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Vitamin D De ciency
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What is the treatment for a vitamin D de ciency?


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Vitamin D3 has been shown to be the best choice for


supplements. Vitamin D2 supplements do not raise your
levels the same amount as D3 and, in some cases, they
have been shown to decrease levels over long-term use.

The amount of vitamin D that is needed to correct a


de ciency will depend on the severity of the de ciency
and your individual health risks. The time of year will
also matter. For example, if you are on the low end of
adequate blood levels and heading in to the winter
months you would need a bit more than if you were
heading in to the summer months. The goal for everyone
is to get your stores to a safe level and prevent them
from dropping with a maintenance plan.

What you take is as important as how you take it. Vitamin D supplements
should be taken with a meal that contains fat. Studies have shown that when
taken on an empty stomach versus with a meal containing fat, there was an
average of 32% more vitamin D absorption in the fat-containing meal. This
ranged from 11%-52%. Even an 11% reduction is signi cant and can impact your
vitamin level. A recent study instructed people to take their supplement with
their largest meal (typically the one with the most fat), and in three months, their
blood levels went up an average of 56.7%.
There are supplements that can be taken on a daily, weekly, or monthly basis.
It's a matter of preference and, most importantly, which one you will be more
likely to take. You may start out at a higher dose and decrease after a month or
two. Most experts feel that the goal is to get your level above 30-40 ng/mL,
depending on your risk factors, and then take a maintenance amount. When you
are de cient, it is recommended to have your blood tested after two to three
months of taking the supplement to be sure that your levels are going up. Work
with your doctors to nd the optimal plan for you.

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The task force for the Endocrine Society makes the following
recommendations:

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For children 1-18 years of age who are vitamin D de cient, we suggest
treatment with 2,000 IU/d of vitamin D3 for at least six weeks or with 50,000
IU once a week for at least six weeks to achieve a blood level of 25(OH)D
above 30 ng/ml, followed by maintenance therapy of 600-1,000 IU/day.
We suggest that all adults who are vitamin D de cient be treated with
50,000 IU of vitamin D3 once a week for eight weeks or its equivalent of 6,000
IU of vitamin D3 daily to achieve a blood level of 25(OH)D above 30 ng/ml,
followed by maintenance therapy of 1,500-2,000 IU/day.
In obese patients, patients with malabsorption syndromes, and patients on
medications affecting vitamin D metabolism , we suggest a higher dose
(two to three times higher; at least 6,000-10,000 IU/day) of vitamin D to treat
vitamin D de ciency to maintain a 25(OH)D level above 30 ng/ml, followed by

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maintenance therapy of 3,000-6,000IU/day. One study found that for every 33


lbs. of body weight the serum 25(OH)D level was 4 ng/ML lower at the end of
one year of monitoring. This could lead to a signi cant change in the amount
required to supplement based on your body weight and starting serum level.
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Reviewed on 2/26/2015

NEXT: Can vitamin D de ciency be prevented?

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Author:

Medical Editor:

Betty Kovacs, MS, RD

Melissa Conrad Stppler, MD


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