New Guidelines Highlight Who Should Be Getting More Than the Recommended Vitamin D

Over 40% of American adults are deficient in vitamin D. But how do you know when you actually need to take a supplement?

That guidance is still lacking, a panel of clinical experts agreed. Together, they teamed up to establish clinical practice guidelines for the Endocrine Society, which they published earlier this month.

After evaluating randomized placebo-controlled trials, the researchers determined several groups need more vitamin D than the Recommended Dietary Allowance suggested by the National Institutes of Health (NIH), which is 600 IU or 15 mcg for people between the ages of 1-70:

• Children and adolescents aged 1 to 18 years in order to prevent nutritional rickets and lower the risk of respiratory tract infections
• People 75 and older to reduce mortality risk
• Pregnant people in order to reduce preeclampsia risk, pregnancy loss, preterm birth, and low infant birth weight
• People with high-risk prediabetes in order to prevent progression to diabetes

The researchers did not suggest an ideal dose of vitamin D for any of these groups; they only indicated these people need more vitamin D than current dietary guidelines suggest.

Low vitamin D levels are linked to many negative health outcomes, including issues related to bone health, heart health, and immune health. Still, the endocrinologists recommended against regular screenings for vitamin D deficiency for the general population, concluding the risk of over- or under-diagnosis is too great given the lack of clarity about what vitamin D levels should be in the first place.

The authors note that these suggested vitamin D recommendations are not meant to replace the current Recommended Dietary Allowance for the general population. Nor do these guidelines apply to people with established indications for vitamin D treatment or testing, like people with kidney disease.

How to Support Healthy Vitamin D Levels

Based on these new suggested guidelines, children, pregnant people, those over the age of 75, and those with high-risk prediabetes should consider supplementing with vitamin D at a dose that exceeds the Recommended Dietary Allowance, ideally under the guidance of a healthcare provider. For all others who don’t have a medical condition that dictates otherwise, supplementation to help meet the currently recommended dosage of 600 IU/day is suggested. (For people older than 70, that recommendation increases to 800 IU).

When choosing vitamin D supplements, some data suggests opting for vitamin D3 as opposed to vitamin D2 in order to increase levels faster.

Edwina Clark, RD, a California-based dietitian who was not involved with the research, agrees with the Endocrine Society’s findings that while existing guidance is helpful, vitamin D recommendations should really be tailored to the individual. She also emphasizes that the proposed new guidance does not recommend mega-dosing on vitamin D.

“Consuming too much supplemental vitamin D can be toxic and even fatal,” Clark told Verywell. “Symptoms of vitamin D toxicity include loss of appetite, nausea, vomiting, muscle weakness, confusion, dehydration, thirst, kidney stones, and eventually calcifications of tissues and organs.”

There aren’t many food sources of vitamin D, but a few items can help you meet your needs, including:

• Rainbow trout
• Sockeye salmon
• Mushrooms
• Fortified orange juice
• Dairy milk
• Fortified plant-based dairy beverages
• Fortified breakfast cereal

“Fortified breakfast cereal now contains [up to] 20% of the daily value for vitamin D, making it an affordable and convenient option to add to your family’s routine,” Elizabeth Shaw, RD, told Verywell.