What Is Your Current Vitamin D Status
If you are already at an optimum level for vitamin D, this personalized maintenance dose will keep you at optimum.
But if you are currently deficient in vitamin D, a maintenance dose is not really enough to overcome your deficiency. Eventually it would, but it might take between six months and a year before you would reach optimum vitamin D blood levels.
That is why we recommend that people who are vitamin D deficient should take a larger dose of vitamin D for 60 days, to quickly bring their vitamin D blood level to optimum. See vitamin D deficiency treatment.
The best way to know your vitamin D status is to take a vitamin D blood test. This is also the only way to be certain of your new vitamin D status once you start supplementing. We recommend a blood test three months after starting supplementation, and thereafter once a year.
If you dont take a blood test, you can estimate your vitamin D status, but because people vary in the way their bodies make and use vitamin D, your estimate may not be completely accurate.
How Is A Vitamin D Deficiency Diagnosed
Your doctor can order a blood test to measure your levels of vitamin D. There are two types of tests that might be ordered, but the most common is the 25-hydroxyvitamin D, known as 25D for short. For the blood test, a technician will use a needle to take blood from a vein. You do not need to fast or otherwise prepare for this type of test.
What You Can Do Now
If youre concerned about vitamin D deficiency, ask your doctor to check your vitamin D level, says Dr. Deal. If the level is low and your provider starts you on supplements, you need repeat testing in eight to 12 weeks to make sure the level is not too high or too low.
If testing shows your vitamin D level is normal, you need repeat testing every two to three years unless you have major changes in your overall health.
Different diseases need different doses of vitamin D. If you have chronic kidney disease or parathyroid disease, ask your kidney specialist or endocrinologist about the type and dose of vitamin D you need.
If youre pregnant or breastfeeding, Dr. Deal recommends you keep taking vitamin D supplements as long as your doctor prescribes them. The supplement is linked to healthy development for you and your baby.
For bone health, be sure to stay active and remember to eat a calcium-rich diet. Consult with your doctor frequently to make sure youre taking the right steps to current bone health.
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What Happens When Your Vitamin D Is Low
When vitamin D levels are low, there are some noticeable changes in the body, says Konstantin. Low vitamin D levels can lead to decreased energy levels, low mood, and potentially frequent bouts of illness. Checking for nutritional deficiencies can rule out any underlying issues that might be causing your lowered energy levels or even exhaustion and allow you to supplement based on what your body requires.
Can You Get Enough Vitamin D From The Sun Alone
Some people will be able to get enough vitamin D just from sunlight. However, it depends on where in the world they live, the time of year, the time of day, and their skin color.
People who live nearer the equator get more sun exposure. In the Northern Hemisphere, a person may not get sufficient vitamin D from sunlight during the winter.
The sun is usually strongest between 11:00 a.m. and 3:00 p.m. In the summer, a person does not need to be out in the sun for very long during this period to make enough vitamin D.
The amount of melanin a persons skin contains affects how much vitamin D they can make. Less melanin results in lighter skin, which does not protect as well against harmful ultraviolet rays.
People with more melanin in their skin have better protection from the sun, but take longer to make vitamin D. In the United States, the Centers for Disease Control and Prevention found that Mexican-Americans and non-Hispanic black people are more likely to have vitamin D deficiency.
These varied factors make it difficult to recommend how much sunlight a person should get to make the vitamin D that their body needs.
The Vitamin D Council gives some examples:
- At noon during summer in Miami, someone with a medium skin tone would need to expose one-quarter of their skin to sunlight for 6 minutes.
- At noon during summer in Boston, someone with a darker skin tone would need to expose one-quarter of their skin to sunlight for 2 hours.
- egg yolk
- beef liver
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What Does Sunlight Have To Do With Getting Enough Vitamin D
There are health benefits of sunlight. Vitamin D is produced when your skin is exposed to sunshine, or rather, the ultraviolet B radiation that the sun emits. The amount of vitamin D that your skin makes depends on such factors as:
- The season: This factor depends a bit on where you live. In areas such as Cleveland, OH, the UV-B light does not reach the earth for six months out of the year due to the ozone layer and the zenith of the sun.
- The time of day: The sun’s rays are most powerful between 10 a.m. and 3 p.m.
- The amount of cloud cover and air pollution.
- Where you live: Cities near the equator have higher ultraviolet light levels. It is the UV-B light in sunlight that causes your skin to make vitamin D.
- The melanin content of your skin: Melanin is a brown-black pigment in the eyes, hair and skin. Melanin causes skin to tan. The darker your skin, the more sun exposure is needed in order to get sufficient vitamin D from the sun.
Coronavirus And Vitamin D
Theres been a lot of buzz around vitamin D and coronavirus, but in June 2020 the National Institute for Health and Care Excellence concluded that based on the existing research there was no evidence that taking vitamin D supplements could prevent or treat coronavirus or other respiratory tract infections.
However, its well established that vitamin D supports the normal function of your immune system. So if you do catch coronavirus, your recovery might be easier if youre not deficient.
More recently, a new US has study backed this up, finding that patients with low vitamin D levels suffered more complications with Covid-19.
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Randomized Clinical Trial Of Vitamin D Versus Placebo In Patients With Moderate To Severe Covid
In a double-blind, placebo-controlled randomized trial that was conducted at two sites in Brazil, 240 hospitalized patients with moderate to severe COVID-19 received either a single dose of 200,000 international units of vitamin D3 or placebo.10 Moderate to severe COVID-19 was defined as patients with a positive result on a SARS-CoV-2 polymerase chain reaction test and a respiratory rate > 24 breaths/min, oxygen saturation < 93% on room air, or risk factors for complications. The primary outcome in this study was the length of the hospital stay.
The median length of stay was not significantly different between the vitamin D3 arm and the placebo arm . No significant differences were observed between the arms in the percentages of patients who were admitted to the intensive care unit, who required mechanical ventilation, or who died during hospitalization.
It should be noted that this study had a small sample size and enrolled participants with a variety of comorbidities and concomitant medications. The time between symptom onset and randomization was relatively long, with patients randomized at a mean of 10.3 days after symptom onset. In this study, a single, high dose of vitamin D3 did not significantly reduce the length of stay for hospitalized patients with COVID-19.
Mayo Clinic Q And A: How Much Vitamin D Do I Need
DEAR MAYO CLINIC: I have heard different recommendations from different sources regarding vitamin D. One doctor told my husband that everyone living in the Northern Hemisphere should take a vitamin D supplement every day, even in the summer. What do you recommend?
ANSWER: Understanding how much vitamin D you need can be confusing because there are different recommendations about how much vitamin D adults should get. Using the recommendations that fall on the low end, many adults dont get the amount of vitamin D they should. Because few foods contain vitamin D naturally, eating foods fortified with vitamin D and taking a supplement may be beneficial.
Vitamin D is important because it helps your body sustain normal levels of calcium and phosphorus. Because it works as a key that allows your body to absorb calcium, vitamin D plays a critical role in forming and maintaining healthy bones. It also helps keep your muscles, nerves and immune system healthy.
Research suggests that consistently getting enough vitamin D can significantly lower the risk for the bone-thinning disease osteoporosis. Low vitamin D also is associated with falls, multiple sclerosis, rheumatoid arthritis, chronic pain, diabetes, high blood pressure, cardiovascular disease and some cancers. However, an association does not mean low vitamin D causes these conditions, or that taking a vitamin D supplement will adequately prevent or treat them.
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What Are The Optimal Blood Levels Of Vitamin D
To find out if you are deficient in vitamin D your doctor can order a blood test, called a 25-hydroxy vitamin D test.
- Vitamin D levels should be above 20 nanograms per milliliter of blood, which indicates that you arent suffering from severe vitamin D deficiency.
- A level of 50+ ng/mL indicates a good level of vitamin D, while 3050 ng/mL means you want to supplement with vitamin D, work on spending more time in the sun and adding vitamin D foods into your diet.
- Subclinical vitamin D deficiency is thought to be very common. It is defined as a lower than normal vitamin D level that has no visible signs or symptoms. Levels below 30 ng/mL indicate vitamin D insufficiency.
- A level less than 20 to 30 ng/mL means you are very deficient and definitely want to take immediate action to bring those levels up.
- On the other hand, vitamin D toxicity is considered anything above 200240 ng/mL of blood.
What Causes Vitamin D Deficiency
Vitamin D deficiency can be caused by specific medical conditions, such as:
- Cystic fibrosis, Crohn’s disease, and celiac disease: These diseases do not allow the intestines to absorb enough vitamin D through supplements.
- Weight loss surgeries. Weight loss surgeries that reduce the size of the stomach and/or bypasses part of the small intestines make it very difficult to consume sufficient quantities of certain nutrients, vitamins, and minerals. These individuals need to be carefully monitored by their doctors and need to continue to take vitamin D and other supplements throughout their lives.
- Obesity: A body mass index greater than 30 is associated with lower vitamin D levels. Fat cells keep vitamin D isolated so that it is not released. Vitamin D deficiency is more likely in obese people. Obesity often makes it necessary to take larger doses of vitamin D supplements in order to reach and maintain normal D levels.
- Kidney and liver diseases: These diseases reduce the amount of an enzyme needed to change vitamin D to a form that is used in the body. Lack of this enzyme leads to an inadequate level of active vitamin D in the body.
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Vitamin D Benefits And Warnings
Although the research is still hazy, some people will benefit from taking vitamin D supplements, along with sufficient calcium intake, to promote their bone health. But they don’t require large amounts of vitamin D to get the benefit. “More is not necessarily better. In fact, more can be worse,” says Dr. Manson. For example, a 2010 study published in JAMA showed that intake of very high doses of vitamin D in older women was associated with more falls and fractures.
In addition, taking a supplement that contains too much vitamin D can be toxic in rare cases. It can lead to hypercalcemia, a condition in which too much calcium builds up in the blood, potentially forming deposits in the arteries or soft tissues. It may also predispose women to painful kidney stones.
If you’re taking vitamin D supplements, the take-home message is moderation. Taking too much can limit the benefits of the sunshine vitamin.
Selected food sources of vitamin D
What’s The Best Way To Combine Vitamin D3 With Vitamin K2
We recommend taking vitamin K2 consistently throughout the year, daily and at the best dosage for you . Adjust the dosage of vitamin D3 to suit your lifestyle, or – even better – to suit the level of vitamin D3 25D in your blood.
If you sunbathe for a sufficient time more than twice a week in summer, you probably won’t need any extra vitamin D3 at this time of year. For the rest of the year, experts recommend adjusting vitamin D intake to suit your lifestyle and age, so that your 25D level remains in the optimal range of 50 to 80 ng/ml.
Experience has shown that for most people, depending on the time of year, a daily dosage of between 2500 and 5000 IU of vitamin D3 is the best way to maintain a healthy level of 50-60 ng/ml of 25D in the blood.
Vitamin D3 and vitamin K2 work together directly, but the dosages of these two vitamins are independent of each other, which means that no matter how much vitamin D3 you take, the optimal dosage in order to benefit from the full effect of vitamin K2 always remains the same – between 100 and 200 mcg per day .
Note: If you have a regular daily intake of more than 5000 IU, we recommend that you have the level of 25D in your blood tested every 3 months. This test is especially useful when you begin taking vitamin D3, to find out how much vitamin D3 you need to take every day to achieve an optimal level.
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Vitamin D And K Only Work Well As A Team
Anyone who regularly takes vitamin D as a dietary supplement also needs to take vitamin K2. This important vitamin is responsible for depositing calcium at the right places in the body – i.e. in the bones and teeth. It also prevents calcification, the accumulation of calcium in places where it is not required – i.e. in the arteries and other soft tissue of the body.
Taking vitamin D stimulates the body to produce more of the vitamin K2-dependent proteins that transport calcium. These proteins have many health benefits, but cannot be activated if insufficient vitamin K2 is available, so anyone who is taking vitamin D needs more vitamin K2. Vitamin D and K2 work together to strengthen bones and promote the health of the heart and arteries.
Are There Any Side Effects
There are few side effects to worry about, especially if youre only taking the recommended daily allowance. However, if you take too many supplements then something called vitamin D toxicity or hypervitaminosis D can occur. If this happens, then the main consequence is a build-up of calcium in the blood which can cause vomiting and nausea, muscle weakness and frequent urination. The toxicity would also escalate if its not dealt with and create issues in the bones and kidneys, such as the creation of calcium stones.
For this to happen, however, there would need to be a daily intake of about 60,000 IU over several months. This is 100 times higher than the recommended daily allowance of 600 to 800 IU per day so it would be quite hard to achieve by accident. Vitamin intake via the sun or foods doesnt contribute to this, as the body regulates any naturally occurring vitamins coming into the body.
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Vitamin D And Statins
There has been some debate around whether statins could stop us making enough vitamin D because statins lower cholesterol. In reality, we have more than enough cholesterol to make vitamin D, even if you take statins. Its more important to make sure youre getting enough time in sunlight or getting enough vitamin D from foods or supplements.
How Much Vitamin D Should You Take Then
Now that we’ve got that out of the way, you’re probably wondering how much vitamin D you should take in supplement form.
Before you even worry about dose, make sure your supplement contains vitamin D3 , which is significantly more effective at raising and maintaining vitamin D levels in the body than vitamin D2 .*
From there, research has demonstrated that supplementing with 1,000 I.U. of vitamin D3 raises the average adult’s serum D level by approximately 10 ng/ml, which means it takes 5,000 I.U. of vitamin D3 per day to raise your level to that goal of 50 ng/ml.*
In some cases of significant deficiency, though, it may take up to 10,000 I.U. of vitamin D3 daily to meet the mark,* Henderson says. Heck, according to Crouch, even a couple of months at 50,000 I.U. per week may be necessary to correct a major deficiency.*
Another special circumstance to consider here: Adults with overweight or obesity have vitamin D needs that are two to three times higher than those with a normal weight, so working with a health care provider to regularly monitor your vitamin D status and supplement regimen can ensure you truly get the amount of the nutrient you need to feel your best.*
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