Simplifying the New Vitamin D Recommendations From The Institute of Medicine

Pam Flores @phflores Health Guide
  • Last month the Institute of Medicine (IOM) produced a 500-plus page recommendation for the daily intake of Vitamin D that will affect our recommended daily allowance (RDA) of this nutrient.


    Since most of this is a bit confusing, I thought we'd break it down for you to make it easier to understand and explain who it applies to.


    Let's start with the previous recommendation that was issued in 1997 and was recently updated November 30, 2010.


    Institute of Medicines Previous Vitamin D Recommendations


    Healthy Adults under 71

    200- 400 International Units (IU) a day

    Adults over 71

    600 IU a day


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    IOMs New Recommendation on D


    Healthy Adults under 71

    600 IU a day

    Adults over 71

    800 IU a day


    For some of us these numbers seem rather low because we are either extremely D deficient or just deficient and our doctor has us on a much higher dose.  When a patient is put on a higher dose of D than what's listed above it's because our circulating D test scores fall below the ˂ 30 ng/mL amount.


    For those who've been following the above recommendation, this is a step in the right direction since it is increasing the amount we need to take.


    The IOM did not address the amounts a high risk patient should take, so those on a therapeutic dose, that is much higher than what is recommended, should remain on that dose until your doctor changes the amount.


    The upper tolerable limit (UTL) for this vitamin is now at 4,000 IUs a day.  If you are taking more than 4,000 IUs a day, you may be a high risk individual or your D levels are too low. Therapeutic doses are taken until you raise your vitamin D score to an acceptable score.  If you are concerned about this amount, talk to your doctor and have a vitamin D test done to see where you stand on your vitamin D score.


    Since vitamin D is difficult to get from our diet, most need to supplement with oral D.  The things that contain vitamin D are: fortified foods, fatty fish and daily sun exposure.  If you are unable to get daily sun, due to your geographic location, then supplemental D is very important.


    Many of the vitamin D experts do not agree with the IOM recommendations or the U.S. labs interpretation of a normal 25 (OH) D test result.  According to our labs, a normal score is anything between 30 and 100 ng/mL.


    Osteoporosis Foundations That Differ From the IOM on Vitamin D

    • The National Osteoporosis Foundations recommendations on D are:

                      Those over the age of 50 should take 800-1,000 IUs a day

                      Those 19 to 49 should take 400 to 800 IUs of vitamin D a day

                      Those over the age of 50 should take 800-2,000 IUs a day

                      Over 50 should take 400-1,000 IUs a day

    • National Osteoporosis Society (UK):

                      Older patients should take 400 IUs a day


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    According to the National Osteoporosis Foundation (NOF) Osteoporosis Canada, and the National Osteoporosis Society, they have no plans to change their recommendations to that of the IOM since bone loss puts individuals at high risk and their recommended amounts are under the UTL suggested by the IOM.  The NOF recognizes that many at-risk individuals would need to take an amount higher than the recommended amounts of 1,000 IUs a day.  These figures, from the NOF, have been in place since 2008.


    If you have concerns with this new RDA in the U.S., and the amount you are taking, discuss this with your doctor since you may be on a necessary higher dose due to your high risk status.




Published On: December 11, 2010