Q & A

Dr. Holick appreciates your comments and questions. While he cannot answer every question, he responds to as many as he can and will periodically post answers to questions here. Please submit your comments and questions in the window at the bottom of the page.

Some of these comments, and Dr. Holick’s responses to them, come from previous versions of this website. They have been re-posted here by this site’s administrator.

For more discussion of specific issues related to Vitamin D, and to download some of Dr. Holick’s original journal articles, click here to go to Dr. Holick’s other website, VitaminDHealth.org.

742 Comments

  1. Joel
    Posted March 10, 2014 at 11:43 pm | Permalink

    Would you recommend Carlson Labs as a reputable supplement company? I have been using some of their D3 drops in the 2,000 IU strength and have been giving my kids the 1,000 IU drops. Here’s a link to the 2,000 IU drops on their website

    http://www.carlsonlabs.com/p-294-super-daily-d3-2000-iu.aspx

    While the drops are a little more difficult to administer, they are much less expensive. I’ve tried putting them in water, but there always seems to be some oily residue left on the glass after drinking it, which concerns me that we are not getting the full dose.

    Any feedback is much appreciated!

    • admin
      Posted April 4, 2014 at 2:20 pm | Permalink

      Dear Joel,
      Carlson labs is a very reputable supplement company. I have given several talks on their behalf at various meetings including one recently at the Expo West in Anaheim last week. I would not put the drops in water because the oil may attach itself to the sides of the glass. I prefer putting it in milk.

  2. Joanna Bejarano
    Posted March 10, 2014 at 5:04 pm | Permalink

    Hi.
    I just finished reading your book on my kindle and have found it very intriguing. I am a 44-year old female who had serious back problems at the end of last year and hip pain as well. The doctor checked my vitamin d. My 25-OH-vitamin d level was 12.88ng/ml. I was in so much pain at the time that I didn’t think anything of it.

    I am American living in Spain. I was prescribed Hidroferol 0,266mg (Calcifediol) and was told to take 1 ampoule a month. I understand that this is the 25-OH-d3 the metabolite. I’m confused and wonder if this is enough to raise my Vitamin d levels. Everything I read on the internet seems to only talk about the Vitamin d2 for deficiencies in the USA.
    My ferritin was 19, my phosphorus was 3,2 and Calcium 9,4. If that helps. I’m also overweight.
    After reading this book I have hope that I will eventually feel better and not weak and tired all the time.
    thank you!

    • admin
      Posted April 4, 2014 at 2:21 pm | Permalink

      Dear Joanna,
      There is no reason in why you can’t simply take vitamin D. I’d recommend 3000 IUs daily. 25-hydroxyvitamin D is available in Europe and can also raise blood levels. Vitamin D2 is a supplement that comes from yeast and can be found in mushrooms exposed to ultraviolet light and sunlight. It is also the pharmaceutical form of vitamin D available in the United States. Vitamin D2 and vitamin D3 are equally effective in treating vitamin D deficiency and maintaining Vitamin D sufficiency.

  3. Cris
    Posted March 9, 2014 at 12:51 pm | Permalink

    I am a 63 yr old female with osteoporosis in my spine and osteopenia in my hip. I have been taking a d3/k2 supplement (10,000 iu daily of d3) and have a blood serum level of 50+. However, a recent test showed a vitamine d3 deficiency at the cellular level. A DNA analysis indicates a ++ variant in my VDR taq and a +- variant in my VDR bsm. In your vitamin D video you state that the higher your serum levels, the better your bone density. My bone density has decreased steadily over the past decade, even though my serum levels are within the “normal” range. My ND and I are both trying to determine how to work around this genetic problem in order to improve my bone health, without reaching toxic serum levels. Any suggestions would be much appreciated.

    • admin
      Posted April 4, 2014 at 1:49 pm | Permalink

      Dear Cris,
      I doubt that the polymorphism is the problem. Lack of estrogen markedly increases bone loss on average 3-4% in the spine and 1-3% in the hip each year. I often put women on hormone replacement therapy if they have no history of breast cancer. Alternatives are anti-resorptives but a further workup for bone remodeling activity with osteocalcin and urine N-telopeptide is also helpful before starting any therapy. Also I worked patients up to be sure that they are not suffering from hypercalciuria.

  4. Jessica
    Posted March 7, 2014 at 8:18 pm | Permalink

    Dear Dr. Holick,

    I expose my arms and legs to the sun 2 – 3 times a week around 11am for about 15 – 20 minutes, based on the guidelines from your book (I prefer sunlight instead of supplements because the sunlight helps with my chronic insomnia).

    However, I have started to apply a 17.5% glycolic acid body lotion every other day to relieve keratosis pilaris on my arms and legs. It has been working wonderfully and I do not plan to stop.

    I’m concerned that the glycolic acid will cause my skin to become too sensitive to sunlight. I am planning to decrease the amount of time to 10 – 15 minutes outside but I am unsure if that will provide me with adequate Vitamin D. I’d love to hear your thoughts on whether or not you think one can safely expose skin to sunlight for Vitamin D while also using glycolic acid body lotions.

    Thank you.

    • admin
      Posted April 4, 2014 at 2:20 pm | Permalink

      Dear Jessica,
      You may want to try the app dminder.info which can provide guidance for sensible sun exposure. Some people do develop a sensitivity to sunlight when using glycolic acid and reducing the amount of exposure reduces risk. Do you know what your blood level of 25-hydroxyvitamin D is?

  5. Atul
    Posted March 5, 2014 at 5:04 am | Permalink

    Hello Dr Holick

    I thank you for the selfless work that you are doing

    I want to know of your recommendation of Vit d supplementation and Calcium dosage in people who suffer from Calculus disease of the kidney.

    I am a doctor myself and constantly keep getting patients who have the above set of conditions and my policy till now is to give Vit D and Calcium in the normal recommended dosage as withholding Vit D supplemention is far more riskier than giving the two ie Ca and Vit D and risking stone formation.

    Whats your take on this?

    Many thanks

    • admin
      Posted April 4, 2014 at 2:18 pm | Permalink

      Dear Atul,
      The major cause of kidney stones is hyperabsorption of oxalate from the diet. For my patients with kidney stones I treat them with calcium citrate and have them take it with meals. The calcium will bind the oxalate and prevent it from being absorbed in the intestine and the citrate will chelate calcium in the ultra-infiltrate in the kidneys and reduce risk of kidney stone formation. There is no evidence that Vitamin D increases risk and therefore I keep my patients on an adequate amount of vitamin D equivalent to 3000 IUs daily. The total amount of calcium is 1000 mg daily from diet and from calcium citrate.

  6. Gina Frack
    Posted March 1, 2014 at 3:20 pm | Permalink

    Our 16 y/o son is a long distance runner (cross country and track) without any other health conditions. He had repeated stress fractures, chronic back pain and stress reactions in the pelvis region and femurs over a 10 month timeframe. After switching orthopedic docs, he was finally tested for Vit D 25 hydroxy. His level in early January 2014 was 22. We started him on the following daily supplementation regimen of: Vit D3 6,400 (including amount in multivitamin); Calcium Carbonate 1200mg; Vitamin K2 300 mcg; Magnesium 400mg and a multivitamin. He started this regimen Jan 17th. He had a bone density scan Feb. 27th. The results showed Osteopenia. Z scores in the femoral neck were -1.7 and -1.9 respectively. Spine readings were normal.
    These are our questions: At the level his Vit D level was and based on the supplementation regimen he has been on since January 17th, how long before we could expect optimal vit D level? Along with this, when could we expect to see his bone density come back to normal? (I’m assuming Vit D levels will be optimal before bone density comes back to normal.) At what level would you recommend his Vit D level to be before we can allow him to resume impact activities (running)?
    Last question: We remain baffled why he is ‘deficient’ on Vit D. This is a kid that is outdoors as much as he can year round. Is very physically active and maintains a very healthy diet. He never uses sunscreen. He doesn’t drink pop/soda, drinks on av no tobacco use etc… Basically, this is a kid that doesn’t present with any of the ‘usual’ risk factors for vitamin D deficiency so why is he low?

    • admin
      Posted March 5, 2014 at 9:13 am | Permalink

      Dear Gina,
      Usually within 6-8 weeks the blood levels of 25-hydroxyvitamin D are maximized. There are a lot of factors that influence bone mineral density. If the bone loss is simply due to vitamin D deficiency and osteomalacia he can get almost total recovery within one to two years. However I suspect that there are other secondary causes for his low bone mass. I am not surprised that he was vitamin D insufficient in January. He basically cannot make any vitamin D from sun exposure from November through February. There is essentially no vitamin D in the diet and therefore everyone is at risk especially during the winter.

  7. Jo
    Posted February 27, 2014 at 1:34 pm | Permalink

    Dr. Holick,
    What is the correlation between Vitamin D and allergies. I have noticed this past allergy season that when I take 5,000 IU, I seem to have fewer symptoms to the tree pollen.

    Also, my son has a skin condition that the dermatologist couldn’t diagnose. It’s patchy areas of skin but not psoriasis, a fungus or anything else he can figure out. He just said it might be dermatitis. Would a topical Vit D be worth trying? And can you just call a compounding pharmacist and ask them to make it, or must you have a prescription? Vectical is really expensive.

    Thanks.
    Jo

    • admin
      Posted March 3, 2014 at 12:50 pm | Permalink

      Dear Jo,
      There is mounting evidence that Vitamin D plays a critical function in modulating the immune system. You can try to have a compound pharmacist make it. I have used 15 mcg/gram Vaseline as being effective for treating psoriasis.

  8. M A Widhani
    Posted February 25, 2014 at 8:06 pm | Permalink

    Dear dr , My vitamin D total(25 HYDROXY)# are as under S E R O L O G Y. 5.03. ng/ml. >30. Is it ok or not if not ok Kindly suggest the medicine dose I should take. Thanks

    • admin
      Posted March 3, 2014 at 12:51 pm | Permalink

      Dear MA,
      I’d recommend you take 50,000 units of vitamin D once a week for 8 weeks and then 50,000 units of vitamin D every 2 weeks thereafter or their equivalent daily i.e. 6600 IUs daily followed by 3000 IUs daily.

  9. Enid Sterling
    Posted February 24, 2014 at 11:45 pm | Permalink

    It is only just yesterday that I have finally have an answer as to why my whole life has been shot with fatigue, bad pain in my body, asthma like symptoms etc. I am certain that I am Vitamin D deficient and will confirm with the blood test. I plan on taking 50,000 iu for 8 weeks as you suggest. My question is since I am very depleted can I simultaneously use the Sperti Lamp? I understand from a previous post that you recommend to your patients using the Sperti lamp to expose the front of their legs and abdomen one day and then expose the back of the legs and the back a day later. Would this be okay for me? Also, how long should I use the Sperti lamp for each session? Thank you very much. Sincerely, Enid Sterling

    • admin
      Posted March 3, 2014 at 12:51 pm | Permalink

      Dear Enid,
      You can maintain an adequate vitamin D status by taking 50,000 IUs of vitamin D once every 2 weeks. If you wish to use a Sperti lamp you need to follow the manufacturer’s directions; distance from the lamp and your skin type will depend on how long you should be exposed to it.

  10. Gerard
    Posted February 24, 2014 at 3:27 am | Permalink

    Dear Dr Holick,

    I was wondering if you could comment on D2 vs D3.

    I am looking at the following numbers:
    25-Hydroxy D2: < 4 ng/mL
    25-Hydroxy D3: 13 ng/mL

    Treatment: Vitamin D 5000 units daily for 8 weeks and then 1000 units daily.
    The prescribed Vitamin D is D3, not D2, thus I wonder about the D2 deficiency not being addressed.

    What is the difference between D2 and D3, and which one is better to take, or should take both?
    I am told that D2 is not a reliable, but I have seen you mentioned to take D2 in your video (from UCTV)

    Thanks so much!

    Best,
    -Gerard

    • admin
      Posted March 3, 2014 at 12:53 pm | Permalink

      Dear Gerard,
      Vitamin D2 comes from yeast and mushrooms and a supplement and is as effective as vitamin D3 which comes from the skin and from animal sources in maintaining a healthy vitamin D status. Vitamin D2 is reliable.

  11. James Helmers, M.D.
    Posted February 23, 2014 at 5:40 pm | Permalink

    I was wondering about vitamin D supplements for a patient on warfarin. I read about a risk of arterial calcifications as a result. What do you think about this.

    Thank you.

    • admin
      Posted March 3, 2014 at 12:52 pm | Permalink

      Dear James,
      In my opinion there is no evidence that Vitamin D increases vascular calcification especially for patients on warfarin.

  12. Soumya
    Posted February 21, 2014 at 10:37 am | Permalink

    I live in Kerala, India, where the temperature soars up to 38 degree C with a very high percentage of humidity. The sunlight is quite intense after 10 A.M. and hence sunbathing is not a pleasant experience for us. I still get moderate sun exposure and hence I was surprised to find out that I have vitamin D deficiency. What are the options we have?

    • admin
      Posted March 3, 2014 at 12:52 pm | Permalink

      Dear Soumya,
      Have you tried using the app dminder.info which may be useful in telling you how much vitamin D you’re making when you are outside.

  13. Elizabeth
    Posted February 18, 2014 at 8:30 pm | Permalink

    Dear Dr. Holick,

    I was wondering if you could comment to those of us who do work outdoors. I live in NC and work on the beach year round. I know that in the winter I should be taking Vitamin D supplements since only part of my face is exposed most days and my hours outdoors are much less, but I wonder more about your recommendations for the summer. I can typically be in the sun anywhere from 5-7 hours a day. I tend to put sunscreen on before I go in the field (before I start to sweat and get sandy), and since I start early, I sometimes put sunblock on before sunrise. I use mineral block throughout the day, and I am curious if you think I am still getting enough Vitamin D even though I have sunscreen on all day? Do I still need to have time outside without sunscreen? Should I hold off putting sunscreen on until a certain time after sunrise? I try to wear pants most of the time, a short sleeve shirt and a hat. So my arms get a lot of exposure, and even though I wear a hat and sunblock, my face also gets tan. I guess I am not very knowledgeable about how effective the sunblock is when I apply it 2, sometimes 3, times a day. Also, on top of work, I occasionally go ride waves for a couple of hours 2-3 times a week (also with sunblock and usually with a long-sleeve UPF rashguard). I would love to hear your recommendations for people like me who do get a lot of sun and how we should be using sunscreen and UPF clothing.

    Thank you!

    • admin
      Posted March 3, 2014 at 12:53 pm | Permalink

      Dear Elizabeth
      You may find the app dminder.info to be valuable in providing you with guidelines for how long to stay outside to make an adequate amount of vitamin D followed by good sun protection either with an SPF of 30 or clothing.

  14. Cindy
    Posted February 13, 2014 at 5:25 pm | Permalink

    Hello
    I’ve been on vit d 50,000 units for almost a year once a week. Now I had to stop because of a severe burning tongue from the vit d. I have tried all brands and liquid form and still get a burning tongue when I take it. I really do need the d because my levels go to 6. It took a year to get to 31. I also feel it’s the Prevacid I take for reflux that is causing my absorption issues because my vitamin b’s are low as well.
    Any recommendations on what to do for my vitamin d intake? Maybe a sun lamp?
    Thank you

    • admin
      Posted March 3, 2014 at 12:55 pm | Permalink

      Dear Cindy,
      Sensible sun exposure using the app dminder.info may be helpful. The FDA has sanctioned the Sperti lamp as a way to produce vitamin D for those who wish to obtain it from ultraviolet light exposure.

  15. Posted February 9, 2014 at 8:02 pm | Permalink

    Dr Dr Holick,
    Thank-you for your Vitamin D solution book which I began reading after my Doctor found me to be very low in vitamin D after blood tests. Your book mentions many medical issues within my family, one of which involves my youngest daughter, now 20 years of age who was born with VACTERL. A blood test found her to have a vitamin D deficiency and Fanconi syndrome. She is also border-line Long QT syndrome and from the age of four years has had repeated episodes of Cyclic Vomiting for which she is enrolled in a study by Dr Richard Boles in America who speaks of Mitochondrial dysfunction as being a factor.
    Mothers instinct tells me that vitamin D deficiency and Mitochondrial dysfunction are interconnected.
    I would be interested in your thoughts on this.?
    Thank-you.
    Regards,
    Mrs Jennifer Lawton.
    Hamilton.
    New-Zealand.

    • admin
      Posted February 14, 2014 at 10:35 am | Permalink

      Dear Jennifer,
      At this time there is little information about vitamin D deficiency and mitochondrial dysfunction. However it is reasonable for patients with mitochondrial dysfunction to be taking an adequate amount of vitamin D to maintain blood levels of 25-hydroxyvitamin D in the range of 40-60 ng/mL.

  16. Marco
    Posted February 5, 2014 at 4:04 pm | Permalink

    Dear Dr. Holick,

    I recently finished reading the Vitamin D Solution and found it extremely compelling. I have two follow up questions I would like to ask you.

    First, I am unclear about your position of not supporting sunbed use to produce Vit D while being ok with sensible outdoors sunlight exposure. Would being in a sunbed (with the precautions you stated – i.e. exposing oneself for only half the manufacturer-recommended maximum exposure time) not be the same as, for example, spending that same amount of time on the beach at 1pm in mid July?

    I like the idea of producing Vit D naturally but I live at northern latitudes and sunlight is too weak to allow my skin to generate any Vit D between November and March so I would need to rely on sunbed use.

    Second, I have a benign hematological condition called polycythemia vera (a myeloproliferative disorder) which, as you may know, is characterized by an elevated red blood cell mass (and accompanying high hematocrit/hemoglobin) and sometimes high platelets too. My condition is quite mild (asymptomatic with relatively normal hematocrit/hemoglobin but somewhat elevated platelets) so that all the hematologist recommends is daily low-dose aspirin and a phlebotomy every 2-3 months.

    I remember reading some time ago that being Vit D sufficient can have a positive effect on a myeloproliferative disorder. Would you know if Vit D can improve my polycythemia and associated blood markers?

    Thank you.

    • admin
      Posted February 14, 2014 at 10:36 am | Permalink

      Dear Marco,
      I do not recommend tanning. However for those who wish to obtain their Vitamin D from a tanning bed they need to make sure that it is a broad-spectrum tanning bed that emits UVB radiation. I recommend some protection on face and to go in for 50% of the time recommended for tanning. Regarding myeloproliferative disorders some studies have suggested that the use of activated vitamin D may be of some value. Whether vitamin D deficiency can help control them is not clear.

  17. Posted February 4, 2014 at 2:36 pm | Permalink

    Hello Dr. Holick,
    I am very impressed with your work and am trying to help educate people in the Philadelphia area of the importance of optimizing their D3 levels. I am a general dentist and take blood tests on all my patients with gum disease. I found that almost all were deficient in D3. I even published and article about it in my local paper that you can read here: http://m.buckscountycouriertimes.com/life-style/guides/your-health/sunshine-vitamin-good-for-gums-and-general-health/article_9f317bab-6161-520a-8108-1d8609fa295b.html?mode=jqm. I’d love some of your feedback. I also recommend your book, The Vitamin D Solution. Please keep up this important work.
    Best Regards,
    Dr. Gordon

    • admin
      Posted February 14, 2014 at 10:34 am | Permalink

      Dear Jerry,
      Thank you for your thoughtful comments. There is strong evidence that vitamin D deficiency increases risk for periodontal disease and tooth loss. Keep up the good work.

  18. Gunnar
    Posted February 4, 2014 at 10:01 am | Permalink

    Dear Dr Holick,

    Since you are the the person that really knows all about D vitamin and have probably read all studies regarding vitamin D.

    I have come to the belief that high cholesterol levels is simply a sign of D vitamin deficiancy.

    My reason for believing this is that as we age, the skin becomes less efficient at producing D and the body tries to compensate this by making more cholesterol. Now, older people doesn’t stay in the sun very long so it will not work as intended. They becomes D deficient but also gets high cholesterol levels.

    Is there any supporting evidence for my hypothesis/belief in the research litterature?

    • admin
      Posted February 14, 2014 at 10:34 am | Permalink

      Dear Gunnar,
      There is some evidence that vitamin D deficiency may be associated with high blood cholesterol. However this is not because of the skin’s lack of producing vitamin D. The skin makes 7-dehrdrocholesterol which is a precursor for cholesterol and which when exposed to sunlight is converted to vitamin D. The body does not provide the skin with cholesterol for this purpose.

  19. Prema Kuru
    Posted February 4, 2014 at 8:06 am | Permalink

    Dear Doctor,

    I once read in an article, that after exposure to sun it is recommended to avoid bathing for 48 hours as the chemicals in soaps and shampoos affect vitamin D production. Does the same apply to moisturizers like Vaseline. I worry as, it would be tough not to moisturise after sunbathing for around 15 mins exposing the skin on a daily basis (given concern surrounding skin ageing, etc.).
    Also my vitamin D level was around 3.25 ng / ml. After on and off sunbathing for around 45 days and taking medication like D-rise twice (60,000 IU) it has come to 16.5 ng/ml. How should I boost it to reach around 30 to 40 ng/ml a bit quicker ? Once I attain those levels, should I continue taking tablets with a 4000-5000 IU dosage or can I manage with a twice a week sun bathing exposure ?

    Many Thanks.

    • admin
      Posted February 14, 2014 at 10:30 am | Permalink

      Dear Prema,
      It is a myth that you should not bathe after some exposure because you will wash off the vitamin D. This is not correct. You make vitamin D in the living cells in the top layer of the skin. This cannot be washed off. You can increase your 25-hydroxyvitamin D level by taking an equivalent of 3000 IUs of vitamin D daily or 60,000 IUs of vitamin D every 2 weeks. Sensible sunbathing can be effective. Have you tried the app dminder.info which can provide you with guidance.

  20. Sarah-Jane
    Posted January 29, 2014 at 9:20 pm | Permalink

    Hello Dr Hollick,

    I’ve just received my 25-hydroxy D3 results back which were 50 nmol/L, predictably low after spending the past 6 months indoors studying everyday and noticing a massive change in calf muscle mass (probably due to inactivity too). I’ve worked out that this equates to 20 ng/ml and I know that I should aim for 40-60 ng/ml. What I am trying to work out is how I should be evaluating my calcium results as part of this equation? My calcium level was 2.48 mmol/L or 2.44 mmol/L with an adjustment for albumin. I’ve just taken a dose of 10,000IU D3 but am not sure how long I should take this for. And since I am interested in bone health (creaky knees – I am only 28 – and cavities in teeth) should I be concerned with phosphate levels also? They were in high normal range of 1.5 mmol/L. I eat a vegan diet and live in Australia. Thank you so much for the work you do! It’s greatly appreciated!!

    • admin
      Posted February 14, 2014 at 10:32 am | Permalink

      Dear Sarah Jane,
      I have my patients on 3000 IUs of vitamin D daily. It is effective in maintaining blood levels of 25-hydroxyvitamin D >75 nmol/l or 30 ng/mL. To achieve a level above 100 nmol/l or 40 ng/mL usually 4000 IUs of vitamin D daily works.

  21. Maureen
    Posted January 28, 2014 at 8:03 am | Permalink

    Maureen

    Posted January 7, 2014 at 12:12 pm | Permalink
    Your comment is awaiting moderation.

    Dear Dr Holick
    Referring to your kind replies dated 16 Sept and 30 Sept 2013: after 4 months’ of planned sun-baths of 15 mins in mid-day sun (UK) and a 2 week sunny holiday in Italy, my 1,25 (OH)2 Vit D was 67 pmol/l on 18 Oct 2013. As the lab range is 42 – 143 pmol/l, would you regard this as rather low? My doctor tells me the reading is fine as it is “within the normal range”. The 25 OH Vit D measured at the same time was 65.5 nmol/L.
    This was the nearest I could achieve to obtaining simultaneous readings: 10 days prior to the above readings, I had serum Ca 2.46 mmol/L, adjusted Ca 2.36 mmol/L, and parathyroid hormone 7.39 (beyond top of range given as 1.60-6.90 pmol/L). My high cholesterol however had reduced by two whole points, perhaps because some was used up to make some pre-Vitamin D in the skin (?).
    A chest X-ray seems to have ruled out sarcoidosis, especially as my PTH is always high in the range (and not low, as I understand it would be if I had sarcoid). Meantime, I have also been diagnosed as having a small cyst in the left kidney (7mm), a large right-side ovarian cyst (4 inches diameter), and a small gallstone. I also have intermittent pain in the left upper quadrant/ribs/spleen area. I am 61.
    My endo suggested 50,000 iu Vit D3 for 6 weeks, at the end of which (31 Dec 2013) my readings were: serum Ca 2.51 mmol/L (range 2.20-2.60), adjusted Ca 2.43 mmol/L (range 2.20-2.70), 25(OH) Vit D 94.2 nmol/L and PTH 6.32 (range 1.60-6.90 pmol/L). But my doctor would not order a further 1,25(OH)2 test, as he believes there is nothing wrong with me as all results are “within the normal range”.
    Could this be a Vitamin D malabsorption problem, perhaps at the stage in the kidneys when it is converted to the active form 1,25(OH) Vit D?
    I’d be very glad to have your comments.
    Kind Regards, Maureen.

    • admin
      Posted February 14, 2014 at 10:28 am | Permalink

      Dear Maureen,

      Your doctor is correct. You don’t want to measure 1,25-dihydroxyvitamin D since it tells you nothing about your vitamin D status. Your 25-hydroxyvitamin D is excellent as is your calcium and PTH.

  22. Ravindra
    Posted January 28, 2014 at 2:11 am | Permalink

    Dear Sir

    Vitamin D is fat soluble vitamin, hence oil based formulation like capsules etc will have better absorption and bioavailability than Tablets/Granules? Is it true? should we take Vitamin D Tablets ?

    Ravindra

    • admin
      Posted February 14, 2014 at 10:28 am | Permalink

      Dear Ravindra,

      We have found that vitamin D is absorbed perfectly fine in a tablet, powder or oil. It does not matter.

  23. Ljupka Peev
    Posted January 28, 2014 at 12:06 am | Permalink

    Dear Prof. Holick,

    I greatly value your opinion and am wondering what you think of the review published in the Lancet January 2014, available here:
    http://www.thelancet.com/journals/landia/article/PIIS2213-8587(13)70165-7/abstract
    Here’s an excerpt:
    Results from intervention studies did not show an effect of vitamin D supplementation on disease occurrence, including colorectal cancer. In 34 intervention studies including 2805 individuals with mean 25(OH)D concentration lower than 50 nmol/L at baseline supplementation with 50 μg per day or more did not show better results. Supplementation in elderly people (mainly women) with 20 μg vitamin D per day seemed to slightly reduce all-cause mortality. The discrepancy between observational and intervention studies suggests that low 25(OH)D is a marker of ill health. Inflammatory processes involved in disease occurrence and clinical course would reduce 25(OH)D, which would explain why low vitamin D status is reported in a wide range of disorders. In elderly people, restoration of vitamin D deficits due to ageing and lifestyle changes induced by ill health could explain why low-dose supplementation leads to slight gains in survival.

    With kind regards,
    Ljupka Peev

    • admin
      Posted February 14, 2014 at 10:29 am | Permalink

      Dear Ljupka,
      There continues to be mounting evidence that improvement in vitamin D status reduces risk for all-cause mortality.

  24. Nishant
    Posted January 20, 2014 at 3:03 am | Permalink

    Hi!

    I grew up in sunny Dubai and went to Toronto for university. Those were the worst 4 years of my life – I became very depressed, anti-social, etc in spite of being happy go lucky in Dubai. I didn’t know the reason but I became so averse of Canada despite so many positives in the country, that I decided to forgo job opportunities there and came back to Dubai.

    Back in Dubai, I am becoming better but not quite their yet and on researching the net I found out about VitaminD benefits and believe that this is the reason why I went through the 4 years of depression, etc in Canada.

    My question is, how long does it take to buildup VitaminD reserves in the body after severe depletion? I try to sunbath for about 20 to 40 minutes everyday in Dubai. I prefer not to take supplements.

    • admin
      Posted January 31, 2014 at 11:51 am | Permalink

      Dear Nishant,
      It depends upon the time of day and season and your skin type. You may want to try the app dminder.info which provides guidance for sensible sun exposure.

  25. Karon
    Posted January 18, 2014 at 12:22 pm | Permalink

    Thank you for this Q&A forum. It has helped me greatly. Although, I do have several questions.
    I am a healthy female, 5’5″, 125 lbs, 56 yrs old. I purchased the Sperti D/UV-F (vitamin D sunlamp). I received it 4 days ago and have started to use it.

    I have been taking D-3 tablet of 5000 IU/per day for the past 2 months (since last November).

    All last spring and summer I was very diligent getting out in the sun at the appropriate times for vitamin d exposure. I live in north Texas, so around the first of October there was no more vitamin d exposure from the sun for me to reap. Around the first of November I fell into a huge depression, having huge amounts of anxiety, lots of crying spells.
    One of my questions is, could this have been because of a drop in vitamin d for me? OR, could it be the result of starting to take the vitamin D-3 supplement? I’ve never taken a vitamin D-3 supplement before.

    Should I continue to take the 5000 IU/per day if I am starting to use the vitamin D sunlamp?
    Or should I take the 5000 IU every other day?
    Since I am starting to use the vitamin d sunlamp do I EVEN NEED to continue to take the vitamin D-3 supplement?

    The recommended exposure schedule for maintenance dosage using the vitamin d sunlamp is for 5 mins, 3 times per week (maximum).
    Does it hurt if I want to use the vitamin d sunlamp daily for 5 mins?
    Does this type of lamp cause the skin to tan?
    Would I be doing harm to my body if I use it daily?
    Can my body produce more vitamin d if I use it daily (just like taking more of a daily supplement of vitamin d)?
    How long will it take for my body to start showing results of using the vitamin d sunlamp?

    I know I’ve ask a lot of question, sorry:/, but I’m really seeking answers.

    Thank you so much for your help! It’s so appreciated!!

    • admin
      Posted January 31, 2014 at 11:52 am | Permalink

      Dear Karon,
      The amount of vitamin D and the amount of time under the Sperti lamp depends on your blood level of 25-hydroxyvitamin D and your skin type. I would recommend that if your blood level is above 30 ng/ML for 25-hydroxyvitamin D than you only need 3000 IUs of vitamin D. The amount of time under the lamp depends on your skin type. This lamp can cause a sunburn and will also cause you to tan. I recommend to my patients using the Sperti lamp to expose the front of their legs and abdomen one day and then expose the back of the legs and the back a day later. The reason is that when you make vitamin D in your skin it continues to be released from your skin into the bloodstream for approximately 24 hours. Thus there is no need to be exposed every day.

  26. HeltonPons
    Posted January 14, 2014 at 8:54 pm | Permalink

    Hello Dr. Holik,
    In my country, Brazil, I observe a growing number of prescriptions for sublingual vitamin D3. My question is: If to activate vitamin D3 to calcitriol, is one ncessário hydroxylation in the liver and one kidney, what is the efficacy of this preparation, since the sublingual absorption no passage through the liver?

    • admin
      Posted January 31, 2014 at 11:50 am | Permalink

      Dear Helton,

      Taking vitamin D sublingually will enter the blood and will eventually go to liver and into the kidneys. Therefore it is perfectly fine to take vitamin D sublingually.

  27. Karen
    Posted January 12, 2014 at 7:46 am | Permalink

    Hi,

    Do anti convulsants like gabapentin and zonegran deplete vitamin D and if so should you take even higher doses of Vitamin D to reach an optimal level?

    Many thanks,

    Karen

    • admin
      Posted January 31, 2014 at 11:49 am | Permalink

      There is evidence that many of the anti-seizure medications can increase the destruction of 25-hydroxyvitamin D. I usually have my patients on higher doses of vitamin D up to 50,000 IUs once a week. The best way to know is to have your blood level of 25-hydroxyvitamin D checked. It should be at least 30 ng/mL and preferably 40-60 ng/mL.

  28. Karen
    Posted January 11, 2014 at 4:14 pm | Permalink

    Dear Doctor, I am wondering what your opinion is on the recent articles that say there is doubt now on vitamin D’s role to prevent disease? Also do you feel that it can help prevent autoimmune diseases such as MS and arthritis if taken in larger daily quantities? Thank you.

    • admin
      Posted January 31, 2014 at 11:48 am | Permalink

      Dear Karen,
      Most of the recent articles are meta-analyses. They looked at studies that used suboptimal doses of vitamin D. Thus it is not a surprise that they would conclude that vitamin D is of no benefit for preventing autoimmune diseases. However most of the literature suggests that there is an association with vitamin D deficiency and increased risk for autoimmune diseases including multiple sclerosis, type 1 diabetes and rheumatoid arthritis.

  29. Maureen
    Posted January 7, 2014 at 12:12 pm | Permalink

    Dear Dr Holick
    Referring to your kind replies dated 16 Sept and 30 Sept 2013: after 4 months’ of planned sun-baths of 15 mins in mid-day sun (UK) and a 2 week sunny holiday in Italy, my 1,25 (OH)2 Vit D was 67 pmol/l on 18 Oct 2013. As the lab range is 42 – 143 pmol/l, would you regard this as rather low? My doctor tells me the reading is fine as it is “within the normal range”. The 25 OH Vit D measured at the same time was 65.5 nmol/L.
    This was the nearest I could achieve to obtaining simultaneous readings: 10 days prior to the above readings, I had serum Ca 2.46 mmol/L, adjusted Ca 2.36 mmol/L, and parathyroid hormone 7.39 (beyond top of range given as 1.60-6.90 pmol/L). My high cholesterol however had reduced by two whole points, perhaps because some was used up to make some pre-Vitamin D in the skin (?).
    A chest X-ray seems to have ruled out sarcoidosis, especially as my PTH is always high in the range (and not low, as I understand it would be if I had sarcoid). Meantime, I have also been diagnosed as having a small cyst in the left kidney (7mm), a large right-side ovarian cyst (4 inches diameter), and a small gallstone. I also have intermittent pain in the left upper quadrant/ribs/spleen area. I am 61.
    My endo suggested 50,000 iu Vit D3 for 6 weeks, at the end of which (31 Dec 2013) my readings were: serum Ca 2.51 mmol/L (range 2.20-2.60), adjusted Ca 2.43 mmol/L (range 2.20-2.70), 25(OH) Vit D 94.2 nmol/L and PTH 6.32 (range 1.60-6.90 pmol/L). But my doctor would not order a further 1,25(OH)2 test, as he believes there is nothing wrong with me as all results are “within the normal range”.
    Could this be a Vitamin D malabsorption problem, perhaps at the stage in the kidneys when it is converted to the active form 1,25(OH) Vit D?
    I’d be very glad to have your comments.
    Kind Regards, Maureen.

    • admin
      Posted January 31, 2014 at 11:43 am | Permalink

      Dear Maureen,
      A blood level of 1,25-dihydroxyvitamin D is of no value in determining a person’s vitamin D status. Only 25-hydroxyvitamin D can tell you about your vitamin D status. However 1,25-dihydroxyvitamin D level can give an insight as to whether the patient has primary hyperparathyroidism or sarcoidosis. It is quite possible that you have normal calcemic hyperparathyroidism. Your blood level of 25-hydroxyvitamin D is perfectly fine.

  30. jeannine
    Posted January 7, 2014 at 9:42 am | Permalink

    Hello! I have always believed in Vit D and sun exposure once I read your first book!

    I am desperate to know your thoughts on still getting sun exposure once you have had a Melanoma stage 1. I had a stage 1 melanoma on my arm (very, very small) removed successfully with lymph nodes clear as well. My doctors are warning me to totally stay out of the sun now in case the sun caused my Melanoma.

    Is there any evidence that UVA or B causes and effects melanoma? I WANT TO GO BACK IN THE SUN!.And, I want to use tanning beds of course very moderately for overall health benefits and disease prevention.

    Also, I started taking 5000 Iu by a pill that dissolves under the tongue. They say it will absorb faster and more completely in your bloodstream. Do you agree??

    THANK YOU SO MUCH FOR TAKING THE TIME TO READ THIS. I AM A BIG, BIG FAN AND THANK YOU FOR YOUR WORK!

    • admin
      Posted January 31, 2014 at 11:47 am | Permalink

      Dear Janine,
      Most melanomas occur on the least exposed areas and occupational sun exposure reduces risk. It is sun burning experiences that is a major causative factor. Sensible sun exposure may be reasonable. You can use the app dminder.info that can help guide you. Regarding dissolving vitamin D under the tongue there is no evidence it is more bio available and absorbed than when you take it orally.

      • jeannine
        Posted February 15, 2014 at 2:14 pm | Permalink

        Thanks so much for this information and agree it should be fine for me to have limited sun exposure and not complete 100% avoidance as my derm suggested.
        BUT, I wasn’t aware that sunburn could be causative for Melanoma. I thought it was just causative for the other forms basal and squamous? Is this not true?
        If so, does it take many years from a childhood sunburn to form into a potential cancer and even a Melanoma?

        Again, you thoughts are invaluable to me. You are my only trusted source and I think it is fantastic that you take the time to answer questions! Thank you

        • admin
          Posted March 3, 2014 at 12:54 pm | Permalink

          Dear Jeannine,
          Sunburns increase risk for both melanoma and non-melanoma skin cancer. That risk remains for your lifetime. The skin has a memory for the sunburns.

  31. Hanson
    Posted January 6, 2014 at 11:01 am | Permalink

    I am the neck down paralysed, recently I ask my GP to check the level of my vitamin D. The result was 8. And he prescribe vitamin D3 800 three times a day,I personally believe it is very low. And considering having 8000 three times a day is not enough because my Paine and fugitive are the same. Can I have your idea please.

    • admin
      Posted January 31, 2014 at 11:47 am | Permalink

      Dear Hanson,
      I treat my paralyzed patients the same way I treat all my patients i.e. 50,000 IUs of vitamin D once a week for 8 weeks and then 50,000 IUs of vitamin D once every 2 weeks thereafter. Alternatively you can take 3000 IUs of vitamin D daily.

  32. Posted December 30, 2013 at 8:29 pm | Permalink

    I am 46, always exercised, never smoked etc. However due to my job, school and trace ignorance and the fact that I despise the cold, I don’t get much sunlight. I have severe pain in both hips. Dr. says vitamin d level ok. I take 5000 IU daily. Despite his saying I’m not deficient, since I still have arthritis in my hips and hands and my urine is extremely, ( I repeat extremely), strong smelling, could my problem stem from some undiagnosed kidney problem thereby preventing absorption? I’m miserable, can’t sleep..hip and back pain. I also take glucosamine plus a multivitamin. I hardly drink water but even experimenting by upping water intake, urine still very foul. What do you think is going on?

    • admin
      Posted January 31, 2014 at 11:31 am | Permalink

      Dear Kimberly,
      I doubt that your arthritis-like symptoms are due to vitamin D deficiency especially since you are taking 5000 IUs daily. I seriously doubt that you have a kidney problem. Your doctor can easily determine that with a blood creatinine level. The kidneys activate vitamin D they do not help in its absorption.

  33. Abhishek
    Posted December 30, 2013 at 2:39 am | Permalink

    Dear Doc, Due to backache, my doc has put me on Boneshine 60k. Just started. As i read that if i stop taking the medicine few month down the line, i may again become Vitamin D deficient. As I live in India and consume complete vegetarian diet, please advise me best food as a source of Vitamin D.

    Regards
    Abhishek

    • admin
      Posted January 31, 2014 at 11:35 am | Permalink

      Dear Abhishek,
      Unfortunately there are very few foods that naturally containing vitamin D. They include oily fish, cod liver oil and mushrooms exposed to sunlight. Being a vegetarian the latter may be helpful. Also sensible sun exposure is an excellent source. You can use the app dminder.info to help guide you for sensible sun exposure.

  34. Constanza May
    Posted December 29, 2013 at 5:21 pm | Permalink

    Hello, We live in Berlin, Germany. I am mother of two teen boys- balet dancer at 18 and other 14 with obesity ( 170 high 100 kg). We use to live on Black see coast but now already 2 yers in Germany without any sun. I have got info for you several years ago, and now the information for your resurch pops up in my screan from no where. I would like to thank you for all you do dear dr. Holik. As I would like to start taking seriouse actions for bringing my so missed and need vitaminD for me and my kids, can you please recommend me some specialist in Berlin, Germany who is open to that kind of treatment, or the steps- what kind of exams i need to force my doctor for?, what brand of Vitamin D to choose (European or to be ordered by internet- which is safed and already cheked). Also do we have to take Vitamin D with Calcium?Where I can find 50 000 IU Vitamin D from? And if get this ammount once per week or two weeks? And what ammount of Calcium should be taken with 50 000 UI? How much for any of us; I am 34, my ballet dancer 18 with strong phisical activity (phseroasis treatment need it too), and my 14 years old with obesity. Thank you in advance for your kind respond! Kind regards- C.May

    • admin
      Posted January 31, 2014 at 11:35 am | Permalink

      Dear Costanza,
      Any national brand of vitamin D should be adequate. You and your children can take 3000 IUs daily which should be adequate. The brand that I personally endorse is Vital Choice which is salmon based vitamin D3. You can find it on the Internet.

  35. Rita Reifman
    Posted December 26, 2013 at 6:42 am | Permalink

    Dear Dr. Holick,

    First of all, thank you for all your work and educating on the importance of Vit D3.

    I, myself, have been a firm believer in using Vit D3 and have shared the benefits with many people.

    A few years ago was the last time I had my levels checked and my Vit D3 was at 59, and that was after I started supplementing with 5,000 i.u. daily. I decided to up it to 8,000 iu daily, plus I get 600 iu’s from my multi-vitamin and I have been doing that amount for about 2 years now.

    I decided to up it because of a few reasons: 1). since I no longer believe in getting the flu shot, I wanted the higher dosage for prevention, 2) due to my osteoporosis.

    For my osteoporosis, I was on Actonel for 5 years and when I started doing my own research and then when I began seeing a functional medicine doctor, I realized that the drugs were not something that I thought was beneficial once I understood more about what they were actually doing to my body.

    My mother has severe osteoporosis and has a huge dowagers hump and so I wanted to be proactive to hopefully prevent that from happening to me.

    I wanted to know from you if you felt that the 8,000 iu’s is too much to take each day. I split it up, 4,000 iu’s in the morning and 4,000 in the evening. Along with the Vitamin D3 I take: 1300 mg of calcium (as calcium carbonate, dicalcium phosphate, calcium citrate, calcium gulconate, calcium amino acid oligofructose complex), Vit. K- MK-7 (200 mcg/day), magnesium (900mg/day), biotin (5,000mcg/2x’s/day).

    One more piece of information – I’m 58 years old and I weigh 120 lbs. I noted that you yourself use 3,000 iu’s a day, and therefore I was a bit concerned that my own dosing of 8,000 iu’s daily might be too much.

    I would greatly appreciate it, based on the above, if you’d kindly let me know your expert opinion. I am currently unable to see the doctor, so I’d be grateful for your suggestions.

    Thank you in advance,

    Sincerely,

    Rita Reifman

    • admin
      Posted January 31, 2014 at 11:36 am | Permalink

      Dear Rita,
      There is no reason to split up the vitamin D. If you can have your blood level checked that would be helpful. I find that for me personally and for most of my patients that 3000 IUs of vitamin D daily is adequate to maintain blood level of 25-hydroxyvitamin D between 40-60 ng/mL which is the preferred range recommended by the Endocrine Society.

  36. Vania
    Posted December 24, 2013 at 4:53 am | Permalink

    Hello Dr. Holick,
    I’m reading your book “The Vitamin D Solution” and I really thank you for your work wich has opened for me a fascinating field in medicine!
    I’ve been diagnosed fibromyalgia almost 1,5 years ago and asked my doctor to check my levels of D3 vitamin. The result was insufficient. I’m assuming 25.000 Ul of supplement every 15 days and soon I’ll test my levels again.
    I’ve got some improvements with my muscle pains and aches, but not as much as I was expecting.
    I’ve many problems with my skin as well and this is negatively influencing my live.
    I’ ve 3 questions for you:
    1) which is the optimal level I should reach in ng/mol?
    2) should I test my calcium levels as well?
    3) somewhere in Internet I read that vit. D is as well protecting against mycosis and fungal problems, is it true?

    Waiting for your kind replay, for which I hope you’ll find the time,
    txs in advance
    br
    Vania from Italy

    • admin
      Posted January 31, 2014 at 11:36 am | Permalink

      Dear Vania,
      The Endocrine Society recommends a preferred level of 25-hydroxyvitamin D between 40-60 ng/mL which is equivalent to 100-150 nmol/l. It’s not unreasonable to have your blood calcium checked. Improvement in vitamin D status has been associated with reduced risk of infectious diseases. I am not aware however of any studies regarding reducing risk for fungal diseases although I would expect that it would.

  37. D-deficient
    Posted December 22, 2013 at 5:42 pm | Permalink

    I’m vitamin d deficient. My doctor recommended I take 1000IU a day, but I’ve been taking a multi at 1000IU a day already. I have to take cholestyramine and have a high BMI near 40. Also, I have to wear sunscreen everyday on my face for rosacea. I’m thinking I might need a much higher maintenance dose than the normal person. What would you recommend? If you can’t get back with, I still want to say thanks for all of the info you have provided in your book and online.

    • admin
      Posted January 31, 2014 at 11:42 am | Permalink

      You definitely need more of vitamin D for 2 reasons. The first is that cholestyramine reduces the absorption of vitamin D and the second is that if you have a BMI >30 often need at least 2-3 times more vitamin D to both treat and prevent vitamin D deficiency. I would recommend that you should be on at least 5000 IUs of vitamin D a day and to check your blood level of 25-hydroxyvitamin D.

  38. James Plummer
    Posted December 21, 2013 at 12:51 pm | Permalink

    Dr. Holick, is there any difference in how your body uses vitamin D between it being made in your skin from UVB light or taken orally. Considering it is passed through the liver when taken orally but goes directly into your bloodstream when exposed to UVB. I have read in some studies that not only is UVB exposure (and as you have said in lectures) 10 times more efficient but the quality and how it works in your body is extremely better. Do you know of a difference? Thank you.

    • admin
      Posted January 31, 2014 at 11:46 am | Permalink

      Dear James,
      The vitamin D that you make in your skin lasts at least 2-3 times longer in your blood stream than when you take vitamin D orally. Both methods are fine for satisfying your vitamin D requirement.

  39. Piyush Talus
    Posted December 20, 2013 at 4:16 am | Permalink

    Hello Doc, The Vit D level of my wife was 4.74 ng/ml on 29th July 2013. She took medications as advised and took the D-Gain sachet once a week. She didn’t take th medicines for longer duration. We got the test redone on 16th Dec 2013 and the reading was 13.09 ng/ml. The problem we are facing is that she is having acute pain in back and shoulder blade. No medication is helping it out. Can you suggest something here??

    Rgds,
    Piyush Talus

    • admin
      Posted January 31, 2014 at 11:30 am | Permalink

      Dear Piyush,
      Although I don’t know what the cause of her acute pain is, she is clearly vitamin D deficient. She should be taking an equivalent of 3000 IUs of vitamin D daily. It may help the pain.

  40. Posted December 19, 2013 at 10:05 pm | Permalink

    Hello Dr. Holick,
    Would you mind commenting on Vitamin D and MS? I realize there are a plethora of studies that indicate minimizing ones “risk” of developing the demyelinating disease, but what about someone like me who has had it for ~14 years? I’ve been rather stable, (I’m 43 y/o) however, just recently, I had a huge flare up in which I’m still recovering. 4 weeks ago, my D level measured 29. Perhaps this explains my recent attack, but I’m not sure. Over the past 3 weeks, I’ve been taking 15,000 IU’s on a daily basis so as to get to a better baseline. Symptom wise, I’m not really noticing any difference (with hip flexor strength, some spasticity, foot drop, generalized leg weakness, etc.). Might the Vitamin D help the remyelination component? If so, when might I expect to see noticeable results?
    Thanks for everything you do!
    Warm regards,
    Peggy

    • admin
      Posted January 31, 2014 at 11:22 am | Permalink

      Dear Peggy,
      Most studies have suggested that vitamin D deficiency increases risk for developing MS. There are very few studies to suggest that taking large doses of vitamin D can treat MS. However there is a physician in Brazil that treats MS patients carefully with megadoses of vitamin D with good success. You need to be very careful and have your blood and urine calcium measured if you take megadoses of vitamin D. I give my MS patients 50,000 IUs of vitamin D once every 2 weeks. It can sometimes improve muscle strength.

  41. Linda
    Posted December 18, 2013 at 3:43 pm | Permalink

    I watched your video and was intrigued by the Activated Vitamin D3 for psoriasis. My doctor wrote me an Rx but the compounding pharmacy said it was not sufficient. How is the Rx supposed to read exactly? And are there other companies who inventory the already made product tubes in the US now? You mentioned Galderma brand from Germany but I have not found anywhere that carries it so far. Thanks for your help!!

    • admin
      Posted January 31, 2014 at 11:21 am | Permalink

      Dear Linda,
      Vectical is available in the United States. It is calcitriol 3 mcg/gram base. Alternatively you can have your compound pharmacist formulate a 15 mcg calcitriol/gram Vaseline which is what we used in our initial clinical trials.

  42. Carol
    Posted December 17, 2013 at 12:26 pm | Permalink

    Starting in August, I experienced foot pain, like a pinched nerve. Then in October, I started to experience pins/needles (numbness) in both feet and hands. My doctor tested my blood and found out I was low Vitamin D. She said I was at 11 or 12 and normal is 30-100. She put me on 8 weeks of mega doses of 50,ooo mcg. She recently retested my blood and said it was within normal range. But I still have the pins and needles. I does come and go and seems to be improving slightly. Even though my blood levels quickly came back to normal levels, will it take longer for the numbness to go away? I have been taking the vit D for about 6 weeks now. Thank you in advance for your time!

    • admin
      Posted January 31, 2014 at 11:22 am | Permalink

      Dear Carol,

      Vitamin D can sometimes help neuropathic pain and tingling. However there are many other causes for these symptoms that are not treatable with vitamin D. You should however continue taking vitamin D to remain sufficient. I typically have my patients on 50,000 IUs of vitamin D every 2 weeks or to take 3000 IUs of vitamin D daily.

  43. Sidra Khan
    Posted December 16, 2013 at 8:55 am | Permalink

    Is it necessary to take the vitamin D IM injections early morning or can they be given at any time of the day?

    • admin
      Posted January 31, 2014 at 11:19 am | Permalink

      Dear Sidra,
      You can take it anytime of the day it does not matter.

  44. Murtaza
    Posted December 16, 2013 at 7:34 am | Permalink

    Hullo Dear Dr,

    My daughter is of 13 months old. She is suffering from blood disorder with excessive time of bleeding from any of trauma. A doctor has prescribed to give Vit-D by in shape of “Indrop-D” injection.

    I would like to know that is it useful or may cause some problem please.

    Waiting for your reply.

    Regards
    Murtaza

    • admin
      Posted January 31, 2014 at 11:21 am | Permalink

      Dear Murtaza,
      If she has excessive bleeding I would certainly not give her an injection of vitamin D but rather give it to her orally either in milk or a suitable substitute.

  45. Denise Fletcher
    Posted December 8, 2013 at 11:19 am | Permalink

    Re:Parkinson’s muscle pain and depression w/ hx of low Vit D
    Dr Holick,
    I am 64yo. I live in FL. I was diagnosed with Parkinson’s in 2008. My motor symptoms are slowness and stiffness of gait. In 2007 my endocrinologist(seeing for thyroid) was doing a study on Vit D. My results were 18. He treated me. Since I have had PD my levels have fluctuated down to 6 at one time. Depression and anxiety is one of my major PD sx too. My PCP thinks 1000u daily of Vit D is sufficient with serum levels of approx 37. Lately I have severe muscle pain all over especially my legs which is affecting my stamina to walk and excercise in general. My depression has been a real challenge to manage with meds. What would your recommendation be of dose and type of Vit D and Calcium?
    I so appreciate any recommendations to give me better quality of life.
    Denise Fletcher

    • admin
      Posted January 31, 2014 at 11:17 am | Permalink

      Dear Denise,
      Is your blood level 37 ng/mL or 37 nmol/l? The former is okay, the latter is considered to be vitamin D deficient. I typically have my patients on 1000 mg of calcium from diet and supplements and 3000 IUs of vitamin D daily or 50,000 IUs of vitamin D every 2 weeks.

  46. Trishala Jain
    Posted December 6, 2013 at 3:18 am | Permalink

    Dear Doctor,

    I am Trishala and I am from India.

    I developed panic attack and anxiety in the year 2011 which lasted for about a month. Later on, I started developing pulling sensation in my head and often used to feel dizzy and out of balance. I did all kinds of tests including Echo, CTScanc for sinus, blood work ( they did not prescribe Vitamin test). Nothing came in the result and my doctor put me on flunarine for few months.
    In 2012 April, I started getting migraine headaches and head pulling, nausea, muscle twicting, body pain, fatigue, ringing in the ears etc., I met the neurologist and she put me on Beta blockers…for few months..which helped but as soon as I stopped teh tablets the head problem woudl appear.
    In 2013, I got my Brain MRI and it was normal. Then my doc got my Vitamin D 3 tested and it was 7.89 ng/mL. This was in July’13.
    My doc put me on 50000 IU of vitamin d 3 supplement once a week for 8 weeks after which I was advised to take 60000 IU once a month . All my symptoms started disappearing from 1st week itself. However, I have been having uneasiness in my head , cannot get proper sleep and worry a lot about my health.
    It has been 3 months since I started my 60000 IU monthly course. I feel teh dosage is not helping me. I have deveoped sizziness and sleeplessness again since one week.
    Can you please advise me as to what shoudl be teh apporpriate dosage. I did my blood work in sept ’13 and my level was 39 ng/ml.

    I want to have

    • admin
      Posted January 31, 2014 at 11:14 am | Permalink

      Dear Trishala,
      I usually give my patients 50,000 IUs of vitamin D every 2 weeks once I have corrected their vitamin D deficiency. That is what I would recommend for you based on your blood level of 39 ng/ML.

  47. Maria
    Posted December 3, 2013 at 10:44 pm | Permalink

    Dr Holick,

    My blood test results shows vitamin D in 13 ng what that means? The test shows D 3 in 13 ng and D 2 in 4 ng

    Thank you

    • admin
      Posted January 31, 2014 at 11:12 am | Permalink

      Dear Maria,
      A 25-hydroxyvitamin D of 13 is consistent with vitamin D deficiency. The D3 represents what you were getting from sun exposure and diet and D2 represents any vitamin D2 from your diet or from supplements. You should definitely be treated.

  48. Melissa
    Posted December 2, 2013 at 6:17 pm | Permalink

    I was tested 8/13 and the results were
    25-HydroxyVitamin D -20
    D2 – <4
    D3 – 20

    After taking 50,000 IU weekly for 10 weeks my test results were
    25-HydroxyVitamin D – 45
    D2 – 34
    D3 – 11
    Is this normal and why did the "D3" level decline?

    • admin
      Posted January 31, 2014 at 11:12 am | Permalink

      Dear Melissa,
      You have been successfully treated. 45 ng/mL is perfect. The reason for the assay result of D2 of 34 is because you are taking vitamin D2. The D3 represents the vitamin D that you had obtained from sun exposure and diet.

  49. Eunwhan
    Posted November 28, 2013 at 3:25 pm | Permalink

    Dear Dr.Holicks,
    I am 25 years girl and suffering from vitamin D deficit. I have a lower back pain wheneva i stand for more than 15-20 mins or walk continuously or do so physical work. Its been 6-7 years i have this back pain.I did MRI also but the result shows nothing so big problem to have this so much pain. I have pain in lower back and spread towards the lower half of the body. 2 months before i had blood test for vitamin D and found its 5.5. Since then I have been taking 60000IU calcirol till now. I have been taking calcium tablets also since 2 months. But still i have pain in my joints, even in my shoulders. I feel like i want to elongate my hands and legs time and again. It really hurts me alot and the pain goes worse at night when i stay in my bed. I use hot water bag to lower the pain. I feel so tired all the time. Always sleepy, yawning time and again. And I am so nervous most of the time. High heart beating time and again since many years. There are so many problems in every part of my body. I am 5 ft 8 inch tall and weighs 70 Kg. Please tell me what should i do now ? My doc said i need to take the medicines for 2 mths only and now its 2 months. I checked my vitamin d and now it is 73. It is fine now. But i have the pain and i think it is spreading all over my body. Please help me and guide me what to do ahead. Thanks!!

    • admin
      Posted January 31, 2014 at 11:11 am | Permalink

      Dear Eunwhan,
      Often patients with vitamin D deficiency and osteomalacia bone pain require at least several months of vitamin D therapy before they experience any improvement. Your blood level of 73 nmol/l is fine and you should continue taking vitamin D of 3000 IUs daily. If the pain does not improve then there is likely another cause separate from vitamin D deficiency.

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