How Much Vitamin D Should You Take?

The safe dose of vitamin D supplements to get most of the population to the optimal level is 2,000 i.u. a day, but the elderly and overweight may need more.

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After all that work plowing through the new science and the same 2,000 iu/day recommendation I made in 2011 remains. http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/

If you missed the first two videos in this series, see: <br />• Do Vitamin D Supplements Help with Diabetes, Weight Loss, and Blood Pressure (http://nutritionfacts.org/video/do-vit-D-supplements-help-with-diabetes-weight-loss-and-blood-pressure)
• Will You Live Longer if You Take Vitamin D Supplements? (http://nutritionfacts.org/video/will-you-live-longer-if-you-take-vitamin-D-supplements)

And I wrap up with:
• The Optimal Dose of Vitamin D Based on Natural Levels (http://nutritionfacts.org/video/the-optimal-dose-of-vitamin-D-based-on-natural-levels)
• The Best Way to Get Vitamin D: Sun, Supplements, or Salons? (http://nutritionfacts.org/video/the-best-way-to-get-vitamin-D-sun-supplements-or-salons)
• The Risks and Benefits of Sensible Sun Exposure (http://nutritionfacts.org/video/the-risks-and-benefits-of-sensible-sun-exposure)

Have a question for Dr. Greger about this video? Leave it in the comment section at http://nutritionfacts.org/video/how-much-vitamin-d-should-you-take and he’ll try to answer it!

Image Credit: Peter Rosbjerg via flickr.

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20 Risposte a “How Much Vitamin D Should You Take?”

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  2. VITAMIN D STUDIES FROM NEW ENGLAND JOURNAL OF MEDICINE

    DIABETES. Among persons at high risk for type 2 diabetes not selected for vitamin D insufficiency, vitamin D3 supplementation at a dose of 4000 IU per day did not result in a significantly lower risk of diabetes than placebo.

    CANCER and HEART DISEASE. Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo.

    No Value for Routine Vitamin D Supplementation

    Thomas L. Schwenk, MD

    A randomized trial, a meta-analysis, and a guideline all point in the same direction.

    Enthusiasm for recommending vitamin D supplementation to prevent a wide range of skeletal and extraskeletal disorders was diminished considerably by three publications in 2018.

    In VITAL (Vitamin D and Omega-3 Trial), researchers randomized nearly 26,000 middle-aged and older adults with no history of cardiovascular (CV) disease, cancer, or other serious disorders to receive vitamin D3 (2000 IU daily) or placebo. Mean serum 25-hydroxyvitamin D level increased in vitamin D3 recipients only. During median follow-up of 5 years, major adverse CV events and invasive cancer occurred with equal frequencies in the two groups (NEJM JW Gen Med Dec 15 2018 and N Engl J Med 2018 Nov 10; [e-pub]). The VITAL researchers are expected to report eventually on other outcomes, including fractures.

    In a meta-analysis of 33 randomized trials, effects of supplementation with calcium, vitamin D, or both on fracture rates were investigated in older community-dwelling adults (age, ≥50). There was no reduction in risk for hip fracture or vertebral, nonvertebral, and total fractures for any supplementation intervention. The results applied to subgroups with 25-hydroxyvitamin D levels lower than 20 ng/mL or with previous fractures (NEJM JW Gen Med Feb 15 2018 and JAMA 2017; 318:2466).

    Finally, the U.S. Preventive Services Task Force (USPSTF) updated previous guidelines addressing vitamin D supplementation. The Task Force found adequate evidence to recommend against vitamin D supplementation to prevent falls and found insufficient evidence to recommend supplementation to prevent fractures in men and premenopausal women. For postmenopausal women, they recommend against low-dose supplementation, but evidence was insufficient to determine whether higher doses prevent fractures. The USPSTF emphasized that these recommendations apply only to community-dwelling older adults who are not known to have osteoporosis or vitamin D deficiency (NEJM JW Gen Med May 15 2018 and JAMA 2018; 319:1592).

    The VITAL study joins many others in which disease associations with low vitamin D levels do not necessarily translate to benefit from supplementation. However, given widespread routine measurement of vitamin D levels by clinicians (a practice for which there is no supportive evidence currently) and over-the-counter availability of supplements, vitamin D use is unlikely to decline.

    Groups at high risk — Older persons confined indoors may have low serum 25(OH)D concentrations. Cutaneous production of vitamin D declines with age and in the northern latitudes. In addition, dietary vitamin D intake is often low in older individuals. As an example, in a study of postmenopausal women living in France, mean daily vitamin D intake from food was 144.8 international units /day. More than one-third of women consumed <100 units/day from food.

    Vitamin D insufficiency appears to be common among several other populations, including those who are:

    ●Dark skinned

    ●Obese

    ●Taking medications that accelerate the metabolism of vitamin D (such as phenytoin)

    ●Hospitalized on a general medical service

    ●Institutionalized

    And those who have:

    ●Limited effective sun exposure due to protective clothing or consistent use of sun screens

    ●Osteoporosis

    ●Malabsorption, including inflammatory bowel disease and celiac disease

  3. UHN NEWS
    More not always better when it comes to vitamin D

    Bourne Auguste
    Dr. Bourne Auguste, Clinical Fellow in the Home Dialysis Program, Nephrology, examined the 54-year-old man who took high doses of vitamin D over two years, resulting in kidney failure. (Photo: Dr. Bourne Auguste)

    An unusual case study from the Nephrology Clinic of Dr. Joanne Bargman at Toronto General Hospital (TG) has shown that excessive amounts of vitamin D can lead to kidney failure.

    The case study describes a 54-year-old man who had been prescribed a high dose of vitamin D by a naturopath. He did not have any prior fractures or documented vitamin D deficiency.

    Not finding the specific brand prescribed by the naturopath, the patient substituted another one that had a higher concentration of Vitamin D. Over two years, he took eight to 12 drops of vitamin D daily – for a total dose of 8,000 to 12,000 units a day.

    Related to this story:
    CBC Radio Interview with Dr. Bargman
    Read story in US News & World Report
    He now has kidney failure due to high blood levels of calcium leading to deposits of calcium in the kidney tissue. His kidney function is 34 per cent, compared to normal functioning at more than 60 per cent.

    According to Osteoporosis Canada, doses up to 2,000 units daily are safe. They recommend vitamin D doses from 800 to 2,000 units daily for older adults and those at high risk for osteoporosis.

    The case is reported in the April 8 edition of CMAJ (Canadian Medical Association Journal) by Drs. Bourne Auguste and Joanne Bargman, Nephrology, TG, and Dr. Carmen Avila-Casado, Pathology, UHN.

    "Patients should recognize that vitamin D is a medication, and can be associated with risks, particularly when taken at large doses," says Dr. Auguste, Clinical Fellow in the Home Dialysis Program, Nephrology, and the first author of the case report. "More is not better in this example."

    Symptoms of vitamin D toxicity can include: high blood pressure, confusion and kidney stones.

    Dr. Auguste also points out that not everyone might need vitamin D supplements, and that low-risk patients should speak to their physicians about why they are considering taking it.

  4. [01:40] The U-shaped curve is old data.

    [01:58] Routine testing of Vitamin D levels is not recommended. The tests may be unreliable and misleading.

    [02:47] Recommended dose is (at least) 2,000 IU (50 µg).

    [03:23] Overdose may occur over 10,000 IU (250 µg) a day.

    [03:36] Overweight, obese and elderly people may need more.

    [03:53] Again, no need for the average person to test and retest…

    [04:02] The (US) Institute of Medicine Recommendation is 600 IU to 800 IU.

    [04:11] Official recommendations are all over the map, ranging from just 200 IU a day, all the way up to 10,000 IU a day.

  5. One video says you can take 10000 per day without any harm but drink lots of water. So many variations on youtube it leaves you confused. My son has inflammation so he is on 4000 to 10000 per day for better absorption.

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