From the Guidelines
Adolescents should receive 400-600 IU of vitamin D daily, as recommended by the ESPGHAN Committee on Nutrition and the American Academy of Pediatrics 1. The main function of vitamin D is the regulation of calcium and phosphate, essential for bone health, and adolescents need adequate vitamin D for bone development and overall health during this critical growth period. According to the study, a daily dose of 400-600 IU is recommended for children and adolescents, and a serum 25(OH) vitamin D concentration > 50 nmol/L indicates sufficiency 1. Key points to consider:
- The optimum vitamin D requirements are not fully established, but current recommendations suggest a daily intake of 400-600 IU for adolescents 1.
- Prolonged daily intake up to 10,000 IU or up to serum concentrations of 25(OH)D of 240 nmol/L appears to be safe, but serum concentrations >375 nmol/L are associated with acute hypercalcaemia and hyperphosphataemia 1.
- Tolerable upper intake levels identified by the IOM are 4000 IU/day for children and adolescents ages 9-18 years 1. It is essential to monitor vitamin D levels, especially in adolescents with risk factors like limited sun exposure, darker skin tones, or certain medical conditions, and to avoid excessive vitamin D supplementation to prevent toxicity 1.
From the FDA Drug Label
Vitamin D3 50,000 IU is essential for absorption of calcium and necessary for healthy bones and a healthy immune system. WARNINGS: ... Not recommended for children, pregnant or lactating women, or individuals with liver disease, and those taking thiazide diuretics may be at greater risk of toxicity. DIRECTIONS: Take 0ne (1) capsule each week, or as directed by your physician.
The recommended dosing for adolescents is not explicitly stated in the label. Adolescent dosing is not directly addressed, and the label only states that the product is not recommended for children. Therefore, no conclusion can be drawn about the appropriate dosing for adolescents. 2
From the Research
Adolescent Vitamin D Dosing
- The optimal vitamin D dosage for adolescents is a topic of ongoing debate, with various studies suggesting different recommendations 3, 4, 5, 6.
- A systematic review of available recommendations found that most documents targeted the general population, rather than specifically adolescents, and that there is a lack of consensus on the optimal concentration of serum 25-hydroxyvitamin D to aim for, with levels varying between 25 nmol/L and 150 nmol/L 3.
- The recommended daily preventive doses of vitamin D vary between 400 IU and 4,000 IU, depending on factors such as season, skin pigmentation, sun exposure, consumption of vitamin D-fortified foods, body mass index, and coexistence of certain medical conditions 3.
- A pilot randomized controlled trial found that both 50,000 IU monthly and 150,000 IU 3-monthly of vitamin D3 safely and effectively correct vitamin D deficiency in adolescents 5.
- Another study suggested that vitamin D intakes of between 10 and 30 µg/d may be required to avoid deficiency and ensure adequacy in adolescents, which is greater than the current recommendations of 10-15 µg/d 6.
- The type of vitamin D supplement used may also be important, with cholecalciferol (D₃) and ergocalciferol (D₂) being two common forms, although the study on this topic was focused on older adults rather than adolescents 7.