You Need More Vitamin D…For Now

Vitamin D has been all the rage of late.  Here is a brief review from the New York Times.  Once considered strictly a regulator of calcium and bone mineralization recent findings suggest that vitamin D deficiency is associated with several types of cancer, cardiovascular disease, osteoarthritis, osteoporosis and immune system disorders, raising risk of infection, auto-immune diseases, including rheumatoid arthritis, multiple sclerosis and type-I diabetes. 

I have found that the overwhelming number of patients that I see have at least insufficient vitamin D levels, while at least half have vitamin D deficiency.  Those at highest risk are obese patients, patients with digestive disorders and, not surprisingly, people who work long hours at desk jobs without sun exposure (lawyers and investment bankers tend to have the lowest in my practice).  In fact, over the past year I have only seen a handful of patients not already taking supplemental vitamin D that meet the suggested 25, OH vitamin D level of 40 ng/ml.

My advice is to start at 1000 IU of vitamin D₃ daily to be taken with a meal (aiding the absorption of this fat-soluble vitamin).  For those at higher risk or whose vitamin D levels do not rise, I suggest 2000 IU or even more aggressive dosing for those severely deficient, although I have found that this moderate supplementation usually is sufficient.   This is not the first vitamin to gain public favor – vitamins A, C and E were popular not that long ago, although follow up studies on broad use of them as supplements in healthy individuals has yet to yield convincing evidence of their benefit.  For now, the association of vitamin D deficiency and disease is convincing.  Whether follow-up studies demonstrate efficacy of vitamin D supplementation in preventing and managing these diseases will ultimately guide recommendations. 

To read the full NY Times article, click here.