From the Guidelines
For a vitamin D level of 10 ng/mL, the recommended treatment is typically 50,000 IU of vitamin D2 or D3 once weekly for 8 weeks, followed by a recheck of the serum 25(OH) D level, with subsequent dosing based on the results. This approach is based on the guidelines from the NCCN task force report on bone health in cancer care 1. The goal of treatment is to bring serum 25(OH) D levels to 30 ng/ml (75 nmol/L) or higher, which is considered ideal for bone health.
- Key considerations for vitamin D supplementation include:
- The form of vitamin D, 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
- The potential for vitamin D toxicity, which 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
- The importance of monitoring serum 25(OH) D levels after initiating treatment to adjust the dosing regimen as needed
- It is also important to note that many patients may need more than the recommended amount of vitamin D and should be repleted based on serum 25(OH) D level, as stated by the NCCN Bone Health in Cancer Care Task Force 1.
From the Research
Vitamin D Dosing for Levels of 10
- The ideal dosing for vitamin D when levels are at 10 is not directly stated in the provided studies, but we can look at the dosing used in the studies to correct vitamin D deficiency/insufficiency.
- In the study 2, patients with a mean serum 25(OH)D level of 15.2 ng/mL were given oral vitamin D2 72,000 IU/week for 12 weeks, followed by 24,000 IU/week as maintenance therapy.
- The study 2 showed that this regimen was safe and sufficient to obtain and maintain optimal serum 25(OH)D concentrations.
- Another study 3 investigated the safety of monthly high-dose vitamin D supplementation and found that monthly 100,000 IU vitamin D3 supplementation over several years did not increase kidney stone risk or serum calcium.
- However, it's essential to note that the dosing may vary depending on individual factors, such as the presence of kidney disease or other health conditions, and should be determined by a healthcare professional.
- The studies 4 and 5 provide additional information on the effects of vitamin D supplementation, but do not directly address the ideal dosing for a level of 10.
- The study 4 found that long-term vitamin D supplementation resulted in increased risks of hypercalcemia and hypercalciuria, which were not dose-related.
- The study 5 compared the effects of 1,25-dihydroxy-vitamin D3 and 19-Nor-1,25-dihydroxy-vitamin D2 on serum calcium and phosphorus in hemodialysis patients, and found that 19-Nor caused less hypercalcemia and elevated calcium x phosphorus product.