July 19, 2024

Health Supplements

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New Guidelines Highlight Who Should Be Getting More Than the Recommended Vitamin D

4 min read

Key Takeaways

  • Vitamin D deficiency is common.
  • New proposed guidelines suggest that testing for vitamin D deficiency before supplementation may not be necessary.
  • Children, people over the age of 75, pregnant people, and those with prediabetes should take in vitamin D at a dose that exceeds the current Recommended Dietary Allowance.
  • Other groups of people should not exceed the daily recommendation of 600 IU unless they have an underlying condition that suggests otherwise.

Over 40% of American adults are deficient in vitamin D. But how do you know when you actually need to take a supplement?

That guidance is still lacking, a panel of clinical experts agreed. Together, they teamed up to establish clinical practice guidelines for the Endocrine Society, which they published earlier this month.

After evaluating randomized placebo-controlled trials, the researchers determined several groups need more vitamin D than the Recommended Dietary Allowance suggested by the National Institutes of Health (NIH), which is 600 IU or 15 mcg for people between the ages of 1-70:

  • Children and adolescents aged 1 to 18 years in order to prevent nutritional rickets and lower the risk of respiratory tract infections
  • People 75 and older to reduce mortality risk
  • Pregnant people in order to reduce preeclampsia risk, pregnancy loss, preterm birth, and low infant birth weight
  • People with high-risk prediabetes in order to prevent progression to diabetes

The researchers did not suggest an ideal dose of vitamin D for any of these groups; they only indicated these people need more vitamin D than current dietary guidelines suggest.

Low vitamin D levels are linked to many negative health outcomes, including issues related to bone health, heart health, and immune health. Still, the endocrinologists recommended against regular screenings for vitamin D deficiency for the general population, concluding the risk of over- or under-diagnosis is too great given the lack of clarity about what vitamin D levels should be in the first place.

The authors note that these suggested vitamin D recommendations are not meant to replace the current Recommended Dietary Allowance for the general population. Nor do these guidelines apply to people with established indications for vitamin D treatment or testing, like people with kidney disease.

How to Support Healthy Vitamin D Levels

Based on these new suggested guidelines, children, pregnant people, those over the age of 75, and those with high-risk prediabetes should consider supplementing with vitamin D at a dose that exceeds the Recommended Dietary Allowance, ideally under the guidance of a healthcare provider. For all others who don’t have a medical condition that dictates otherwise, supplementation to help meet the currently recommended dosage of 600 IU/day is suggested. (For people older than 70, that recommendation increases to 800 IU).

When choosing vitamin D supplements, some data suggests opting for vitamin D3 as opposed to vitamin D2 in order to increase levels faster.

Edwina Clark, RD, a California-based dietitian who was not involved with the research, agrees with the Endocrine Society’s findings that while existing guidance is helpful, vitamin D recommendations should really be tailored to the individual. She also emphasizes that the proposed new guidance does not recommend mega-dosing on vitamin D.

“Consuming too much supplemental vitamin D can be toxic and even fatal,” Clark told Verywell. “Symptoms of vitamin D toxicity include loss of appetite, nausea, vomiting, muscle weakness, confusion, dehydration, thirst, kidney stones, and eventually calcifications of tissues and organs.”

There aren’t many food sources of vitamin D, but a few items can help you meet your needs, including:

  • Rainbow trout
  • Sockeye salmon
  • Mushrooms
  • Fortified orange juice
  • Dairy milk
  • Fortified plant-based dairy beverages
  • Fortified breakfast cereal

“Fortified breakfast cereal now contains [up to] 20% of the daily value for vitamin D, making it an affordable and convenient option to add to your family’s routine,” Elizabeth Shaw, RD, told Verywell.

What This Means For You

New proposed guidance says you don’t need testing for a vitamin D deficiency. If you fall into certain age groups, are pregnant, or have prediabetes, talk to your doctor about starting a vitamin D supplement.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cui A, Xiao P, Ma Y, et al. Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001-2018. Front Nutr. 2022;9:965376. doi:10.3389/fnut.2022.965376

  2. Demay MB, Pittas AG, Bikle DD, et al. Vitamin D for the prevention of disease: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. Published online June 3, 2024. doi:10.1210/clinem/dgae290

  3. National Institutes of Health Office of Dietary Supplements. Vitamin D: fact sheet for health professionals.

  4. van den Heuvel EG, Lips P, Schoonmade LJ, Lanham-New SA, van Schoor NM. Comparison of the effect of daily vitamin D2 and vitamin D3 supplementation on serum 25-hydroxyvitamin D concentration (total 25(OH)D, 25(OH)D2, and 25(OH)D3) and importance of body mass index: a systematic review and meta-analysis. Adv Nutr. 2024;15(1):100133. doi:10.1016/j.advnut.2023.09.016

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