It is estimated that over half the population is deficient in Vitamin D, most of them undiagnosed. A 2013 study in the International Journal of Health Sciences indicated that Vitamin D deficiency is associated with hypothyroidism.
Even when we are fortunate to have a doctor test our vitamin D to determine we are deficient, how much should we take? What is the optimal Vitamin D range? What is the best type of supplement to take and when? Angela Pifer shares important tips to discuss with your doctor to get you to optimal.
Written by Angela Pifer
I often see a vitamin D supplement listed among the current supplements on my patient’s intake forms. After reviewing their past labs and assessing their dose, I don’t often see an appreciable increase reflected on their labs over time. They may have been taking 2000IU of vitamin D3 daily for the past two years and yet their labs only show a shift from 22ng/ml to 25ng/ml.
What I find is that they are usually taking a vitamin D3 supplement in a soft capsule form, often called a ‘gem,’ and they are taking it in the morning and not in the evening.
Many of my patients are surprised to learn that even though vitamin D is called a vitamin, vitamin D is really a hormone and not actually a vitamin. In fact, it is a fat soluble hormone.
For optimal absorption, the oral supplement “Vitamin” D3 is best taken as a liquid emulsion
with dinner. A liquid emulsion is simply a vitamin D3 supplement suspended in a little fat. This is a fat soluble hormone, so taking this as a liquid emulsion improves the absorption and taking this with dinner, which often has the most fat of all the meals, improves the absorption as well. You’ll only need a tiny drop or two of the liquid emulsion on your tongue, as this usually has 1500IU or 2000IU of vitamin D3 per drop (check the label).
Since this is a hormone, it is best taken at night, because hormones are best absorbed at night.
WHAT IS THE OPTIMAL VITAMIN D (25 OH) RANGE?
If you have had your vitamin D levels tests, your doctor most likely tested your 25-Hydroxy Vitamin D levels. On your lab this will be listed as “Vitamin D (25 OH)” or “25-Hydroxyvitamin D (25OHD),” or “25(OH)D,” but these are the same test. Even though the lab may report an adequate level of vitamin D as 25-30 ng/ml, the optimal vitamin D range is 45-65 ng/ml.
WHAT DOSE SHOULD YOU TAKE?
In addition to taking a vitamin D3 liquid emulsion at night, taking the right dose to raise your Vitamin D (25 OH) levels up to your goal is also important. A few small studies have shown that 2000IU vitamin D3 taken over three months, will raise Vitamin D (25 OH) levels by 20ng/ml. This may be the reason that many doctors prescribe this dose. Clinically, this doesn’t play out. Some people will need a lot more vitamin D to raise their levels over time.
If your Vitamin D (25 OH) is 25ng/ml and your goal is 45ng/ml, move to a liquid emulsion, taken with dinner and try a 2000-4000IU dose for six months and then retest. Assess how much your vitamin D level moved during that duration and then work with a licensed health care provider to reassess your dose. Once you reach your desired level, you will likely need 1000-2000IU vitamin D3 a day to maintain these levels.
You can use the chart, which offers guidelines for dosing, based on where you are starting and where you want to go. I have found these dosages to be more relevant clinically.
VITAMIN K2
Vitamin D3 should never be taken alone. Always take a combination Vitamin D3/Vitamin K2 liquid emulsion like this one from Thorne Research. This is because vitamin D3 improves calcium absorption across the GI tract and vitamin K2 is the cofactor needed to transfer calcium into your bones, and not your arteries.
About Angela Pifer, MSN, CN
Angela Pifer is a Functional Medicine Nutritionist and Licensed Certified Nutritionist with a Master’s in Nutrition out of Bastyr University. She has been a practicing nutritionist in Seattle for over a decade. Her 25 years in the health and fitness industry and the past 10 years as a functional medicine nutritionist focusing in the areas of weight loss, digestive health, inflammation, and metabolic conditions, have earned Angela recognition as the go-to weight loss expert. She is founder of the Clean & Lean Revolution.
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No One , I repeat No One should be taking calcium supplements. You should get your calcium from your food. And yes be sure to take vitamin d3 and vitamin k2 , have blood work done to check your d3 levels.
The pure encapsulation link says the k/d product is not available.😣
I was found vitamin D deficient last week. My supplement is coming in the mail tomorrow. I am going to be taking 1500 IU vitamin D and 600 mg calcium as calcium citrate. I find it easier to digest, as the acid is built into it. With calcium carbonate, you have to supply the acid to break it down. Since i can’t depend on my stomach acid to digest it, calcium citrate is a good alternative for me. This supplement also has vitamin K in it, as well as magnesium, Boron, and a few other things required for good bone growth. My hair has not been so full lately, I have a headache, I’ve been tired and depressed, and my balance has been off. I hope my hair will grow back once my D levels are up to par.
My Vitamin D levels were checked 6 months ago they were barely over normal. I started on 2000 iu x2 twice a day. I just had my levels checked again and they are now below normal. My doctor recommended 3000iu daily. I have Hashimotos, sjogrens and rheumatoid arthritis. I am 41 seems like alot going wrong at my age!
I been taking 50,000 mg of vitamin D. What do that really mean
50,000 iu is not milligrams. Im on same dose. It’s actually less than 2 milligrams and you only take it weekly. I have been prescribed this 2 months ago and can honestly say I see improvements. Best of luck.
I meant 5,000 mg of D3 not 50000. Sorry.
I am taking thyroid meds and progesterone and 50000 mg of D3 plus Vit. E 400 and CoQ10 100 for my heart. I need to take K2 for my bones. Can I still take K2 if I am taking these other things. Thank you for helping me. Doctors don’t seem to know anything about nutrition.
All the vitamin products, etc that are recommended are extremely expensive! What can people on set retired incomes do to maintain their health, who can’t afford your recommendations? It is frustrating to try to get better when you can’t afford too.
Try the app good rx. My prescription vitamins the insurance company didn’t cover yet the good rx app gives me significant discount on the ones I take
I take 65mg for my thyroid i have alot of trouble with my throat getting horse alot amd my hormonal in balance. I hurt when i have sex i am not comtable. I need help what can i take please help.
Can you recommend a good brand to take for D-3 liquid and K2
I know and understand that Vit D should be taken with Vit K2, but what should people on Warfarin/Coumedin ( blood thinners ) do ? If they need to take Vit D.
Can you just take Vit D without it K2?
I raised my Vitamin D2 to 8,000 IU per day because I need to take that much to have an 80ng/ml reading on the lab test. Dr. Perlmutter (of Grain Brain fame) states that you should be shooting for a reading of 80ng/ml for optimum brain health.
Oops sorry! I meant D3.
I have Secondary Hypothyroidism (d/t messed up Pituitary Gland r/t stress) and one of many symptoms were dry eyes. My D3 was low and I started taking Sport Research 5,000 IU of D3 with K2 100 Mcg – made with MenaQ7, and the dry eyes disappeared and D3 test showed significant increase. I’m ordering these Sport Research supplements because they are free of all allergens, through Amazon.
I have tried 4 different types of D3 including the liquid with k2 and they all give me panic attacks when they enter my system. With the liquid it happens within 10 minutes and the pills of course take longer. What am I doing wrong?
Hi. Did you ever figure this out? I am the same. Thanks!
Try magnesium glycinate
How do you treat hair loss due to Hypo thyroidism ? My GP says that my thyroid is stable at the moment but hair loss is worrying me.
Does anyone have a treatment for this?
Possibly your adrenals ( Cortisol) need to be tested. You will need a salvia test kit with four vials.
Or Iron is low . You will need the four iron tests and ferritin to test Iron and if low you can take Dediccated Liver pills found on Amazon
Desiccated dang it
Adrenals need to be checked
Please tell me I have my adrenal checked..