What is the treatment for vitamin D deficiency with a vitamin D level of 15 ng/mL?

From the Guidelines

To treat a vitamin D deficiency with a level of 15 ng/mL, a common regimen 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. This approach is based on the recommendation that 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 1. Some key points to consider when treating vitamin D deficiency include:

• The two forms of vitamin D available in supplements are 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 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.
• Current expert opinion on supplementation for adults older than age 50 is 1200 mg of calcium (from all sources) and 800 to 1000 IU of vitamin D daily, which is also recommended for younger patients at risk for cancer treatment–associated bone loss 1. It is essential to recheck vitamin D levels after the initial treatment phase to ensure they have increased to the optimal range (30-50 ng/mL) and adjust the maintenance dose accordingly. Additionally, incorporating vitamin D-rich foods into the diet and having regular, brief sun exposure can help maintain optimal vitamin D levels. It's crucial to take vitamin D supplements with meals containing some fat to improve absorption. A level of 15 ng/mL indicates a moderate deficiency that requires treatment to prevent complications like bone loss, muscle weakness, and potential immune system effects.

From the Research

Treatment of Vitamin D Deficiency

To treat vitamin D deficiency with a level of 15 ng/ml, the following steps can be taken:

• Vitamin D supplements can be used to improve musculoskeletal health, with doses of 800-5000 IU/day recommended 2
• A cumulative dose of at least 600,000 IU administered over several weeks may be necessary to replenish vitamin D stores 2
• Single large doses of 300,000-500,000 IU should be avoided 2

Choosing the Right Vitamin D Supplement

When choosing a vitamin D supplement, consider the following:

• Vitamin D3 (colecalciferol) may be more effective than vitamin D2 (ergocalciferol) in increasing total and free 25-hydroxyvitamin D levels 3
• Prescription formulations are more strictly regulated and tend to have more accurate label claims than non-registered dietary supplements 4

Monitoring Vitamin D Levels

It is essential to monitor vitamin D levels to ensure optimal treatment:

• The adequacy of vitamin D stores is determined by measuring 25-hydroxyvitamin D serum concentrations 2
• Optimal values range from 30-80 ng/ml, with levels below 20 ng/ml considered deficient 2, 5