New Vitamin D Guidelines

Many Coeliacs and Gluten Sensitives malabsorb as part of the very nature of the conditions, and one of the key nutrients missing is often Vitamin D. My recent research putting together the TGF protocol shows just how important a nutrient it is to us and I shall write further about this no doubt at some point. Meantime, you can read my recent post on how to determine your Vitamin D levels and how much is enough on the Purehealth site.
I note today that The Endocrine Society has released a Clinical Practice Guideline on the evaluation, treatment, and prevention of vitamin D deficiency.
The new guidelines, which are to assist clinicians in treating vitamin D deficiency, were developed by vitamin D experts Drs Michael Holick and Robert Heaney along with 5 other scientists.
Key points from the report are:
  • a minimum blood level of 30 ng/mL is recommended and to guarantee sufficiency between 40 and 60 ng/mL for both children and adults
  • high risk groups should be screened for deficiency including; obese individuals, blacks, pregnant and lactating women, and patients with malabsorption syndromes
  • Screening should be performed using a reliable assay for 25-hydroxy-vitamin D (25[OH]D), not 1,25-dihydroxy-vitamin D (1,25[OH]2D), “which tells you nothing about vitamin D status” [see the correct Vitamin D test here. Ed].
  • Vitamin D deficiency is defined as 25[OH]D levels below 20 ng/mL
  • Supplementation at the suggested daily intake and upper tolerable level is recommended, considering that vitamin D deficiency is very common in all age groups and that few foods contain vitamin D
  • For bone health, infants and children up to 1 year of age require at least 400 IU/day vitamin D, and children 1 year and older need at least 600 IU/day, the guideline states. However, at least 1000 IU/day of vitamin D may be needed to raise the blood level of 25(OH)D consistently above 30 ng/mL
  • Adults aged 19 to 70 years require at least 600 IU/day of vitamin D to maximize bone health and muscle function. However, getting 25(OH)D levels consistently above 30 ng/mL may require at least 1500 to 2000 IU/day of vitamin D
  • Adults 70 years and older require at least 800 IU/day of vitamin D for bone health and fall prevention; at least 1500 to 2000 IU/day of supplemental vitamin D may be needed to keep 25(OH)D levels above 30 ng/mL
  • Pregnant and lactating women need a minimum of 600 IU/day of vitamin D; 1500 IU/day may be needed to maintain blood levels of 25(OH)D higher than 30 ng/mL.
  • Obese children and adults and children and adults on anticonvulsant medications, glucocorticoids, antifungals such as ketoconazole, and medications for AIDS need at least 2 to 3 times more vitamin D for their age group to satisfy their body’s vitamin D requirement
  • Tolerable upper limits of vitamin D, which “should not be exceeded without medical supervision,” include the following:
    o 1000 IU/day for infants aged up to 6 months,
    o 1500 IU/day for infants aged 6 months to 1 year old,
    o 2500 IU/day for children aged 1 to 3 years,
    o 3000 IU/day for children aged 4 to 8 years, and
    o 4000 IU/day for everyone older than 8 years.
  • 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
  • Both vitamin D2 and vitamin D3 are equally fine in treating and preventing vitamin D deficiency [not sure about this one – I would always advise D3. Ed]

    Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011 Jun 6. [Epub ahead of print] Source Nutri June 11

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2 thoughts on “New Vitamin D Guidelines

  1. Hi Micki,

    Just wondered what you consider to be the best way to raise your vitamin D levels if you have celiac disease?

    • Hi there. It would have to be something preferably grain and especially corn-free in an absorbable form and high enough dosage. Dosage should be determined by Vit D testing always and then re-tested 4 months later after the correct supplementation, then levels adapted.

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