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• January 17, 2009 7:58 p.m.

  My daughter (44)is low on Vit. D. She lives in Minnesota and works inside a large building with few windows. She is of the opinion that by sunning herself for hours in the summer she can store up enough Vit D to get her through the winter. Any comments?

  - Lenny Qua

• January 17, 2009 10:05 a.m.

  My oral/maxillofacial surgeon recommended 4,000 IU of vitamin D3 per day, along with 1,500 mg. calcium, because I have had six failed dental implants. The failure was due to the jawbone not bonding with the implants. After four months on this regimen, I now have one new implant. Time will tell whether or not this treatment has made a difference. I live in sunny Arizona and have been meticulous about wearing sunblock. At the very least, this regimen has made me feel much better psychologically.

  - Christine

• January 16, 2009 6:59 p.m.

  I've had knee pain for 2 years. When I walked up and downs the stairs it is painful. My new doctor tested me for my vitamin D level and it turned out that my level was 12. I am on 4000IU Vitamin D3 right now but so far my knees still hurt and know I have back pain. I have been taking topamax now for over 3 years. From what I understand it could be the topamax causing the deficiency, however I wasn't warned my the drug company, doctor, or pharmacy. Studies suggest that osteoporosis (brittle bone disease) and osteomalacia (softening of the bones) are potential side-effects of certain anti-epileptic medication. This is due to the reduction in the body's vitamin D, caused by these drugs, which in turn may lead to possible loss of bone mass. http://www.epilepsy.org.uk/campaigns/surveys/osteoporosis I wonder how much damage this drug has done? And I hope this Vitamin D kicks in soon.

  - lor

• January 16, 2009 12:37 p.m.

  For many with low vitamin D levels, chronic deficiency is a possibility. For this, ask you health professional to consider long-term supplementation of vitamin D3 at a low dose. Vitamin D2, the synthetic source contained in most prescriptions, is great for initial infusions, but not recommended long-term at high doses.

  - Bonnie Minsky MA, MPH, CNS, LDN

• January 14, 2009 1:57 p.m.

  After reading a lot about Vitamin D in the last month, I asked my doctor about it as I thought that might help explain why I am always so tired. I live in Alaska, so not much sun exposure, particularly in the winter. She tested my levels and found my level was at 12 when the reference range is 32-100. She is having me take 50000 IUs of Vitamin D once a week for 8 weeks to get my levels back to the normal range. Just started yesterday, so I don't know if I will have any side effects. I am hopeful this will work and know that I am probably going to have to take supplements regularly once I get my levels back to the normal range.

  - kac

• January 14, 2009 11:17 a.m.

  I was prescribed 50,000IU. of D/week when my level was <4. I have never felt better. My aches and pains have disappeared. I've had no side effects from this dosage. I live in Northern Minnesota and am allergic to the sun so I get no natural vitamin D whatsoever. After learning about the effects of D deficiency I was happy to give the supplement a try and I'm very glad I did. Hooray to my doctor who discovered the cause of my symptoms. I'll probably have to be on some sort of D supplement for the rest of my life. My doctor knows this and I am tested every three months for my level of the vitamin and so far I'm still too low to be comfortable. I'll keep taking the D and have no worries about any toxic affect as I haven't had any so far. Thank you.

  - Kathy

• January 14, 2009 9:23 a.m.

  A word of caution. My Dr prescribed 40K units twice a week to bring my Vit D level up. I experienced sever toxic reaction. extreme weakness, great pain, unable to lift my arms above my head. Unable to walk from room to room without feeling extremely weak. Discontined lg amounts of Vit D systoms went away?????? Any advice?

  - Kate

• January 14, 2009 9:15 a.m.

  I have been suffering with seasonal disorder for more years then I can remember. I dreaded the onset of winter and disrupted sleep. When I started taking a vitimin D supplement, It all went away. I have experimented with various dosages and found that 1400 IU is just right for me. I also found that the hard tablets upset my stomach while the gelcaps did not.

  - Paul

• January 13, 2009 6:17 p.m.

  I have chronic pain with from differnt types of neuralgia. Recent blood work showed a low level of vitamin D, so I am taking 50,000 IUs once a week. I've done this for 5 weeks now, and I can honestly say I've had more good days than bad and the pain is more managable.

  - Kelly

• January 13, 2009 5:57 p.m.

  I'm 82 and at an annual blood test my vit D level was within the desired range. However a specialist I attended said that people over 80 need to maintain a higher level. So he specified vit D supplement. This I took on a daily basis - but didn't lift the blood level to the required figure. About this time reports appeared suggesting that vit D intake above about 2,000 unit a week could be dangerous. My GP then said - 2 supplements a day for 5 days, one a day on weekends! I have yet to have another blood test so don't know the effect!

  - David

• January 13, 2009 5:29 p.m.

  My internist has been doing the Vitamin D testing in her practice now and the vast majority of patients have been coming back low. She said that many will be prescribed a Vitamin D prescription. Normal Vitamin D Level range is from : 31-80. Mine was shown to be 47. She said to keep on doing what I am doing. What I am doing is taking two 1,000 mg. of Vit.D per day. My range of 47 is about midway between 31 and 80, so I think I will increase my Vitamin D to at least one or two more a day. Vitamin D has been found to have so many healthy effects on the body; such as a cancer-fighting agent in many of the cancers. The Vitamin D issues were the big deal at the most recent medical seminars that the docs go to. In time, we will see Vit. D testing become a common test for everyone. I just wonder how much Vitamin D can be absorbed into the body at one time, but I will spread my intake throughout the day.

  - Gigi Freidman

• January 13, 2009 3:41 p.m.

  When I increased my vitamin D due to a deficiency, it greatly helped my SAD (seasonal affective disorder) symptoms.

  - Ellen

• January 13, 2009 3:33 p.m.

  I have osteoporosis and had been taking 1000 units of vitD for a couple of years. Now my Dr. said I could not be absorbing it after all this time. Have had blood work done twice and he said my Vit D is down. What could have happened?

  - Joan

• January 11, 2009 10:03 p.m.

  We have started checking vitamin D in some of our patients here and their levels of <10! And we are here in Sunny California. Two patients with asthma on chronic steroids had even lower levels. Make sure to take your vitD/calcium supplements! We have been giving some of them 50K IU daily and then rechecking their weekly vitamin D levels and they finally their levels increase. It's been an eye opener! I agree go to www.grassrootshealth.org for a vitamin D test.

  - S. LeBon RD

• January 10, 2009 1:43 p.m.

  I have a history of hyperactive thyroid, diagnosed at age 46, I am now 54 and take synthetic thyroid hormone. Three years ago, I was diagnosed with osteopenia. My stomach can't handle Actonel/Boniva - type drugs, and approx. 18 months ago, my endocrinologist prescribed 50,000 IU of Vitamin D every two weeks plus ~ 1,000 mg of calcium a day as an alternative for the osteopenia. After a year, a bone density scan showed a small improvement. I have not experienced any signs of toxicity, and believe my immune system is stronger overall as well. I'm hoping this won't turn out to be a mistake, it sure beats those osteo drugs - ugh!

  - Jen in AZ

• January 10, 2009 3:41 a.m.

  Thank you all, I am going to Holland and Barrett straight away and I shall get myself equiped with the relevant pills. As I am 1.55 m and weigh 54 kg I think I should start with 1000 IU. I forgot to mention that I am 70, very active and in excellent health thanks to the Mayo Clinic advise on diet and exercise.

  - Martha Aitchison

• January 9, 2009 10:45 p.m.

  Great discussion – living at northern latitudes in the winter, darker pigmentation, skin protection, being pregnant, or a breastfed infant are all factors that put you at risk for vitamin D deficiency. And for that reason, consider supplementation. The current tolerable upper limit is 2000 international units. If you are taking higher doses, toxicity happens over a period of time. Talk to your doctor about higher level intakes, duration of supplementation, and follow up on your blood levels. Thanks for your postings.

  - Katherine, your blog host

• January 9, 2009 9:33 p.m.

  Exactly because there are so many variables on absorption of D, a one-size-fits-all recommended daily intake is, frankly, ridiculous. One variable the article left out, for instance, is skin color. In all studies over the past 50 years, the average D level is much lower for people of color, aside from any other factor. As interviewed on NPR, Dr. Douglass Bibuld at Boston's Mattapan Community Health Center prescribes up to 7000 IU of D to certain patients, based on their test. There is no way to get that much from milk or even the typical one-a-day. Knowledge is power. The way to find out what your own supplementation rate should be is to get a 25-OH-D test. The optimum level is 50 to 60 ng/mL. If the test shows your level is, say, 30 ng/mL (better than most Americans), then you need to gain 20. One rule of thumb is to multiply the gap by 150 IU, which in this case would be 3000 IU a day. For comparison, Canadian pediatricians advise nursing mothers to take 6000 IU (the amount needed before D spills over into breastmilk). Dr. Anthony Norman, who 40 years ago discovered that D is a hormone, and 17 other U of California scientists, advises 2000 IU a day. So clearly, the 600 IU mentioned in the article is inadequate. Luckily, there is now a reliable home test. This 'blood spot' test is so much easier for babies and children, not to mention squeamish adults. Go to grassrootshealth.org and click on "Join" to get one. It hurt less than pulling a splinter.

  - Lauren Ayers

• January 9, 2009 8:24 a.m.

  Martha You will not make any vitamin d if the UV index is less than 3. So in London you will get no vitamin d from the sun until at least April. The only way to get a reasonable amount of D3 in the winter is in tablet form, food has too little. Researchers seem to think that about 1000IU of D3 for each 25lbs of body weight is a good start. Take a look in your health food shop (my D comes from Holland & Barrett). I have taken 6000IU (I weigh 100Kg) for 2 years with no toxicity, but I get less colds, gum infections and I get to keep my tan over the winter without sun exposure.

  - Pete

• January 9, 2009 8:09 a.m.

  Hi, Former Mayo fellow here. Heme/Onc. Live in Boston. Due to profession and not wanting to fry my skin, avoided sun assiduously, used sun hat, sunscreen. Took standard multivit, and a D + Ca++ supplement religiously (lactose intolerant). Not enough in retrospect. Then, one late Winter (exercise a lot, BMI 19, no other health issues), broke 5th metatarsal walking. Slow to heal. Again next winter, this time the fourth meta. Diagnosed with osteopenia, took 50,000 D2 every 2 weeks for one year; now on 6 to 8 thousand IU per day plus Ca++ ~1800 to 2400 mg / day for the last 3 yrs; drink lactaid too. Osteopenia stable. Fractures a thing of the past. I feel great. No foot/back pain/ better all around. A study in submariner men under water for 3 months (as i recall) showed that they consumed about 6000 or so IU / day. Lifeguards get 20 to 30 K in the sun. I have had stable Ca++ levels, high normal D levels, normal renal function, etc. I think the "toxicity" due to D is highly exaggerated due to outdated literature and beliefs. More studies needed obviously. The newest recommendations I think are best: adults w/no other health issues 1000 to 2000 IU/day. Sensible sun exposure too. If you start such a regimen, always good to check a Ca++ and Vit D level before and about 6 months later. L

  - Lou Vaickus MD

• January 8, 2009 6:19 a.m.

  I live in London, England, it is Winter so when I go out the only bits exposed are my face and hands, I am of Italian origin so my skin is very pale but does not burn easily, I do not use sun screen in Winter. Is 10 to 15 minutes out of doors around midday enough to get the Vit D I need?

  - Martha Aitchison