Supplements help patients reach target vitamin D levels

Key takeaways:

• Most people in the U.S. do not get the recommended amount of vitamin D.
• Supplements help patients reach their recommended levels, but it is important to not rely on them for general health, a speaker said.

BOSTON — Most people in the United States do not get enough vitamin D, but supplementation helps patients reach the daily recommended dietary allowance, according to a speaker at the ACP Internal Medicine Meeting.

An estimated 20% to 40% of the population take vitamin supplements, Noah Stratton, DO, FACP, an internal medicine specialist in Temple, Texas, said in his presentation.

“This does represent over a $50 billion industry as of some 2020 data,” he said. “[But] the data [are] so nuanced and inconsistent, either based on dosing or timing, that it’s really difficult to have consistent evidence.”

Stratton touched on the evidence surrounding various vitamins throughout the presentation but spent most of his time on vitamin D because it is “considered one of our shortfalls in nutrients.”

“Essentially, it’s a nutrient that we don’t get enough of as a population,” he said. “It is synthesized endogenously so you don't have to consume it, and what’s interesting about vitamin D receptors is they’re really found throughout the body, so it has been implicated in a number of different disease states.”

The recommended dietary allowance for vitamin D is 600 to 800 IUs per day, but “when you look at U.S. consumption of vitamin D, you're only getting about 160 to 200 IUs of vitamin D per day,” Stratton said. To remedy this, an estimated 30% of the population takes some form of vitamin D supplement.

“For those that do supplement, they tend to get 800 plus IUs,” he said. “So those that supplement tends to hit that recommended daily allowance.”

The most common supplements come in two forms, D2 or D3, both of which are well-absorbed in the gut and will raise serum 25(OH)D levels. However, D3 will increase them for longer and to a greater extent, and “is probably your better choice between the two.”

Overall, Stratton said it is important to eat a balanced, healthy diet and know that more supplementation is not always better. If a patient is healthy, a vitamin supplement will not help them stay healthy — proper sleep, nutrition, stress management, exercise and a sense of purpose will.

He concluded with a quote from the 2020-2025 Dietary Guidelines for Americans.

“Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods,” Stratton said. “In some cases, fortified foods and dietary supplements are useful when it is not possible to otherwise meet needs for one or more nutrients.”