What is the dosing of Vitamin D for vitamin D deficiency?

From the Guidelines

For vitamin D deficiency, the recommended dosing is 50,000 IU of vitamin D once a week for 8 weeks, followed by maintenance therapy of 1500–2000 IU daily, as per the most recent guidelines 1.

Key Considerations

• The goal of treatment is to achieve a serum 25(OH)D level of 30 ng/mL (75 nmol/L) or higher, which is essential for bone health and overall well-being.
• Vitamin D3 (cholecalciferol) is considered more effective than vitamin D2 (ergocalciferol) in raising and maintaining 25(OH)D levels, especially when used in longer dosing intervals.
• Treatment duration and dosing may vary based on the severity of deficiency and individual patient needs, and blood levels should be rechecked after 3-4 months to adjust dosing as needed.

Important Details

• The Endocrine Society clinical practice guidelines provide current recommendations for vitamin D supplementation across age ranges and subpopulations, emphasizing the importance of individualized treatment plans.
• Vitamin D toxicity is rare but can occur with daily doses exceeding 50,000 IU, resulting in hypercalcemia, hyperphosphatemia, and activation of bone resorption.
• Patients with severe deficiency (blood levels below 20 ng/mL or 50 nmol/L) may require higher therapeutic doses, while those with mild deficiency may be treated with lower maintenance doses.

Clinical Application

• Healthcare providers should consider the patient's overall health status, dietary habits, and sun exposure when determining the optimal treatment plan for vitamin D deficiency.
• Regular monitoring of serum 25(OH)D levels is crucial to ensure effective treatment and prevent toxicity, as well as to adjust dosing as needed to maintain optimal levels.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION THE RANGE BETWEEN THERAPEUTIC AND TOXIC DOSES IS NARROW. Vitamin D Resistant Rickets: 12,000 to 500,000 IU units daily. Hypoparathyroidism: 50,000 to 200,000 IU units daily concomitantly with calcium lactate 4 g, six times per day.

The dosing of Vitamin D for vitamin D deficiency is not explicitly stated in the provided text. However, for related conditions:

• Vitamin D Resistant Rickets: 12,000 to 500,000 IU units daily
• Hypoparathyroidism: 50,000 to 200,000 IU units daily It is crucial to note that DOSAGE MUST BE INDIVIDUALIZED UNDER CLOSE MEDICAL SUPERVISION 2.

From the Research

Vitamin D Dosing for Deficiency

• The dosing of vitamin D for vitamin D deficiency can vary depending on the individual's risk factors and health status 3.
• Daily vitamin D supplementation using higher than normal dosing (up to the upper limit value) and intermittent (once or twice per week) dosing have been studied in patients with increased risk of vitamin D deficiency 3.
• The following dosages have been suggested for consideration:
  • 7000 IU daily
  • 30,000 IU per week or twice weekly
  • 50,000 IU weekly
• These dosages are recommended for adults with obesity, liver disease or malabsorption syndromes, or multi-diseased patients, mainly seniors requiring multi-drug treatment, including drugs affecting vitamin D metabolism 3.
• For the treatment of possible vitamin D deficiency without assessment of 25(OH)D in these groups, intermittent doses of 30,000 IU twice weekly or 50,000 IU per week should be considered for a 6-8-week period only 3.
• A loading dose regimen of 50,000 IU weekly for 4 weeks followed by a maintenance dose of 2000 IU/d has been shown to be effective in correcting vitamin D deficiency in patients undergoing total knee arthroplasty 4.
• Vitamin D3 (cholecalciferol) has been shown to be more effective than vitamin D2 (ergocalciferol) in increasing total and free 25-hydroxyvitamin D levels 5.