Vitamin D Deficiency

vitamin d deficiencyVitamin D deficiency has recently been linked with numerous medical disorders, some of which include poor bone health, fatigue, depression, and muscle weakness/pain.  Vitamin D therapy has been use in the treatment of psoriasis, seizures, and the prevent of certain types of cancers.  Adequate Vitamin D levels have also been shown to help with certain chronic conditions such a hypertension, diabetes, and thyroid disease.

Populations who may be at a high risk for vitamin D deficiencies include the elderly, obese individuals, exclusively breastfed infants, and those who have limited sun exposure. Also, individuals who have fat malabsorption syndromes (e.g., cystic fibrosis) or inflammatory bowel disease (e.g., Crohn’s disease), and dark skin pigmentation are at risk.

Normal values for 25 Hydroxyvitamin D = > 34

Current recommendations for daily Vitamin D supplementation include:

  • 200 IU or International Units daily of Vitamin D3 for non-pregnancy individuals under the age of 50 years-old.
  • 400 IU is recommended for all individuals from 50-70 years-old and pregnant women
  • 600 IU is suggested for those who are over 70 years-old
  • Some authors have questioned whether the current recommended adequate levels are sufficient to meet physiological needs, particularly for individuals deprived of regular sun exposure. The upper limit (UL) for vitamin D has been recommended as 2,000 IU daily.  On average, for those chronically low in Vitamin D for each 1,000 IU of Vit D3 taken daily, the serum amounts of Vit D will increase by 10 points.
  • Most Calcium / Vitamin D supplementations have adequate levels of Vitamin D if the patient does not need extra due to the risk factors

treatment guidelinesTreatment guidelines for individuals with low Vitamin D levels are as follows:

  • < 20: 50,000 IU weekly for 8 weeks + the daily maintenance dose of Vit D with adequate calcium intake; rescreen levels in 12 weeks
  • >/= 20 – </= 34: 50,000 IU weekly for 4 weeks + the daily maintenance dose of Vit D with adequate calcium intake; rescreen levels in 12 weeks
  • > 34: Daily maintenance of Vit D intake + calcium supplementation