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011 – Vitamin D: The “Healthy Aging” Dose & FAQs

by Leslie Kernisan, MD MPH 10 Comments

011 – Vitamin D: The “Healthy Aging” Dose & FAQsLeslie Kernisan, MD MPH
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In this Episode:

Dr. K discusses her approach to vitamin D for healthy aging, including:

  • What dose of Vitamin D is likely right for most older adults
  • Why she believes that most older adults should take a vitamin D supplement
  • What experts such as the US Preventative Services Task Force and the American Geriatrics Society recommend
  • Dr. K also addresses many common questions people have about vitamin D, including:
    • What type of Vitamin D should I take?
    • Do I need to have my blood level checked?
    • Will Vitamin D really prevent falls or fractures?
    • Will Vitamin D really prevent dementia, cancer, or premature death?
    • If I’m outside a lot, do I need a vitamin D supplement?
    • What should one’s vitamin D level be?
    • Is a higher level of vitamin D better for you?

Related Resources:

  • Vitamin D: the Healthy Aging Dose to Prevent Deficiency & FAQs
  • Vitamin D Fact Sheet (for Health Professionals), from the National Institutes of Health Office of Dietary Supplements
  • Getting Enough Vitamin D in Later Life, from HealthinAging.org
  • Choosing Wisely: 5 Treatments You Should Question
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Comments

  1. Steve says

    December 6, 2020 at 11:38 AM

    Subject:
    question about Pairing of Vitamin D3 with Vitamim K2 (MK-7)

    A family member has strongly encouraging me to take Vitamin K2 (MK-7) with my daily intake of 1000 IUs of Vitamin D3 and I’ve read several articles. However, I’m looking for some definitive answer to whether this would be beneficial or not. I notice that most commercial products that combine the two contain as much as 5000 IUs of D3 + 100 mcg of K2. I’ve seen pairing of 1000 IUs of D3 with 45 mcg of K2).

    What do you know about this pairing of the two vitamins? Is there valid and reliable research that would support this? My doctor recently advised me to continue taking the 1000 IUs of D3 but has not said anything about taking it with K2.

    Reply
    • Nicole Didyk, MD says

      December 9, 2020 at 5:53 PM

      Thanks for the interesting question. Vitamin K does seem to play a role in bone metabolism, and some small studies, carried out mostly in Asia, have suggested that a person with a low Vitamin K level seem to have a higher risk for fractures. But there’s no good evidence to suggest that we should be advising Vitamin K supplementation as a mainstream treatment for osteoporosis. I would suggest to my patients to take Vitamin D and Calcium , if they’re not getting enough Calcium in their diet.

      Reply
      • HEATHER says

        June 23, 2022 at 6:56 AM

        I have read your article about vitamin d, and am very worried because my level is 76.77. i have been taking a multi vitamin which includes 10ug vitamin d3, which is apparently twice the required dose…
        I am a 79 year old female with Parkinson’s disease, so should I stop taking this supplement?

        Reply
        • Nicole Didyk, MD says

          July 1, 2022 at 10:53 AM

          It’s good that you’re thinking about your Vitamin D levels and having them checked.

          For the older adults that I see in my practice, 77 nmol/L is in the lower range of adequate, but it sounds to me like you’re on a low dose of Vitamin D supplement. 10 micrograms is about 400 IU (International Units) and we recommend taking at least 1000 to 2000 IU per day.

          A pharmacist might be able to tell you if you should add a Vitamin D tablet to your multivitamin to make sure you’re getting enough.

          Reply
  2. HEATHER says

    July 2, 2022 at 1:36 AM

    Thank you for that answer, but it conflicts with your comment ” is to caution patients if they are taking daily vitamin D supplements of more than 2000 IU/day in the absence of documented deficiency. I also discuss a reduction in vitamin D supplementation if a patient has a blood level greater than 50 ng/mL.”

    which is what prompted my query…

    Reply
    • Nicole Didyk, MD says

      July 30, 2022 at 4:22 AM

      Hello again Heather and please excuse the delay in replying to your comment!

      Currently, the National Osteoporosis Foundation and American Geriatrics Society recommend supplementation for those with vitamin D levels below 30 ng/ml or 75 nmol/L (I usually receive my patient’s lab results in nmol/L).

      There is some controversy in the literature and in the osteoporosis community regarding whether over-supplementation with vitamin D could actually increase the risk of fracture, or the risk of some types of cancer. You can read more about that here: https://europepmc.org/article/MED/30383226

      I would reduce Vitamin D supplementation in an individual with a Vitamin D level of 100 ng/ML or 250 nmol/L. At lower levels, there could be some risk of Vitamin D toxicity, although that is where the controversy comes in, and I would look at that on a case by case basis. You don’t mention the units of your lab results, but either way, it would be good to discuss with your doctor whether a reduction in supplementation is right for you especially if you’re worried about it.

      I hope that answer is helpful and thanks for persisting with your query!

      Reply
  3. HEATHER PARK says

    August 14, 2022 at 2:08 AM

    Thank you very much for your helpful reply, unfortunately I recently discovered that i have a calcified aorta, and looking up vitamin d3 and calcification results in hundreds of contradictory results, I am hoping that you can tell me if I should continue taking any vitamin d3 or not, and whether i should start taking vitamin k

    THE calcification was discovered through having a spinal x ray organised by a chiropractor and it is proving difficult to get referred to a cardiologist for appraisal. I hope to get referred within the next few weeks…

    Reply
    • Nicole Didyk, MD says

      August 14, 2022 at 5:32 PM

      I can understand your confusion about Vitamin D, Vitamin K and blood vessel calcification. There is a lot of data out there.

      As a Geriatrician, I follow the recommendations of the Bone Health and Osteoporosis Foundation and American Geriatrics Society for Vitamin D supplementation. This is 1000 units per day of Vitamin D for those over 50. If Vitamin D levels in the blood are below 30 ng/mL (75 nmol/L), higher doses may be needed.

      Right now, we don’t revise our recommendations based on the presence of blood vessel calcification. This may change as more research takes place.

      Remember that we can get Vitamin D from brief (15 minutes per day) sun exposure as well, and dietary sources.

      Reply
      • HEATHER PARK says

        August 17, 2022 at 5:19 AM

        Thank you!

        I would be very grateful if you could give me any advice about whether or not I should take vitamin K2…

        Reply
        • Nicole Didyk, MD says

          August 19, 2022 at 6:29 PM

          Hello and I apologize for not being more clear! Currently, we don’t recommend adding Vitamin K2 to Vitamin D supplementation, based on the best evidence available.

          Reply

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