Vitamin D Testing And Treatment – What You Need To Know
We recommend 1000–2000 IU/day unless you are working with a qualified functional medicine practitioner or nutritionist with regular testing in follow-up. If you are deficient, more than this will likely be necessary, but any supplementation above and beyond 2000 IU daily should only be done in conjunction with periodic testing and under the watchful guidance of a qualified healthcare professional. Again, if you have a serious medical problem, testing and regular follow-up will be needed.
Should I be worried about vitamin D toxicity? How can I prevent vitamin D toxicity?
For most otherwise healthy people who choose not to test for vitamin D levels, it’s generally okay to supplement with 2000 IU vitamin D3 (cholecalciferol) daily, at least between the fall through the spring months, and even in the summertime 2000 IU per day should be fine if you do not get unprotected sun exposure.
However, we do want you to be aware that there are some precautions regarding vitamin D supplementation. If you have any health condition that predisposes you to high calcium in the blood (hypercalcemia), you should not take vitamin D except under the watchful care of a healthcare provider. These conditions include but are not limited to:
- Hyperparathyroidism
- Granulomatous disease
- Sarcoidosis
- Lyme disease
- Lymphoma
- Kidney disease
It also includes anyone taking the diuretic known as hydrochlorothiazide (HCTZ), a “water pill” drug used to treat high blood pressure and fluid retention caused by a range of conditions, including heart disease.
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What are the symptoms of vitamin D toxicity? Can someone be just hypersensitive to vitamin D?
Rarely, an individual may ingest too much vitamin D, which puts them at risk for a reaction from vitamin D hypersensitivity or toxicity. But most people with vitamin D toxicity do not experience symptoms — which is why we do not at this time recommend using more than 2000 IU per day without regular testing and follow-up.
Symptoms of hypersensitivity may be dizziness, and signs of toxicity may include serious stomach upset, vomiting and excessive thirst. If a woman has any concerns or reactions suspected she should stop use immediately and contact the doctor.
The symptoms of too much vitamin D (hypervitaminosis D) are connected with the consequences of having too much calcium in the blood (hypercalcemia). This occurs once the kidneys’ ability to eliminate calcium is exceeded.
Note that this is not a common problem — thankfully, vitamin D toxicity is rare. Most healthy people would have to take a great deal of oral vitamin D before they would reach toxic levels. Here is a list of the clinical manifestations of vitamin D toxicity:
- Anorexia
- Weight loss
- Weakness
- Fatigue
- Disorientation
- Vomiting
- Constipation
At our clinic, whenever we prescribe more than 2000 IU vitamin D daily for a patient, we also prescribe regular retesting, and typically request that their blood calcium levels be checked at the same time, just so there is no question of toxicity. Please refer to the following schedule.