1183618 tn?1277365106


By Darlene Varaleau


Non-compliance (failure to take medications) is common both with prescription drugs and vitamins. Pharmaceutical companies and researchers often seek to address this problem with a "one shot a year" approach to osteoporosis medication and occasionally with vitamins.

In 2010, professors at the University of Melbourne reported results of a study involving 2,256 women (aged 70 years or older and considered to be at high risk of fracture) who received an annual dose of 500,000IUs of D3 supplements for three to five years. They were surprised that the recipients of this high dose vitamin D regime had 26% more fractures and 15% more falls than the placebo group. Treatment of non-compliant people with mega doses of vitamin D does not seem to be the solution....as suggested by earlier research that lower doses ingested daily produce the best results.

There are a number of diseases for which vitamin D supplements can cause elevated blood calcium and possibly compromise the immune system. In these cases, supplements should only be taken under the supervision of a knowledgeable doctor.

The Vitamin D Council advises that most healthy people can receive 5,000-10,000 IU of vitamin D3 a day without harm. But high dose vitamin D must be accompanied by sufficient calcium and magnesium...and people with certain diseases should only take supplements under the supervision of a knowledgeable doctor. Vitamin D is essential for the absorption of calcium and the prevention of osteoporosis. Recent studies have shown that it may also boost the immune system and help to prevent cancer.

Our body will automatically regulate how much vitamin D it produces from sunshine. Studies show that sunbathing in the summer for about 30 minutes can result in the production of over 10,000 IU of vitamin D and that once our skin makes about 20,000 IU, the ultraviolet light begins to degrade the vitamin so that we do not "overdose" on the sun. Vitamin D expert Dr. Vieth reports that there is no practical difference between vitamin D acquired from the sun and that acquired from food and supplements.

The Vitamin D Council reports that doses of 5,000 IU per day from all sources (sun, diet and supplements) are safe for most healthy people and that there are no reports of toxicity up to 10,000 IU per day. But the Council also warns that without calcium and magnesium in sufficient quantities, vitamin D supplementation will withdraw calcium from the bone and will allow the uptake of toxic minerals. As everyone metabolizes vitamin D differently, the best way to identify the optimal level of supplementation is to adjust the dosage to maintain target blood levels. The Vitamin D Council recommends that optimal health is supported by blood levels of 50-80 ng/mL (125-200nmol/L) as identified in a 25(OH)D vitamin D blood test.


High dose vitamin D treatment is broadly accepted in the medical community for people who are suffering from a severe deficiency but are otherwise in good health. There are two views on the best way to receive high dose vitamin D. The most common form of high dose vitamin D in the US is a prescription form of ergocalciferal also known as vitamin D2. But as vitamin D2 is less potent than vitamin D3, many doctors now recommend high dose vitamin D3 which can be purchased in a health food store or on-line.

VITAMIN D2 (50,000 IU/week)

Dr. Michael Holick of the Boston University School of Medicine recommends high dose vitamin D2 treatment for people whose 25(OH) blood levels are below 10 ng/mL (25 nmol/L). He proposes an oral dose of 50,000 IU/wk of vitamin D2 for 8 weeks followed by another blood test to check serum levels. If the levels are still inadequate, another 8-week course of 50,000 IU/week may be prescribed until blood levels reach 30 to 50 ng/mL (75-125 nmol/L). Once these target blood levels have been attained, patients prone to developing vitamin D deficiency may be encouraged to take 50,000 IU of D2 every 2 weeks to sustain their blood levels...or 1,000 IU a day of vitamin D3. He also suggests that exposure to direct sunlight for 5-10 minutes on the arms and legs between 10am-3pm during the spring, summer and fall can prevent further deficiency.

Ergocalciferol is available to U.S. doctors in prescription strength of 50,000 units in the brand names of Drisdol and Calciferol. As it is derived from plants rather than animals, ergocalciferol is considered Kosher.

VITAMIN D3 (4,000 IU/day)

Dr. Vieth (Mount Sinai Hospital in Toronto Canada) recommends that vitamin D3 is the preferred choice for supplementation. In 2001, a study involving 61 healthy men and women resulted in healthy increases in blood levels following daily intake of 4,000 IU of vitamin D 3-without an increase in blood calcium or urinary calcium excretion. After 2-5 months, the blood levels of participants increased to a range of 28-50ng/ml (69-125 nmol/L). Dr. Vieth has proposed a rule of thumb, that 4,000 IU of vitamin D3/day will increase 25(OH)D blood levels by 100nmol/L (40ng/ml) after 8 months of use and that any surplus vitamin D will remain in the body for approximately 2 months.

Dr. Vieth recommends a daily dose of 4,000 IU/day in order to maintain blood levels above 100nmol/L. He also clarifies that published cases of vitamin D causing elevated blood calcium (hypercalcaemia) have involved daily intake of 40,000 IU. Hypercalcaemia due to excessive vitamin D is generally accompanied by blood concentrations greater than 88ng/ml (220 nmol/L).

Dr. Vieth also suggests that high and infrequent dosing may result in blood level fluctuations without producing sustainable improvements in blood levels. Intake of lower doses of 2,000-4,000 IU daily rather than 100,000 IU once a month are more likely to produce the desired results.


Calcitriol is a steroid that is produced after vitamin D passes through the liver and kidneys. The Vitamin D Council warns against treating vitamin D deficiency with calcitriol (or its analogs) as it poses risks of hypercalcaemia (high blood calcium) and fails to replenish the body's stores of vitamin D.

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Hope this help
9 Responses
Avatar universal
You are our leader and, yes, this helps greatly. I agree with Dr Veith. I'm currently taking 3000 IU D3 daily in divided doses to maintain a steady state. However, I'm afraid I'm one of those people in whom vitamin D unmasked another problem. My calcium levels are fluctuating within normal range but an ultrasound revealed benign colloid nodules on my thyroid. I'll be seeing an endocrinologist Wednesday about this. My D levels went up to 27 then down to 24 -- it's very frustrating but I feel that slow and steady 3000-5000 IUs a day gel caps are the way for me to go with the supplements. I'd read the articles on the 500,000 IUs and felt it was ill-adviced to mega dose to that extent -- no wonder there were falls. I'm passing the artilcle you sent along to others with D deficiency. Thanks again Phyllis
Avatar universal
I just came across this article recommending that vitamin d is most effective when take with the largest meal of the day...http://www.realage.com/tips/take-your-vitamin-d-at-this-time?eid=7210&memberid=28729800
1183618 tn?1277365106
Thank's phyllis for the article.
681148 tn?1437661591
I actually went through that treatment for severe deficiency.  I agree that those 500,000 iu/year is not sensible.  It's better to space out the amount one is taking at a safer dosage.  My doctor monitors mine.  She freaked when I told her how much I was taking.  Guess what?  My level is still well below 50 and the Vitamin D Council recommends optimal level of between 50 and 80.  

My neurologist wants me to take my magnesium for migraine prevention separately from the calcium instead of taking them together.  No problem.  The vitamin D will still be in the system through the day after taking it with the magnesium.  Just taking the calcium an hour or two later is good enough.
Avatar universal
I was initially taking Vitamin D2 1000 UI. As advised by bisan, I spoke with my doctor about increasing the dosage back in June. But he said he does not want to increase the dosage so quickly. I was initially taking Vitamin D but then I read somewhere that Vitamin D3 is much effective than Vitamin D. So I changed the medicine. I also was exposing myself to the sun in addition to taking the Vitamin D3.
It's been 3 months now and my vitamin D levels have increased from 10.6 to 24.3.
My doc now increased the dosage to 2000 UI per day. My ringing has also reduced pretty much....it is still there.
I am also taking ayurvedic medicine for the ringing and it is helping me.
I hope to get rid of the ringing pretty soon.
867582 tn?1311627397
Dear Bisan,

I am older and not in good health.  My MD wants me to take 50,000 units of vitamin D twice a week until my levels come up.  Then he wants me to take 4,000 units a day.I am afraid of liver damage or having a bad reaction to the 50,000 units.  I am considering just taking 50,000 units once a week rather than twice.

What is your opinion?

867582 tn?1311627397
Dear Bisan,

Sorry, I missed your response to my earlier similar question (just read it after posting the above) so thank you for your response and kindly just disregard the above.

1821369 tn?1317310916
So amazed to find that many Vitamin D deficiencies went unrecognized for so long.  I was glad to find information about recommendations for dosage for deficiency.  I have had Vit D problems sine I acquired a weird illness while camping in 2007.  I saw a gastro doc that tested for many things. some of which involved vitamin status.  It seems as if I have some sort of malabsorption problem as my fat soluble vitamins are low, particular vit D.  Last test was 10 last week.  I was put on 50,000 for 6 weeks and have taken my first dose last Friday.  This amount seemed extreme, but after reading your post it makes sense.  I am to be retested at 7 weeks to see if this helped.  Have not felt any symptomatic relief yet though.  Then again, not sure if my symptoms are all related to Vit D??  

Thanks for taking your time to post this valuable information.

681148 tn?1437661591
Are you taking the magnesium supplements, too?  Most of us are actually deficient in magnesium, too.  The RDA is actually rather low.  As with vitamin D, though, let's not get silly.  It doesn't help to go overboard with anything.  Usually, you should take equal magnesium and calcium.  However, it is best to take the magnesium in the morning with your vitamin D and the calcium at night.  And, this is per my neurologist's instructions.  The simple explanation is that the body functions that utilize the calcium deplete the magnesium and vice versa.  If you have issues with migraines and digestive issues, you generally need more magnesium than the RDA.  T

he best way to understand the RDA is that it is usually the minimum amount that a person should take, not the maximum.  And, we have to go by what our own bodies need, too--not what the FDA says.  For some, it's as if everything the FDA is absolute truth.  Really?  I think it's safe to say those of us on this forum know that one has to take what they say with a grain of salt, since they don't even jive with what the Vitamin D Council or Dr. Mercola have been telling people in an effort to get the word out.  Then, too, consider all the drug recalls and you realize that the best way thing to say is that the FDA really doesn't know it all when it comes to keeping us safe as well as healthy.  They're not totally evil, but we are better off taking what they say about the RDA of the basic nutrients with a grain of salt.
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