You’re likely hearing a fair bit of controversy over the Institute of Medicine’s (IOM’s) new recommendations (RDA) for vitamin D and calcium. I first reported on this in my blog, “Institute of Medicine says megadoses of vitamin D, calcium unnecessary.”
The IOM calls for MORE vitamin D and LESS calcium … but many experts say the vitamin D doses are still not high enough.
The new RDA is:
But these RDAs are based ONLY on the amount needed to prevent bone problems, such as rickets, osteomalacia, osteopenia, osteoporosis, and fractures.
Higher amounts of vitamin D are associated with a lower risk of falls, cancer, heart disease, autoimmune disorders, etc. But the RDA is not set higher because the IOM feels there’s not sufficient proof of these benefits.
The experts at Prescriber’s Letter (PL)are telling healthcare professionals, “Recommend 400 IU for infants, 600 IU for kids, and 800 to 2000 IU for adults. The higher adult dose is safe and may provide extra benefits.” I’m with Prescriber’s Letter on this one. I concur with the new guidelines from Osteoporosis Canada recommending 1000 IU/day for adults under age of 50 and 2000 IU/day for adults over 50.
PL goes on to say, “Discourage adults from taking over 4000 IU/day without monitoring. Consider vitamin D testing for people likely to be deficient due to advanced age … dark skin … limited sun … malabsorption … etc.”
As I’ve told you before (Vitamin D Supplementation and Cancer Prevention): 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 30, I suggest supplementing with vitamin D and rechecking.”
I give my patients two options:
PL recommends, “Aim for a serum 25-hydroxyvitamin D level above 20 ng/mL for bone health … but below 60 ng/mL until more is known about the long-term safety of higher levels.” In my practice, we’re aiming for levels of 30 to 50 ng/mL.
The new RDA for elemental calcium is:
PL says, “Advise people not to get carried away with calcium supplements. Recommend not going over 2000 mg/day from food AND supplements for adults over 50. Too much calcium FROM SUPPLEMENTS might increase the risk of kidney stones and POSSIBLY heart attacks.
You can read more in my blog, “Can Calcium Supplements Cause Heart Attacks?“