheck 25(OH)D levels 3 months after starting treatment to confirm adequate response 2, 3

Important Considerations

  • Using the rule of thumb, an intake of 1,000 IU vitamin D daily increases serum 25(OH)D by approximately 10 ng/mL, though individual responses vary 2
  • To raise your level from 18.6 ng/mL to the target of 30 ng/mL requires an increase of approximately 11.4 ng/mL (or 28.5 nmol/L) 1
  • Daily doses up to 4,000 IU are generally safe for adults, with some evidence supporting up to 10,000 IU daily for several months without adverse effects 2, 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Vitamin D Insufficiency Treatment Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Vitamin D Insufficiency Treatment

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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