Clinical Pearl Wednesday #145

Vitamin D capsules

One of the most common health & wellness recommendations that we offer patients is to “take your vitamin D”.  However, many of us don’t take the time to teach the detailed information needed for optimal absorption of Vitamin D, resulting in poor improvements in lab levels and symptoms.

Vitamins A, D, E, and K are fat soluble, requiring that fats be eaten at the same time as the Vitamin supplements.  Providers sometimes do recommend Vitamin K with the Vitamin D, but we often overlook the need for the fats. So, teach your patients to take their Vitamin D with some sort of fatty food (or an omega 3!).

Another co-factor for Vitamin D is magnesium.  Ideal forms of magnesium are malate, glycinate, or taurate.  Citrate, oxide, and chloride forms of magnesium are poorly absorbed systemically, but are great for laxative purposes. 

Some manufacturers are beginning to package Vit D and K together, but not many add the magnesium.  A preprinted handout that lists your preferred serving sizes, brands, and dosing pattern saves you time and effort during patient appointments and ultimately improves compliance and patient satisfaction!

Sample dosing suggestions:

          Vitamin D 5000-10000 IUs daily WITH fatty food and

          Magnesium taurate 100-150 mg and

          Vitamin K 50-100 mcg 

So, make sure your patients are taking their Vitamin D with fat, magnesium, and Vitamin K!

6 Responses

  1. Good reminders, please also remember that as a fat soluble vitamin it is possible to have hypervitaminosis. Personally, unless I have a Vitamin D level I do not recommend more than 2000iu daily of D3. And then, a level should be checked in about 3 months. ( I say this in the northeast where having checked 1000’s of levels I don’t see a normal level in anyone with a normal parathyroid who doesn’t supplement.) Lighter skin less vitamin D usually needed (unless awesome about sunblock) and darker skin more.

    1. Yes, you definitely need to keep a close eye on the levels. I personally have found the sweet spot for my patients to be 5000iu daily. It usually keeps their levels in the 60-70 range.

  2. Another pearl to add to my body of knowledge. Our facility only have the oxide formulation on formulary. I will start telling patients to get the other forms.

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