New study recommends 2000 IU daily vitamin D supplementation

4 minutes, 51 seconds Read


In a recently published narrative review nutrients, Researchers discuss the reasonable evidence for the efficacy and safety of 2000 international units (IU), i.e., 50 micrograms (µg) of vitamin D supplementation per day for the prevention and treatment of vitamin D deficiency in the general adult population.

Study: Vitamin D supplementation: a review of the evidence supporting a daily dose of 2000 international units (50 µg) of vitamin D for adults in the general population.  Image credit: FotoHelin/Shutterstock.comStudy: Vitamin D supplementation: review of evidence supporting a daily dose of 2000 international units (50 µg) of vitamin D for adults in the general population. Image credit: FotoHelin/Shutterstock.com

Background

Vitamin D deficiency has many adverse clinical consequences, including manifestations such as poor muscle health, rickets, and osteomalacia.

Furthermore, vitamin D may be important for the prevention of extra-skeletal diseases such as cancer and diabetes.

Vitamin D is biologically inactive in the human body; Thus, in laboratory detection of vitamin D deficiency, they measure serum concentrations of 25-hydroxyvitamin D (25(OH)D), a vitamin D metabolite that is used by the body and reflects the overall supply from various sources, including ultraviolet-B. . ) and food sources, such as sunlight or fish or mushrooms.

Globally, the prevalence of low serum levels of 25(OH)D, i.e., 25–30 nmol/L and below 50 nmol/L, occurs in ~5–18% and 24–49% of people, respectively, emphasizing the need . To take rapid action to reduce the burden of vitamin D deficiency worldwide.

At a dose of 50µg per day, the entire 25(OH)D distribution of a given population may rise to elevated levels; However, there are safety concerns with such a dose as it may increase the risk of vitamin D overdose for individuals at the high end of the distribution.

Furthermore, given the skeletal health implications of excess vitamin D, it is crucial to focus on achieving the 25(OH)D levels necessary to prevent them, rather than safety concerns, to aim for 75 nmol/L (30 ng/mL). Optimal target serum 25(OH)D concentration for skeletal health.

Thus, researchers additionally investigated whether achieving serum 25(OH)D levels ≥50 nmol/L should be the goal.

Current vitamin D supplementation guidelines

Guidelines for vitamin D intake establish serum target 25(OH)D concentrations and recommend doses necessary to achieve those levels, assuming adequate intakes of other nutrients and season (winter or summer).

Accordingly, current guidelines recommend a daily vitamin D intake of 400–800 IU; However, individuals of different races or regions may require higher intakes of 2008–2672 IU to achieve serum levels of 25(OH)D ≥50 nmol/L.

What should be the target serum 25(OH)D level: 75 nmol/L (30 ng/mL) or 2000 IU (50 µg)?

While many observational studies suggest that serum 25(OH)D levels ≥50 nmol/L can prevent rickets and osteomalacia, concentrations ≥75 nmol/L are required for improved health outcomes in diabetes and cancer.

The optimal concentration required may also vary depending on the study population and outcome of interest.

Further, the authors noted that randomized controlled trials (RCTs) testing 25(OH)D requirements may be biased toward healthy people who may not accurately represent the general population, particularly those with obesity.

In fact, the optimal serum 25(OH)D concentration for most chronic diseases is slightly above 75 nmol/L (30 ng/mL).

Thus, obese individuals, individuals with a higher body mass index (BMI), and patients with malabsorption syndromes may require higher doses of vitamin D to increase their serum 25(OH)D levels.

Some may not meet the threshold even after 2000 IU vitamin D supplementation daily, such as patients with inflammatory bowel disease during episodes of high disease activity.

Even drugs, such as antiepileptic drugs, can influence low serum 25(OH)D concentrations by modulating its metabolism.

When serum 25(OH)D concentrations exceed 150 ng/mL, vitamin D toxicity may lead to hypercalcemia; Thus, doctors advise caution for those taking vitamin D supplements.

Recent RCTs such as the Vitamin D and Omega-3 Trial (VITAL) collected safety data on the use of 2000 IU vitamin D/day in a general adult population who showed no signs of vitamin D toxicity for 5.3 years, indicating the safety of this daily dose.

Furthermore, a meta-analysis of 15 vitamin D RCTs found no increase in kidney stones when supplemented with ≥70 µg vitamin D for at least one year.

Another meta-analysis found that daily vitamin D supplementation of 3200–4000 IU for six months increased the risk of hypercalcemia, hospitalization, and falls; However, this did not occur in patients with chronic kidney disease.

Conclusion

Adherence to a conservative dosing regimen of no more than 800 IU (20 µg) of vitamin D per day may not adequately cure vitamin D deficiency, given the interindividual dose-response variability and multiple clinical factors attributable to, e.g. obesity, malabsorption. syndrome, and drugs that interfere with vitamin D metabolism.

This review revealed that daily vitamin D supplementation is more effective than intermittent bolus doses in adults. However, caution is needed for the elderly and sick, who are more prone to the adverse effects of vitamin D overdose.

In real-world settings, clinicians should consider tailoring vitamin D dosage to patient needs and characteristics.

Instead of following a ‘one-size-fits-all’ approach, they can adopt a personalized treatment approach and prescribe a dose range from 800-2000 IUs (20-50 μg).

This is a narrative review lacking a pre-registered systematic review. Nevertheless, based on the evidence described in this review, the authors argue for a daily vitamin D supplement dose of 2000 IU (50 µg) to increase and maintain serum 25(OH)D concentrations >50 nmol/L (20 ng/). mL) and >75 nmol/L (30 ng/mL) in >99% and >90% of the general adult population, respectively.

Furthermore, they found no significant safety concerns with supplementing at such doses for several years, even in individuals with adequate vitamin D status at baseline.

This could be the perfect remedy to combat the vitamin D epidemic in the general adult population.

Journal Reference:



Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *