From the Guidelines
For vitamin D supplementation when levels are just below the normal range, I recommend taking 1,000 IU of vitamin D3 daily, as suggested by the NCCN Bone Health in Cancer Care Task Force 1. This dose can be adjusted based on the patient's serum 25(OH)D level, with a goal of achieving a level of 30 ng/mL or higher.
- The patient should start with this dose for three months, then recheck their levels to determine if the dose needs to be adjusted.
- Vitamin D3 (cholecalciferol) is preferred over vitamin D2 (ergocalciferol) as it's more effective at raising blood levels, especially when given in intermittent regimens 1.
- It's essential to take supplements with a meal containing some fat to improve absorption.
- Consider getting some sun exposure (10-30 minutes several times weekly) as natural vitamin D production occurs when skin is exposed to sunlight.
- Vitamin D is essential for calcium absorption, bone health, immune function, and may help prevent various chronic diseases.
- Most people don't get enough from diet alone, which is why supplementation is often necessary.
- If the patient has kidney disease, sarcoidosis, or takes medications that affect vitamin D metabolism, they should consult their healthcare provider before supplementing.
- The patient's diet should also be taken into account, as strict vegetarians may prefer supplementation with vitamin D2 (plant origin) instead of D3 (animal origin).
- Regular monitoring of serum 25(OH)D levels is crucial to ensure the patient is receiving the correct dose and to avoid toxicity, which can occur with daily doses of more than 50,000 IU per day 1.
From the FDA Drug Label
DIRECTIONS: Take 0ne (1) capsule each week, or as directed by your physician. Take with food. The recommended dosage for Vitamin D supplementation is one capsule (50,000 IU) per week, or as directed by a physician.
- Key considerations:
- Take with food
- Store in a cool, dry place, protected from light
- Follow the physician's directions for supplementation 2
From the Research
Vitamin D Supplementation Recommendations
When considering vitamin D supplementation for individuals with levels just below the recommended range, several factors come into play. The choice between different forms of vitamin D, such as cholecalciferol (D3) and calcifediol, is crucial for effective supplementation.
Forms of Vitamin D
- Cholecalciferol (D3) is a commonly used form of vitamin D for supplementation 3, 4, 5.
- Calcifediol has been shown to be more potent than cholecalciferol, with a more rapid increase in serum 25OHD levels and a higher rate of intestinal absorption 3.
- Ergocalciferol (D2) is less effective and may enhance the degradation of 25-hydroxyvitamin D3 (25[OH]D3) metabolite 4, 5.
Dosage Recommendations
- For individuals with increased risk of vitamin D deficiency, such as obese or multi-morbidity patients, daily doses of 7000 IU or intermittent doses of 30,000 IU/week may be considered 6.
- For the treatment of possible vitamin D deficiency without assessment of 25(OH)D, intermittent doses of 30,000 IU twice weekly or 50,000 IU per week may be considered for a 6-8-week period 6.
- Calcifediol may be a better option for oral supplementation due to its higher potency and more rapid increase in serum 25OHD levels 3.
Considerations
- The choice of vitamin D supplement should be based on the individual's specific needs and health status 7, 5.
- Monitoring of 25(OH)D levels is essential to ensure effective supplementation and prevent toxicity 6.
- The stability and potency of the supplement should also be considered, with cholecalciferol being more stable and potent than ergocalciferol 5.