25-hydroxy Vitamin D level recommendations for patients were plentiful at the American Society for Bone and Mineral Research (ASBMR) 2012 meeting. Many opinions. Little agreement. Research presented was usually observational. It did not specifically look at daily activity levels in relation to falls. It often only studied the elderly and nursing home residents.
Dr Neil Binkley, of the University of Wisconsin, gave the clinical summary presentation about Vitamin D dosing. He cited studies of blood levels in people who get their Vitamin D naturally from the sun. That included surfers, farmers, construction workers, and traditional herdsman cultures in Africa. These groups have average blood levels in the 40-60 ng/ml range. I recommend levels above 40 for my patients.
All Researchers recommend levels of at least 20 ng/ml. Many recommend over 30 ng/ml. I discussed this with the group from Creighton University and others. They agreed that we must evaluate PTH (ParaThyroid Hormone) level, be sure that DXA and VFA are stable, and be sure patients are not experiencing Fragility Fractures. If any of those are issues, they supplement with Vitamin D3 until bone health is optimal. That often requires more than 30 ng/ml.
Take Control Naturally by achieving the Vitamin D blood levels of people living the natural lifestyle of thousands of generations of humans. For those in the north, that includes taking Vitamin D3 supplements, although not necessarily the traditional (tasty ??) cod liver oil version. Remember, most modern Fish Oil supplements do NOT have Vit D3 (Cholecalciferol). Read the label carefully.
Jay Ginther, MD