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25-hydroxyvitamin D3 Blood Levels

25-hydroxyvitamin D3 Blood Levels. Calcium Absorption. Severely deficient < 8 ng/ml Deficient 8-19 ng/ml Insufficient 20-29 ng/ml Sufficient 30-49 ng/ml Optimal 50-99 ng/ml Excessive 100-150 ng/ml

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25-hydroxyvitamin D3 Blood Levels

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  1. 25-hydroxyvitamin D3 Blood Levels Calcium Absorption Severely deficient < 8 ng/ml Deficient 8-19 ng/ml Insufficient 20-29 ng/ml Sufficient 30-49 ng/ml Optimal 50-99 ng/ml Excessive 100-150 ng/ml Toxic >150 ng/ml 32 ng/ml PTH Levels

  2. Seasonal Variation in 25-hydroxyvitamin D Levels in People at Latitude 48° N Cannell JJ, etal. Epidemic influenza and vitamin D. Epidemiol Infect 2006;134:1129-1140.

  3. = 60 ngm 40? = 20 ngrams In Winter: < 15, for 5 months

  4. Published May 2009 AJCN

  5. Breast Cancer Mortality Rates and Contours of Annual Mean Daily Solar Radiation Lappe JM, etal. Vitamin D and calcium supplementation reduces cancer risk: Results of a randomized trial. Am J Clin Nutr 2007;85:1586-1591.

  6. Creighton U: AJCN June Cancer Rates Down RCT with primary objective reduction in Fractures over 25-30 years. Stopped after 5 years because 76% reduction in cancer in group. That had 1100 IU of D and 1 gram calcium. Weakness of study: all cancers bundled together. Lappe AJCN

  7. Journal Science: July 06 • Vit D Makes Your IMMUNE SYSTEM work better • Cathelicidin: Toll-Receptor Protein (autocrine effect) • Not released unless blood level of 32 ng • Enables monocytes (white blood cells that kill viruses and bacteria) to kill TB • Is this why we get colds and the flu in WINTER?

  8. Japan: April 2010 • Randomized Controlled Trial with Schoolchildren and Influenza • 19% rate of flu in normal immunized kids • Versus 10% in kids with Vitamin D • That’s almost a 50% reduction in flu rate • Sinai’s 2009 Vitamin D Campaign: • $ 30,000 ROI in just 3 months with swine flu (2400 employees)

  9. Intermountain Heart • May 2010 • Randomized Trial of Vit D and heart disease • Scheduled to run for 5 years • Cancelled after one year • 70% reduction in mortality in the Vit D controlled group • Good science: recommended that you aim for a goal of 43 ng! • (Presented at the meetings of the American College of Cardiology)

  10. Serum 25-hydroxyvitamin D3 Levels on 0, 1000, 5000, and 10,000 IU of Vitamin D3 a Day (80 ng/ml) 80 ng/ml 10,000 IU qd 60 ng/ml (60 ng/ml) 5000 IU qd 30 ng/ml (30 ng/ml) 1000 IU qd 0 Heany RP, etal. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr2003;77:204-210.

  11. Aurora Sinai Experience • My own data (last 6 months) • 100 consecutive patients admitted from ED to the hospital: typically elderly • Average D level 14 ngrams • Dosing in ED of 100,000 IU PO on admission • That will raise your level about 15 ng in two days 100,000 IU raises you 15 ngs Total cost: $ 2.00

  12. Loading dose of 10K/day for a month with 5 K a day thereafter. Vitamin D Levels In Wisconsin 2,000 IU a day: 20 ng higher With 400-600 IU/day: 4 ng  Without treatment: Caucasians range 20 in winter to 40 in summer

  13. Can I Overdose? • Maybe. Probably not! • A shot of 600,000 U (15 mg) once a year is safe • South Africa: 50,000,000 per person in family of 11. Some were confused. All normal within a week • Toronto: poisoning in the sugar bowl • Child with extra industrial supplement 10,000,000 a day • Slight risk of pancreatic cancer if levels over 50 ng

  14. Institute of Medicine: Dec 10 • Bone specialists from across America and Canada • Ruled on BONE HEALTH only: enough RCTs to justify increasing everyone to 600 IU a day • But 4000 IU a day is safe (doubling the prior upper limit)

  15. Getting Started: Loading Dose? • Recommend Loading Dose: 10,000 IU a day for a month • 100,000 IU single dose: 15 ng in 3 days, and lowers BP 14 mm Hg one month later • Prescription: 50,000 U a week for 12 weeks • Will get you to a level of about 40-60 ngms • Then: 4,000 IU the rest of your life

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