optimum daily dose of Vit D long term

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Hi Here is my story following a wrist fracture in March 2012 I had a dexa scan and was found to have osteopenia.  Bloods test showed low vit D 39

and calcium levels fine.  My gp started me on 2,200 iu per day after 1 year my levels were around 70.   At my next yearly routine blood tests the level had gone up to over 100.  My gp said that this was a little high and half the dose which I did taking it every other day.  In the meantime my surgery made a policy not to prescribe vitamins etc on the NHS so I started buying the same make of vitamin D.  Fast forward to last year when I received a letter from the surgery after yearly blood tests to say that I was low on Vit D and the doctor suggested I buy 1000i.u to take daily.  I then of course had to inform the surgery that I already took that doses.  I then saw the doctor who said that the level was around 50/60 if I remember but they would like it a little higher so to go back to 2,200 unit dose.  I am thinking this is because of the osteopenia and because I have arthritis.  What do others think and what dose it too much.

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  • Posted

    You do need to be careful not to take too much vitamin D as it can cause problems. 39 is low, but the NHS are now saying vit D should not be prescribed if reading is over 25, people should buy it over the counter. I should follow the dose suggested on the box. You can always ask your pharmacist as they are usually very helpful. My blood test results say that normal minimum is 60, although others have said it should be 75. Sitting out in the sun also helps your vitamin D intake. 
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    • Posted

      Thanks for your reply.  I think I might ask my pharmacist also my gp although she seems to think 2,200 iu of vit d3 is fine.  The bottle says 1 a day which is what I take in the evening with my meal.
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    • Posted

      I should follow what the bottle says. I take 800 iu a day. I had a reading of 26 but it has now gone up to 62, I also lie out in the sun whenever possible.
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  • Posted

     Vitamin D levels (Serum 25-OHD concentrations) between 50-75 nmol/I are considered healthy.

    Optimal vitamin D status is when serum concentrations of 25-OHD are 75 nmol/L (30 micrograms/L) or more.

    I suggest you lower your dose and go for 800IU a day for maintenance therapy and prevention, not deficiency - as you are not deficient.

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    • Posted

      Hello thank you for your reply.  As I mentioned in my original post I had my dose reduced by my GP from 2,200 i.u. to 1,100 daily. After 1 year my levels had gone down from around 100 to 50/60 I cannot remember the exact figure.  My GP said although this level was normal they wanted mine a bit higher so I was asked to go back on 2,200 daily.  My next routine blood tests will be around April then I will know if it has shot up again.  As mentioned I have ostepenia,osteo arthritis and other problems and am on various medications. I would have stayed on the lower dose  but it was the doctor who told me to increase it again.

       

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    • Posted

      Provided you have blood checks to ensure that your vit D level is not getting too high you should be OK. You really do not want to get vitamin D toxicity. Which vitamin D tablets are you taking? 
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    • Posted

      libralady13 >>> that's fine then... taking 2,200 IU daily.

      Fact:The body produces 10,000 - 25,000 IU's a day when exposed to the sun and we all know the sun is the best way to get vitamin D naturally, but not in this country or recent weather... so especially during Winter, you need to take supplements otherwise your levels will drop and the effects are manifested with feelings of depression as well as pains in joints and bones.

      Like you, I have arthritis and recently been diagnosed with Osteomalacia (adult Rickets). My vitamin D levels are 5nmol/litre (perhaps even lower now as they were checked in May and I've been on steroids since) and I had to beg my GP and consultant for some vitamin D supplements. My GP prescribed a low dose - 88 IU a day which weren't enough, nor were they vegan, so I procured my own and am taking 10,000IU a day now, from starting with 5,000 a day last week. I still have severe pain all over and am waiting for a Rheumatology appointment - in about 14 weeks (long waiting list). There was no way I was going to wait that long and suffer with just 800IU a day.

      I hope your wrist has healed well and there remains no permanent scarring. Osteopenia just means or low bone mass which could lead to Osteporosis if not treated. You're going to be okay in the hands of your concerned GP who has corrected your dosage and is keeping an eye on your levels. x

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    • Posted

      Vitamin D toxicity is rare, especially if only taking supplements of 2,200IU (international Units) a day = 15,400 IU a week. The body makes 10,000 - 25,000 IU's naturally when exposed to the sun... 
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    • Posted

      Hello Thanks for your reply.  I will probably be due for another dexa scan in the next year or so to check my bone density again.  

      Thank you for asking after my wrist.  Yes it has healed well although slightly mishapen it still works as it should.  I do get odd pains in the arms but I have neck spine and knee arthritis so I do expect it.  Generally speaking my arthritis is improved maybe because I have gone back on the higher dose of Vitamin D3.

      I am sorry to hear you are in so much pain.  I hope the Rheumatology will be able to help you.  Yes 14 weeks is a long time to wait.  I waited ages for my appointment for my knees.  By the time it came through the really bad pain which had kept me housebound was much improved.  I hope to avoid knee replacements at least for a while.

      Good luck with your appointment.

      Take care.

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  • Posted

    Vitamin D deficiency:

    Individuals with symptomatic osteomalacia or rickets have serum 25-OHD concentrations of less than 25 nmol/L (10 micrograms/L).

    A much larger proportion of the UK population have vitamin D insufficiency, with serum 25-OHD concentrations between 25 nmol/L and 50 nmol/lL(10-20 micrograms/L).

    Serum 25-OHD concentrations between 50-75 nmol/I are considered healthy but optimal vitamin D status is when serum concentrations of 25-OHD are 75 nmol/L (30 micrograms/L) or more.

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    • Posted

      Interesting discussion. I've recently been diagnosed with low Vit D and my GP said it was 22. After 3 months on 800iu dose of Vit D I went back and it's up to 55 so she said that was fine...."we like it to be over 40". Considerjng we have passed throug the sunniest months of the year and i do spend alot of time outdoors i asked if she was happy id maintain levels over winter and she simply offered me the chance to be retested should i get concerned and advised i can buy it over the counter if i want. Now I'm reading the figures on here and mine still seems in the low range BUT am I comparing like with like? I'm totally confused to be honest.

      It's also only since reading on here that I know there's an NHS policy of not prescribing Vit D on an ongoing basis.

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    • Posted

      Yes I am just as confused.  My Gp prescibed the higher dose in the summer of 2012 as a dexa scan revealed osteopenia and also the osteo consultant said that I should be on Vit D because I have arthritis.  I continued to have repeat prescriptions until one day it was deleted so then I had to buy to buy them myself.  As for what the level should be I can only think they want mine higher because of arthritis and osteopenia.

       

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    • Posted

      Andrea, I have seen that some NHS areas of UK say that you buy your own vit D if you have a reading of over 25. I am sure it varies from area to area however, like everything else seems to. Mine was 26 and my rheumatologist said I could buy vit D from Holland and Barrett! 
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