From the Guidelines
Vitamin D deficiency treatment typically involves supplementation with vitamin D3 (cholecalciferol), with a recommended dose of 50,000 IU once weekly for 8 weeks, followed by a maintenance dose of 1,000-2,000 IU daily. For most adults with deficiency (levels below 20 ng/mL), this treatment approach is effective in normalizing vitamin D levels 1. Alternatively, daily supplementation with 5,000-6,000 IU for 8 weeks followed by maintenance therapy of 1,000-2,000 IU daily can be effective. Severe deficiencies may require higher doses or longer treatment periods.
Key Considerations
- Supplements should be taken with food containing some fat to enhance absorption, as vitamin D is fat-soluble.
- Regular blood tests every 3-6 months are important to monitor levels until they normalize (30-50 ng/mL).
- Beyond supplements, 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 maintain adequate levels.
- Vitamin D is crucial for calcium absorption, bone health, immune function, and numerous cellular processes throughout the body, which is why addressing deficiency promptly is important for overall health.
Treatment Options
- Oral vitamin D is most often used to treat vitamin D deficiency; other treatment options include increasing dietary vitamin D intake or UVB exposure.
- Commonly available forms of oral vitamin D include vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol).
- According to the Institute of Medicine, daily dietary vitamin D intake of 600 IU in adults aged 18 to 70 years and 800 IU in adults older than 70 years should be sufficient to meet the needs of 97.5% of the adult population 1.
Important Notes
- The lack of an accurate screening strategy to identify vitamin D deficiency, especially in important subpopulations (such as African Americans), is a critical gap in the evidence.
- Further research is needed to determine the cut point that defines vitamin D deficiency, the sensitivity and specificity of various assays using an internationally accepted reference standard, and whether total serum 25-(OH)D is the best measure of vitamin D deficiency in all populations.
From the FDA Drug Label
Vitamin D3 50,000 IU is essential for absorption of calcium and necessary for healthy bones and a healthy immune system. DIRECTIONS: Take 0ne (1) capsule each week, or as directed by your physician. The treatment for Vitamin D deficiency is to take Cholecalciferol (Vitamin D3) 50,000 IU once a week, or as directed by a physician, with food.
- Key points:
- Take with food
- Store in a cool, dry place, protected from light
- Follow the recommended dosage and do not exceed it 2
- Important consideration: Adequate dietary calcium is necessary for response to Vitamin D therapy 3
From the Research
Vitamin D Deficiency Treatment
- Vitamin D deficiency is a global health problem with high prevalence and negative consequences on musculoskeletal and extra-skeletal health 4.
- Cholecalciferol is the form of vitamin D of choice for exogenous supplementation, with calcifediol reserved for patients with liver failure or severe intestinal malabsorption syndromes 4.
- Cholecalciferol has more scientific evidence with positive results than calcifediol in musculoskeletal diseases and guarantees an exact dosage in IU of vitamin D 4.
Comparison of Cholecalciferol and Ergocalciferol
- Cholecalciferol may be superior to ergocalciferol in treating nutritional vitamin D deficiency in non-dialysis chronic kidney disease (CKD) 5.
- Cholecalciferol therapy yielded a greater change in total 25(OH)D than ergocalciferol from baseline to week 12 in non-dialysis-dependent patients with stage 3-5 CKD 6.
- Ergocalciferol is not stable with storage and is more susceptible to breakdown with cooking and baking than cholecalciferol 7.
Treatment Outcomes
- Cholecalciferol may achieve serum levels of 25(OH)D of 30-50 ng/mL, an interval considered optimal for maximum benefit at the lowest risk 4.
- Therapy with cholecalciferol is more effective at raising serum 25(OH)D in non-dialysis-dependent CKD patients while active therapy is ongoing 6.
- Levels of 25(OH)D declined substantially in both cholecalciferol and ergocalciferol arms following cessation of therapy, suggesting the need for maintenance therapy to sustain levels 6.