There is a tremendous variability surrounding the practice of vitamin D supplementation in the United States and around the world, which represents a large amount of existing but debated recommendations. So how does the average mother discern which recommendation is the right one for herself and her family? And once you subscribe to a particular recommendation, how do you see that through to measurable results? In my mind, it all comes down to who you trust. Do you trust that your doctor is independently researching this issue? If not, who do they trust? It might be good to know which organization's guidelines they are following.
I've compiled a list of organizations which make recommendations on Vitamin D supplementation and information or links to their specific guidelines. There are many more but these include (in no particular order) the top government agencies your doctor is most likely referring to. It's also important to note that many organizations don't have specific guidelines, but instead endorse another organization's (e.g., the American Medical Association endorses the Institute of Medicine's recommendations).
IOM (Institute of Medicine)/Food and Nutrition Board
Target Blood Level: >20ng/ml
Click link above for age-specific recommendations
USPSTF (US Preventive Services Task Force)
In its current guidelines, the USPSTF does not endorse the routine use of 400 IU or less of vitamin D and 1000 mg or less of calcium for primary prevention of fractures in postmenopausal women.
Vitamin D Council
Target Blood Level: 40-80ng/ml
Infants: 1000 IU/day, Children: 1000 IU/day per 25lbs of body weight, Adults: 5000 IU/day
The Endocrine Society
Target Blood Level: >30ng/ml but 50-60 ng/ml ideal
Infants: 400-1000 IU/day, Children: 600-1000 IU/day, Adults: 1500-2000 IU/day
Tolerable Upper Limits
1000 IU/day for infants aged up to 6 months,
1500 IU/day for infants aged 6 months to 1 year old,
2500 IU/day for children aged 1 to 3 years,
3000 IU/day for children aged 4 to 8 years, and
4000 IU/day for everyone older than 8 years.
However, the guideline states that for individuals who are vitamin D deficient, higher levels of vitamin D (2000 IU/day for children up to age 1 year; 4000 IU/day for children aged 1 - 18 years, and up to 10,000 IU/day for adults aged 19 years and older) "may be necessary to correct, treat, and prevent vitamin D deficiency," Dr. Holick said.
American Academy of Pediatrics
Like the AMA, AAP endorses the recommendations of the IOM, Food and Nutrition Board. See first listing above.
National Institutes of Health-Office of Dietary Supplements
*Target Blood Level: >20ng/ml)
0-12 mo.-400 IU/day, 1-13 years-600 IU, 14-18 years-600 IU, 19-50 years-600 IU, 51-70 years-600 IU, >70 years-800 IU
Tolerable Upper Limits: 0-6 mo.-1000 IU/day, 7-12 mo.-1500 IU/day, 1-3 years, 2500 IU/day, 4-8 years-3000 IU/day, >9 years-4000 IU/day
*I personally find it very interesting that this government website states that blood levels of 12-20 ng/ml are "generally considered inadequate for bone and overall health in healthy individuals" but that anything 20 ng/ml or greater is "generally considered adequate for bone health and overall health in healthy individuals"!!
Dr. David Perlmutter
Target Blood Level: 80 ng/ml
Dosing Recommendation-Adults 5000 IU/day
Dr. Joe Mercola
Target Blood Level: Optimal 50-70 ng/ml, Treat Cancer and Heart Disease 70-100ng/ml
Dosing Recommendation-Adults 8,000 IU/day.
In my next blog post I'm going to share my family's vitamin D story, information on how to go about getting your family tested and how to select the right vitamin D supplement.