From the Guidelines
Vitamin D deficiency should be treated with 600-800 IU of vitamin D daily for most adults, with higher doses (1,000-2,000 IU daily) recommended for those at risk of deficiency, according to the most recent guidelines 1.
Diagnosis and Treatment
Vitamin D deficiency is diagnosed when blood levels of 25-hydroxyvitamin D fall below 20 ng/mL (50 nmol/L) 1.
- For treatment, adults with vitamin D deficiency should take 600-800 IU of vitamin D2 or D3 daily, with higher doses (1,000-2,000 IU daily) recommended for those at risk of deficiency.
- Severe deficiency may require longer treatment at higher doses.
Prevention
- For prevention, most adults need 600-800 IU of vitamin D daily, with higher doses (1,000-2,000 IU daily) recommended for those at risk of deficiency.
- Blood levels should be rechecked after 3 months of treatment to ensure normalization.
Importance of Vitamin D
- Vitamin D is essential for calcium absorption and bone health, while also playing roles in immune function and inflammation reduction.
- The body produces vitamin D when skin is exposed to sunlight, but many people have insufficient sun exposure.
- Food sources include fatty fish, fortified dairy products, and egg yolks, though dietary sources alone rarely provide adequate amounts.
- Taking vitamin D supplements with meals containing some fat improves absorption.
Recent Guidelines
- The most recent guidelines from 2022 recommend daily oral intakes of vitamin D varying between 600 and 800 IU in adults, or 1500-4000 IU in patients “at risk for vitamin D deficiency” 1.
- The general upper daily limit for vitamin D intake is 4000 IU, but the Endocrine Society has recommended an upper limit of 10,000 IU for patients „at risk“ for vitamin D deficiency.
From the Research
Vitamin D Deficiency Guidelines
- Vitamin D insufficiency and deficiency are widespread in many countries 2
- Deficiency may be adequately treated with many different therapeutic regimens of either cholecalciferol or ergocalciferol 2
- Regular dosing with oral cholecalciferol (e.g., 60,000 IU weekly) may have slight advantages over other regimens when replenishing vitamin D stores following deficiency 2
- For long-term supplementation, smaller regular doses, such as cholecalciferol 1,000 IU daily, or 10,000 IU weekly, are suitable 2
Diagnosis and Treatment
- Vitamin D status is determined by measuring the 25-hydroxyvitamin D serum concentration 3, 4, 5, 6
- Determining the accurate thresholds for vitamin D deficiency is still a matter of debate 3
- Only individuals at risk for vitamin D deficiency should be screened 3
- 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 6
Prevention and Supplementation
- Ensuring optimal levels of vitamin D in the population is a challenge not only for health care and especially for government administration 4
- Vitamin D supplementation should not be offered routinely to other patient populations, except for those with documented deficiency or at risk of deficiency 5
- Sensible sun exposure is an inexpensive and enjoyable way to maintain vitamin D stores, but no safe and well-defined threshold of ultraviolet exposure allows adequate vitamin D synthesis without increasing the risk of skin cancer 2, 3