What are the recommendations for a patient with vitamin D (Vit D) deficiency, specifically a level of 13 nanograms per milliliter (ng/mL)?

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From the Guidelines

You should take vitamin D supplements to raise your levels, as 13 ng/mL indicates vitamin D deficiency, with a goal to achieve a level of 30 ng/mL or higher for optimal bone health. According to the NCCN task force report 1, vitamin D should ideally be supplemented in amounts sufficient to bring serum 25(OH) D levels to 30 ng/ml (75 nmol/L) or higher. A common regimen for patients with serum 25(OH) D levels below 30 ng/mL is prescription vitamin D (ergocalciferol) 50,000 IU weekly for 8 weeks, followed by a recheck of the serum 25(OH) D level, with subsequent dosing based on the results 1. Some key points to consider when taking vitamin D supplements include:

  • Taking supplements with a meal containing some fat to improve absorption
  • Including vitamin D-rich foods in your diet such as fatty fish, fortified dairy products, and eggs
  • Trying to get 15-30 minutes of sunlight exposure several times per week
  • Retesting your vitamin D levels after 3 months of supplementation to ensure they're improving toward the target range of 30-50 ng/mL 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 1.

From the Research

Vitamin D Levels and Supplementation

Your vitamin D level is 13 ng/mL, which is considered low. According to the study 2, a minimum 25(OH)D level of 32 ng/mL is necessary for optimal protection from fracture and intestinal absorption of calcium.

Increasing Vitamin D Levels

To increase your vitamin D levels, you may consider supplementation. The study 3 suggests that increasing the recommended daily allowance of vitamin D to 800 to 1,000 IU per day may be beneficial for most age groups. However, the study 4 found that vitamin D3 increased total and free 25D levels to a greater extent than vitamin D2.

Comparison of Vitamin D2 and D3

The studies 4 and 5 compared the effects of vitamin D2 and D3 supplementation. The results showed that vitamin D3 is more effective in increasing total 25D levels than vitamin D2. Additionally, vitamin D2 supplementation was associated with a decrease in 25(OH)D3 levels 5.

Calcium and Vitamin D Supplementation

The study 6 found that daily supplementation with both vitamin D and calcium was associated with a reduced risk of fracture. The recommended daily doses of vitamin D and calcium were 400-800 IU and 1000-1200 mg, respectively.

Key Points to Consider

  • Your vitamin D level is low, and supplementation may be necessary.
  • Vitamin D3 may be more effective than vitamin D2 in increasing total 25D levels.
  • Calcium and vitamin D supplementation may be associated with a reduced risk of fracture.
  • The recommended daily doses of vitamin D and calcium are 400-800 IU and 1000-1200 mg, respectively.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Calcium and vitamin D: skeletal and extraskeletal health.

Current rheumatology reports, 2008

Research

Vitamin D: a rapid review.

Urologic nursing, 2008

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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