23 responses to “What is the correct dosing for Vitamin D?”

  1. Thank you. Easy to read, clear and concise, and answers a question I’ve been wondering about. confirms that my current approach mirrors best evidence

  2. The optimum & convenient dose of Vitamin D had been bouncing around the long term care directors email board for months.T
    here was consensus that 10,000-20,000 units Vit D a week was the best approach in a nursing home population The Fraser Health Authority has recently given direction to care homes that 20,000 a week is their recommended dose. they based thsi on International lit reviews.
    The work on the adverse effects of a yearly dose is well known ,however the use of weekly doses in geriatrics or a monthly doses in fit adults has not been answered by this article.

  3. 1000 mg daily of vitamin D is a reasonable dose for older adults at risk of falls and osteoporosis

  4. Fraser Health and many other organizations are using higher dose levels of vitamin D. 3500 IU +
    details at
    http://www.vitamindwiki.com/tiki-index.php?page_id=2166

  5. I already advised 1000 units per day for the last few years

  6. The knee-jerk response to the ‘falls after 500000iu annual dose’ study of accepting the 1000iu daily dose is unfortunate. Indeed we have evidence which is quite good on falls and Vitamin D but this is not the whole enchalada. There’s still the numerous other health benefits which only appear when Vitamin D levels are over 100 nmol/l. 1000iu only increases levels by 14 nmol/l given chronically and if your patients are like mine with old skin, clothed skin and indoor skin they have vit D levels of 30-40.With the 1000iu per day they get to an unimpressive 44-54 nmol/l, still in the “moderately deficient” group. We can do better than that for our patients.

  7. Is there any evidence that 2000 units is better than 1000?

  8. Nice and concise

  9. I agree with the literature supporting a role for Vit D supplementation to reduce falls in at risk patients, primrily geriatric and long term care facility patients. Having said that, the majority of the literature is based on small non randomized controlled studies. It would be nice to see a more authoritative paper and / or position statment /guideline reviewed. While I too care for a large number of nursing home patients in the FHA there are concerns of giving all patients 20000 iu of Vitamin D3 weekly. What is the impact of not testing calcium levels in patients beofre doing this? Will we risk issues with nephrolithiasis and painful kidney stones??

    What about patient size, ethnicity, etc on the issue of dose itself. What about bioavailability of the 20000 iu dose vs 2000 iu daily. These and a multitude of other questions need to be answered before jumping onto the Vitamin D3 weekly ward rounds.

    This article also begs the quesiton about the multitude of other Vitamins, lotions and potions fed daily to patients by their families in ECU, in assisted living and residential care otherwise… Should we be endorsing this practice by signing the order to cover the facility. Given the lack of medicinal value to these products, it might be more appropriate to not sign off until a pharmacist has reviewed and rule out significant drug-drug interactions, especially with coumadin which every other person in LTC seems to be on these days, and if not that we get them from the hospital on Fragmin (sometimes 3-4 months post -op)

    Just some thoughts to stimulate discussion.

  10. It appears to me reading the posted comments and the article that there are still unanswered questions re-dosage.
    I am not sure this will change my practice but it has stimulated further enquiry.

  11. I’d like to hear more about the pathophysiology of Vitamin D toxicity… why does one dose help and and a higher one harm?

  12. Very interesting

  13. very helpful article

  14. WILL DEFINITELY CHANGE MY RX OF VIT D DOSES.

    IS THIS DOSING TRUE FOR ALL POST MENOPAUSAL FEMALES

  15. this article conferm my practice I already advised 1000 units per day.

  16. as i use this dose since long time I have no other comment

  17. While I appreciate the thoughtful and succinct review, I am not sure all BC Geriatricians would agree with 1000iu/day for frail failing seniors here. So I’m in the minority here when I voted that I’d consider changing doses (currently I recommend 2000 iu/day, because I’ve seen several cases who appeared to need and benefit from this higher dose). Will wait for more research in meantime.

  18. I really do not know the correct dosage of VitD however I do know that a tremendous number of falls in the elderly could be prevented by having patients use 4-wheeled walkers much sooner than we presently do. As soon as you notice loss of vibration sensation or any signs of instability is the time to start pushing( no pun intended) the use of the walker not after the falls and fractures are history.

  19. I’ve been recommending 2000 IU Vitamin D per day for all adults in cloudy BC, lower doses in children. Why wait for frailty? Isn’t Vitamin D more properly classed as a hormone, than a Vitamin? I have not seen any evidence that this dose is toxic. Sunscreen and sun avoidance in summer makes me inclined to presribe this dose year round.

  20. yes confirms what I already thought we don’t know anything about what the vit d dose should be

  21. tnank you, srongly agree

  22. I have been recommending 1000 IU daily for adults for a few years now. I would like to know more about the studies looking at weekly or monthly admin. I know it’s supposed to be safe but how good are the studies?

    I routinely refuse to do vitamin D levels when patients request them but I have found that they will ask another physician, often a specialist, who orders it for them. Public education might be helpful so we can spend health care dollars on something more worthwhile.

  23. I have numerous long-term care home patients and have been increasing their Vitamin D supplement to at least 1000IU daily at all annual care conferences. This was based on both some primary literature research I did as a resident on the effects of Vitamin D supplementation as an adjunct to treatment for depression in the elderly, as well as, recommended guidelines for Vitamin D supplement in Northern B.C. of around 2000IU daily. I will not change my practise from this as current research also seems to support a decrease in fall risk with supplementation.

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