From the Guidelines
You should start vitamin D supplementation immediately with 50,000 IU of vitamin D2 or D3 once weekly for 8 weeks, followed by maintenance therapy of 1,000-2,000 IU daily, as your vitamin D level of 13 ng/mL indicates deficiency. According to the NCCN task force report 1, for bone health, 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. Some key points to consider when supplementing with vitamin D include:
- Vitamin D is available in 2 forms: D2 (ergocalciferol) and D3 (cholecalciferol), with vitamin D3 potentially being more effective in raising 25(OH) D concentrations and maintaining those levels for a longer time when longer dosing intervals are employed 1.
- Vitamin D toxicity (hypercalcemia, hyperphosphatemia, and activation of bone resorption) 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.
- In addition to supplementation, increasing sun exposure (15-30 minutes several times weekly) and consuming vitamin D-rich foods like fatty fish, egg yolks, and fortified dairy products can help improve vitamin D levels.
- It is essential to recheck vitamin D levels after completing the initial treatment to ensure they've improved to at least 30 ng/mL, which is considered optimal 1.
From the Research
Vitamin D Levels and Supplementation
Your vitamin D level is 13 ng/mL, which is considered deficient according to the study 2.
Deficiency and Insufficiency
- Deficiency is defined as a serum concentration of less than 20 ng/mL
- Insufficiency is defined as a serum concentration between 20-30 ng/mL
- Optimal serum concentrations are between 30-80 ng/mL
Supplementation
The study 2 suggests that vitamin D supplementation can improve musculoskeletal health, and a cumulative dose of at least 600,000 IU administered over several weeks may be necessary to replenish vitamin D stores.
Comparison of Vitamin D2 and D3
Studies 3, 4, 5, and 6 compared the efficacy of vitamin D2 and D3 in improving vitamin D status.
- The study 3 found that vitamin D3 increased total and free 25D levels to a greater extent than vitamin D2.
- The study 5 suggested that cholecalciferol (vitamin D3) is more effective than ergocalciferol (vitamin D2) in improving total 25(OH)D and reducing PTH levels.
- The study 6 found that vitamin D3 was more effective than vitamin D2 in increasing serum 25(OH)D in healthy South Asian and white European women.
Recommendations
Based on the studies, it is recommended to use vitamin D3 for supplementation, as it appears to be more effective in improving vitamin D status. However, the optimal dosage and duration of supplementation are not specified in the provided studies. It is essential to consult with a healthcare professional to determine the best course of treatment for your specific situation.