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Vitamin D

Vitamin D has multiple biological roles in our body. It increases calcium, magnesium and phosphate absorption. 
It is very important to correct the low Vitamin D levels by supplementation. The two major forms  most commonly available are vitamin D2 (ergocalciferol), and vitamin D3 (cholecalciferol).

Uses: Vitamin D deficiency; Prophylaxis, Falls

Vitamin D deficiency dose:
  • 50,000 international units orally once weekly for 8 weeks (or) 6000 international units once daily for 8 weeks to achieve a 25-hydroxyvitamin D level greater than 30 nanograms/mL; follow with maintenance dose of 1500 to 2000 international units/day (guideline dosage)
  • Cost: $5 to $14 per month 
Common Side effects:
  • Gastrointestinal: Constipation, Loss of appetite, Nausea
  • Serious side effect: Endocrine metabolic: Hypervitaminosis D
Renal Impairment
Vitamin D undergoes activation in renal tissue; higher doses may be required in patients with renal insufficiency.
Calcium (Ca-D combinations) should be administered with caution in patients with renal disease (i.e., CrCl < 30 mL/min) to avoid elevations of calcitonin-phosphorus ion products and further development of calcinosis.
Self-reported tiredness or low energy or fatigue, has been linked to low levels of circulating vitamin D. (Further studies are needed to establish this link).
References:  
1. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al: Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96(7):1911-1930.

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