If it is noted as your vitamin D levels rise there is a concurrent elevation in serum calcium levels then vitamin D supplementation should be stopped and a full diagnostic evaluation should be performed in order to determine the cause for this problem. While vitamin D toxicity is rare, the effects of vitamin D supplementation with specific conditions must be done under supervision.
However, for most vitamin D supplementation should be not only safe, but also effective in supporting our overall health.
The other thing that can affect vitamin D levels is specific drug interactions. Certain drugs such as anticonvulsant drugs will cause a depletion of vitamin D. Therefore, it is necessary to assure that the drugs that you are taking are not reducing your serum vitamin D levels.
Having said all of that, based on the current research, I would say that the generally acceptable ranges for blood levels of vitamin D would lie between 60 ng/ml and 80 ng/ml.
HOW TO GET THERE
How to determine how much you require in a supplemental form is the next question that we need to focus on at this point. Obviously, the quantity that you require to take depends entirely on your current blood levels. The following information is not given as a template to be used by everyone reading this series of articles. It is rather to give a basis of understanding for you when you seek attention and care for vitamin D management.
The dosage of vitamin D supplementation has to reflect the specific physiologic requirements and natural production levels of the individual. For many this may place the recommended supplementation level between 5000 IU, and 10,000 IU per day. The 10,000 IU level is the physiologic dose naturally attained by full body sun exposure.
The physiologic requirement comes in at a range of 3000 IU to 5000 IU per day for adult males. In the Center, I use an equation based on the patient’s current blood vitamin D level and our target optimal level to determine the appropriate dosage for that patient.
HOW TO STAY THERE
We also need to consider how long is too long, and how long is just enough time to consume the specified dose in order to attain that target level. As I noted earlier in this series vitamin D supplementation should be performed using vitamin D3 rather than D2 for the reasons that I already outlined. In most instances, vitamin D supplementation at the determined level to reach the target blood level of vitamin D should be continued for at least 5-9 months. This obviously is variable based on testing blood levels of vitamin D to determine current levels.
I will generally retest blood levels of vitamin D anywhere from 3 to 6 months after starting supplementation. If we have achieved our goal level at that point, I will generally reduce the dose. The Vitamin D Council recommends that 2000-3000 IU of vitamin D is sufficient to maintain most individuals levels. Of course consideration must be given to the region of the country in which the individual resides and the amount of sun exposure that they receive every day. It is recommended that you have your blood levels of vitamin D tested annually at a minimum.
A note about the supplement that you select. I have said this so many times in the past that it is becoming almost nauseating to repeat: you get what you pay for with supplements. Therefore, the quality of what you take will generally dictate the dose contained in the supplement, which may not match the dose noted on the label of the supplement. One study found that the supplement used in the study which was produced by a well-known vitamin manufacturer contained just 83% of the stated amount. So please be careful with the quality of the supplement that you choose.
WE'RE HERE FOR YOU
Now, as for the blood test for vitamin D. It has been my experience that many primary care doctors are hesitant to test your vitamin D level because they fear that it will not be covered by your health insurance. This is unfortunately often true.
I had this happen years ago when I retested a patient’s vitamin D level to see if we had reached our desired target at six months past the initial blood test. That second test was rejected by the patient’s insurance carrier. Even after repeated calls from myself and the patient explaining the need to retest her vitamin D levels, they simply refused to pay for it. Ultimately, they admitted that they will only pay for one vitamin D test per year. Therefore, in most instances I will not use the patient’s insurance to run the blood test. This is because labs charge, in many instances, over $200 for a vitamin D blood test.
