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Why Vitamin D Should Be Dosed By Your Healthcare Provider Only (not by you)

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by Mila McManus, MD

Vitamin D is essential for good health. This fat soluble vitamin has anti-depressant effects, increases calcium absorption in the GI tract, enhances immune function, has anti-cancer effects, and is anti-inflammatory.

There are very few rich dietary sources which are egg yolks, fatty fish, and fortified milk. The best and cheapest source is sunlight on arms, face, and legs several days a week for 5 to 15 minutes and without wearing sunscreen.

While deficiency is common, many people are taking far too much. Fat soluble vitamins, such as D, store up in the body, unlike most vitamins that are cleared from the body quickly if unneeded. As a result, Vitamin D should be monitored regularly by your medical provider to ensure the correct dose for you. The optimal dose may vary by age, season, health status, weight, and other variables. Vitamin D can also have some drug interactions and contraindications with certain diseases, another reason why working with your medical provider to maintain appropriate levels is important.

Symptoms[1] of excess Vitamin D include excess calcium in the blood (hypercalcemia) which can cause nausea, vomiting, weakness, and frequent urination.  This toxicity can progress to bone pain and kidney problems, such as the formation of calcium kidney stones.

It is also essential that there be synchronization of Vitamin D with other vitamins such as calcium and vitamin K to ensure proper balance and absorption. For example, vitamin D, K, and calcium are a triad that work together synergistically and need to be balanced properly for optimal bone health and osteoporosis prevention. Excess calcium can lead to arterial and cardiovascular issues.

A common mistake people make is taking extra calcium or vitamin D without accounting for the amounts already in other vitamin supplements such as multi-vitamins and vitamin packed protein drinks.

We emphasize that everyone is different when it comes to vitamin D supplementation. Lifestyle, diet, age, health status, and one’s supplementation regimen must all be considered in order to properly  manage vitamin D levels. This needs to be routinely checked once or twice a year for most people.  Those who spend time outdoors may not need much supplementation, while an elderly individual who rarely gets out and has poorer absorption from the gut would have different requirements.  Very dark skinned individuals are less able to get vitamin D from the sun. 

While a normal reference range for blood levels of vitamin D is between 30-100, we broadly aim for 70-80, however this may not be right for everyone and could cause ill effects for some individuals. It can be dosed in a variety of forms including oral pills and liquids, injections, and can be dosed daily versus weekly. Your medical provider can also be helpful with determining which protocol is right for you.

With Vitamin D, it is wisest not to guess or be your own doctor. Consult with your medical provider for the best approach for you.

Reference:

[1] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-toxicity/faq-20058108#:~:text=The%20main%20consequence%20of%20vitamin,the%20formation%20of%20calcium%20stones.

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