Different amounts of vitamin D needed to prevent different diseases

Does Vitamin D Sufficiency Equate to a Single Serum 25-Hydroxyvitamin D Level or Are Different Levels Required for Non-Skeletal Diseases?

Nutrients 2013, 5(12), 5127-5139; doi:10.3390/nu5125127 (doi registration under processing)

Simon Spedding 1,spedding@adam.com.au, Simon Vanlint 2 Howard Morris 1,3and Robert Scragg 4

1 Division of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia

2 Discipline of General Practice, School of Population Health, University of Adelaide, Adelaide, SA 5005, Australia

3 SA Pathology, PO Box 14, Rundle Mall, Adelaide, SA 5000, Australia

4 School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand

Received: 28 October 2013; in revised form: 27 November 2013 / Accepted: 28 November 2013 / Published: 16 December 2013

Objective: Clarify the concept of vitamin D sufficiency, the relationship between efficacy and vitamin D status and the role of Vitamin D supplementation in the management of non-skeletal diseases. We outline reasons for anticipating different serum vitamin D levels are required for different diseases.

Method: Review the literature for evidence of efficacy of supplementation and minimum effective 25-hydroxyvitamin D (25-OHD) levels in non-skeletal disease.

Results: Evidence of efficacy of vitamin supplementation is graded according to levels of evidence.

Minimum effective serum 25-OHD levels are lower for

• skeletal disease, e.g., rickets (25 nmol/L), osteoporosis and fractures (50 nmol/L), than for

• premature mortality (75 nmol/L) or non-skeletal diseases, e.g., depression (75 nmol/L), diabetes and cardiovascular disease (80 nmol/L),

• falls and respiratory infections (95 nmol/L) and

• cancer (100 nmol/L).

Conclusions: Evidence for the efficacy of vitamin D supplementation at serum 25-OHD levels ranging from 25 to 100 nmol/L has been obtained from trials with vitamin D interventions that change vitamin D status by increasing serum 25-OHD to a level consistent with sufficiency for that disease. This evidence supports the hypothesis that just as vitamin D metabolism is tissue dependent, so the serum levels of 25-OHD signifying deficiency or sufficiency are disease dependent.

Summary of study and some links to other VitaminDWiki pages

Australian National Health and Medical Research Council Evidence Hierarchy

• 1 Systematic review of Level II studies

• 2 Randomised controlled trial,

• 3-1 Pseudo-randomised controlled trial

• 3-2 Comparative study with concurrent controls:

  •      non-randomised, experimental trial,cohort study, case-control study, or interrupted time series with a control group
• 3-3A comparative study without concurrent controls:
  •      historical control study, or two or more single arm study, Interrupted time series without a parallel control group

• 4 Case series with either post-test or pre-test/post-test outcomes

  PDF is attached at the bottom of this page

Comment by VitaminDWiki

There is a lot of evidence that the higher the vitamin D levels, the less occurrence of a particular disease as well of fewer of all diseases.

The study on this page just shows the detectable beginnings of disease prevention due to vitamin D

A nice summary of the prevention evidence is in the following chart

There are also many studies which prove that vitamin D TREATS diseases.

See also VitaminDWiki

• Is 50 ng of vitamin D too high, just right, or not enough

• Click on following chart for details of increasing vitamin D llevels to deal with different diseases

Proof that Vitamin D Works has the following summary

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How often might 50,000 IU vitamin D be taken - results of clinical trials re-arranges the above data (from summer 2013) by dose