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vitamin D toxicity

BUT ISN’T THAT TOO MUCH VITAMIN D?

March 31, 2012 by James Bogash

We’re not going to rehash the benefits and frequency of deficiency of vitamin D here.  If you’re bored sometime, you can read all about vitamin D in past blog posts.  What we will review here is dosages and how mainstream medicine has been approaching the “vitamin D thing.”

First of all, lab values put normal levels of serum 25-OH vitamin D at 30-100 ng/dl.  It is widely excepted among experts in functional medicine that the optimal range is more like 60-100 ng/dl.

It seems like everyone is checking patients’ vitamin D levels these days, but the approach to deficiencies vary.  It is not uncommon for some of my patients to be told they have low vitamin D and put on 50,000 IU of the prescription form of vitamin D (ergocalciferol, or D2).  As high as these levels sound, they do not usually move blood values more than 10 or 20 ng/dl, most often leaving the patient still below optimal.

In our office, we generally start supplementation levels at 2,000 IU per day and move up from there depending on the clinical picture of the patient.  Our office uses an emulsified form of vitamin D3, which is very, very inexpensive, easy to take (can be taken once / week) and very high quality.  What more could one ask for??

However, when we recommend levels beyond 2,000 for specific patients, some are surprised at recommendations up to 6,000 or 10,000 IU / day, thinking this is a very high level (and yet don’t usually question the prescription, low quality 50,000 /  week, which is 7143 IU / day).

This particular article addresses the safety aspects of higher levels of vitamin D.  The author’s review concludes:

  1.  1500 IU is the lowest level needed to positively impact chronic disease risk
  2. Long-term daily intakes up to 10 000 IU of vitamin D do not show signs D toxicity

While it is not common that we recommend as high as 10,000 IU / day, it is considered safe with no signs of toxicity in the medical literature.

Filed Under: Vitamin D Tagged With: Vitamin D supplementation, vitamin D toxicity

BEWARE WHERE YOU GET YOUR VITAMIN D FROM

December 27, 2011 by James Bogash

Anytime I talk about vitamin D, I always urge readers and patients to buy from our office.  There are several reasons why, and this article illustrates one reason perfectly.

First is cost.  Do not ever buy encapsulated vitamin D.  It is much, much more expensive than the liquid forms.  In addition, the liquid forms can be taken on a weekly basis, making convenience another plus.  As I’ve mentioned, our vitamin D at 2,000 IU / day will last for a year at a cost of $20.  Kind of a no-brainer.

But here’s the plus…

Quality of the companies we use are very high.  So, not only is it very inexpensive, but the quality is superb.  As far as quality control, many companies are lacking in this regard, as this particular study clearly illustrates.

One of the jobs of vitamin D is to help our bodies absorb calcium from our gut.  Because of this, vitamin D toxicity from too much vitamin D  can lead to a potentially life threatening condition called hypercalcemia–too much calcium in the bloodstream.  This begins to effect the way our muscles and our heart contracts.   Luckily, this condition is almost impossible to reach with normal levels of supplementation and so it is rare.  While these cases usually end up in the hospital, they almost always resolve without any long term consequences (other than the bill…).

However, this is not the first case report I have come across that found vitamin D toxicity occurring due to mislabeling / quality control issues with the supplement.  While the details are not included, these 2 patients were taking 1,000 times the RDA (400,000 IU).  As a single dose, this would not, by itself, cause a problem.  But these levels taken over the course of weeks or months can drive up vitamin D levels in the bloodstream to toxic heights.

So, while I believe that vitamin D supplementation is essential in today’s day and age, I strongly urge you to buy only from a reputable source.

Filed Under: Vitamin D Tagged With: hypercalcemia, vitamin D toxicity

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