Tuesday, December 31, 2013

Vitamin D Supplementation-Part 1

I've known for a long time about the benefits of Vitamin D and continue to follow the research on suggested dosages and healthy blood levels. But following the research and actually getting my family's blood levels into a healthy range are two very different things! And how do you determine what IS a healthy range? A recent blog post at Healthy Holistic Living really strengthened my resolve to get on top of this issue, especially as people around us seem to be dropping like flies with colds and flu.

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
Dosing Recommendations
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
Dosing Recommendations
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
Dosing Recommendations
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)
Dosing Recommendations
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.

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