Given that an estimated 100 million American adults are diabetic or pre-diabetic, will this sub-population begin to receive prescriptions for vitamin D from their doctors?  This question is now asked because of a revealing study showing diabetics in particular are at 4.5-times greater risk for an early death when their blood levels of vitamin D are low.  The risk of death from infectious disease also doubles for individuals who are deficient in vitamin D.

While an abject deficiency of vitamin D is defined as a blood concentration of 10 nanomoles per liter of blood, survival data confirms “a strong association of vitamin D deficiency (under 50 nanomoles/liter or 20 nanograms/millilter) with increased mortality.”

There are two ways of measuring blood concentration levels of vitamin D.  The most often cited dividing line between health and disease is 20 nanograms/milliliter or 50 nanomoles per liter of blood.

The Institute of Medicine considers blood levels of 50 nanomole/liter or 20 nanograms/milliliter to meet the requirements of 97.5% of the population.  Yet an estimated 42% of Americans are vitamin D deficient when defined as a blood concentration below 20 nanograms/milliliter/ 50 nanomoles/liter of blood.     How Not To Die With Tr... Henriques, Tiago Best Price: $18.23 Buy New $17.97 (as of 08:00 UTC - Details)

A different analysis shows 9600 units of vitamin D from dietary supplements is needed to ensure 97.5% of the population achieves a blood level of 40 nanograms/100 nanomoles.

While this headline study did not find any increased risk for mortality among adults over 75 years of age, other studies do.   Another recently published study reveals a vitamin D blood level of 30 nanograms/milliliter increases mortality rates 2.7 times for elderly adults.  Yet another recent study shows blood levels of vitamin D below 50 nanomoles/liter increased the risk for death from cardiovascular disease in senior adults.

It’s obvious that the Institute of Medicine’s definition of “optimal blood level” for vitamin D (20-50 nanograms/milliliter or 50-125 nanomoles/liter of blood is outmoded.

It takes about 5000 IU (international units) of oral vitamin D3 for most people to achieve a blood concentration of 50+ nanomoles or 20 nanograms.

The Institute of Medicine, which establishes nutrient intake levels (Recommended Daily Allowance), sticks with its 600 IU (15 micrograms)/day recommendation.  This intake level is incorrect say two vitamin D experts.  Specifically, sun-deprived individuals or people with dark pigmented skin who do not produce as much vitamin D from sun exposure, will not be assured of reaching healthy intake levels.  The Institute of Medicine’s “safe upper limit” of 4000 IU is the minimum adults should take to supplement their diet.  The Endocrine Society now says 4000 IU/day should be supplemented for children and 10,000 IU for adults.

Over $1 billion of vitamin D pills are being sold annually and blood levels of vitamin D have risen 83-fold from 2000-to-2010.  About 2000 IU of supplemental vitamin D is needed to raise blood levels 20 nanograms or 50 nanomoles.  The diet provides very little vitamin D (only 400 IU in a serving of fortified milk) which would only trivially raise blood levels.

Except during the summer months, the body makes little if any vitamin D from the sun at latitudes above 37 degrees north (in the United States, the shaded region in the map).

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