Readers of this blog know that, in general, I’m in favor of healthcare professionals checking vitamin D levels as part of routine exams. I do this on all adolescents and adults. And, I’ve blogged more on the topic of vitamin D this year than any other topic. So, I’m trying to post less on the topic, but this and the next too blogs were too important not to mention to you.
The subject of this blog is based upon an abstract of an amazing study titled “Vitamin D Supplementation and Cancer Prevention.” It is authored by Thomas L. Lenz, PharmD, and published in the American Journal of Lifestyle Medicine (2009;3:365-368):
It is estimated that approximately 1 billion people worldwide have blood concentrations of vitamin D that are considered suboptimal.
Much research has been conducted over the past 30 years linking low vitamin D serum concentrations to both skeletal and nonskeletal conditions, including several types of cancers, cardiovascular disease, diabetes, upper respiratory tract infections, all-cause mortality, and many others.
Several observational studies and a few prospectively randomized controlled trials have demonstrated that adequate levels of vitamin D can decrease the risk and improve survival rates for several types of cancers including breast, rectum, ovary, prostate, stomach, bladder, esophagus, kidney, lung, pancreas, uterus, non-Hodgkin lymphoma, and multiple myeloma.
Individuals with serum vitamin D concentrations less than 20 ng/mL are considered most at risk, whereas those who achieve levels of 32 to 100 ng/mL are considered to have sufficient serum vitamin D concentrations.
Vitamin D can be obtained from exposure to the sun, through dietary intake, and via supplementation.
Obtaining a total of approximately 4000 IU/d of vitamin D3 from all sources has been shown to achieve serum concentrations considered to be in the sufficient range. However, most individuals will require a dietary supplement of 2000 IU/d of vitamin D3 to achieve sufficient levels as up to 10,000 IU/d is considered safe.
Vitamin D3 is available as an over-the-counter product at most pharmacies and is relatively inexpensive, especially when compared with the demonstrated benefits.
What am I doing in my practice? As mentioned above, I check a vitamin D level as part of my annual exam. I do this on all adolescents and adults.
If the vitamin D level is below 50, I suggest supplementing with vitamin D and rechecking.
I give my patients two options:
- OTC vitamin D, 2000 IU per day, and recheck the level in 4-6 months, or
- Prescription vitamin D, 50,000 IU per week for 12 weeks and then recheck the level.