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Could Vitamin D Be Even More Vital Than We Thought?
Emerging Research Says Yes
Hector Caraballo, MD
December 23, 2023
Vitamin D: New Blueprint for Dosage Based on Age, Weight, and Health Factors
Greetings Fellow Humans 😊,
We have an essential and thorough vitamin D update for you in this week's newsletter. New research continues to show widespread vitamin D deficiency across the globe, with potentially far-reaching impacts on health.
Observational studies are finding notable links between insufficient blood vitamin D levels and increased risks for an array of chronic illnesses - including heart disease, stroke, cancer, autoimmune disorders, infections, diabetes, and even dementia. Optimizing vitamin D status is correlated with lower risks of death as well.
The paradigm is shifting on what constitutes "optimal" vitamin D levels. Where 20 ng/mL was previously the cutoff for sufficiency, experts recommend maintaining levels >30 ng/mL year-round to maximize health benefits. This likely requires supplementation beyond just sun exposure and diet for most people.
Current vitamin D intake guidelines vary based on age, weight, ethnicity, and underlying health conditions. Recommended dosages range widely - from 400 IU up to 2000 IU daily. The key is finding the "Goldilocks zone" for each individual to raise low levels without overdoing it.
Controversy still exists about whether low vitamin D directly causes illness or is associated with it. However, the accumulating evidence makes a compelling case for actively correcting deficiencies. Maintaining adequate vitamin D levels offers a simple way to support well-being with minimal risks.
Discuss your vitamin D status and supplementation practices with your physician. We'll keep you posted on emerging research about how this pivotal nutrient benefits our health!
Be Well. Be Free. Be Fair. Be Inspired-
Hector Caraballo, MD
Article link: https://doi.org/10.1016/j.jsbmb.2017.01.021
Pawel Pludowski, Michael F. Holick, William B. Grant, Jerzy Konstantynowicz, Mario R. Mascarenhas, Afrozul Haq, Vladyslav Povoroznyuk, Nataliya Balatska, Ana Paula Barbosa, Tatiana Karonova, Ema Rudenka, Waldemar Misiorowski, Irina Zakharova, Alena Rudenka, Jacek Łukaszkiewicz, Ewa Marcinowska-Suchowierska, Natalia Łaszcz, Pawel Abramowicz, Harjit P. Bhattoa, Sunil J. Wimalawansa,
Vitamin D supplementation guidelines, The Journal of Steroid Biochemistry and Molecular Biology, Volume 175, 2018, Pages 125-135
Here is a summary of the key points from the article:
- There is evidence that vitamin D provides health benefits beyond bone/calcium metabolism, but some studies contest this evidence. Overall, the evidence supports vitamin D's positive effects.
- Optimal vitamin D levels are likely 30-50 ng/mL based on evidence, higher than the 20 ng/mL recommendation by IOM guidelines focusing narrowly on bone health.
- Various organizations have set higher vitamin D intake recommendations than IOM, targeting 30-50 ng/mL levels - Endocrine Society guidelines are 600-2000 IU/day depending on age.
- Disease-specific guidelines often recommend 30-50 ng/mL levels and higher doses of 800-4000 IU/day, especially for high-risk groups.
- For treatment of deficiency (<20 ng/mL), high doses are used short-term, followed by lower maintenance doses.
- Vitamin D toxicity risk is low - toxicity generally requires levels over 150 ng/mL. Studies show high doses can safely achieve 40-60 ng/mL levels.
- Practical solutions involve sensible sun exposure, food fortification with vitamin D, and supplements when sun exposure is inadequate to maintain 30-50 ng/mL levels.
Before You Go, It’s Good to Know
Acute Respiratory Infections:
- Adults with 25(OH)D ≥38 ng/mL had 2.7 times lower incidence of acute viral respiratory tract infections compared to lower levels (p = 0.015)
Cancer:
- Women with 25(OH)D ≥40 ng/mL had a 67% lower incidence of invasive cancer compared to women with <20 ng/mL
Mortality:
- Participants with 25(OH)D <10 ng/mL had 1.5 times higher relative risk of mortality compared to those with ≥30 ng/mL
Vitamin D level correlates with considerable differences in incidence and risks of several significant diseases and mortality. Optimal levels around 30-50 ng/mL are associated with lowest risks.
The recommendations aim to provide intake levels likely to achieve optimum blood vitamin D levels for health based on age. Infants need a minimum of 400 IU. Children and teens are advised 600 IU. Adults under 50 may need 600-800 IU. Older adults require higher doses, between 800-2000 IU per day.