Vitamin D: The Right Intake

Taking vitamin D is an excellent preventive, but also therapeutic measure. Because no matter whether it is an increased susceptibility to infections, autoimmune diseases, degenerative symptoms, or problems such as diabetes, high blood pressure, depression, or dementia, a vitamin D deficiency is usually involved in what is happening. We explain how you can detect a vitamin D deficiency in a home test, how much vitamin D you need, and how to combine vitamin D correctly with calcium, magnesium, and vitamin K.

Vitamin D – Calculate the right dosage

Vitamin D is particularly well-known for its bone-strengthening effect. It promotes the absorption of calcium from the intestine, is involved in the incorporation of calcium into the bones, inhibits bone breakdown, and at the same time strengthens the immune system.

At the same time, there is hardly a disease that is not caused by a vitamin D deficiency. For example, vitamin D is considered a vitamin with an anti-inflammatory effect, which alone is reason enough for its positive influence on most chronic complaints – because they are all associated with chronic inflammatory processes.

Unfortunately, hardly anyone knows how to correctly calculate and dose vitamin D and how to take it in the right combination with calcium, magnesium, and vitamin K.

(If you are interested in vitamin D blood levels, which level indicates a deficiency, and which level is just right, check out the link above (under vitamin D).)

Vitamin D – a deficiency is widespread

Vitamin D is not a real vitamin. Because while real vitamins have to be ingested with food, the body can also get enough vitamin D from sunlight alone, since vitamin D is formed in the skin under the influence of UVB radiation.

However, in Central Europe, this only works in summer (from around April to September) – and then only if you don’t constantly use sunscreen, as it inhibits vitamin D formation.

The rest of the year the sun is too low to send enough UVB radiation to the earth. In Central Europe, you can only get a good supply of vitamin D with the help of the sun if you really spend a lot of time outdoors in the warm season in order to replenish your stores so extensively that you can get through the winter well.

However, many people do not succeed in doing what the modern lifestyle of spending hours in closed rooms every day is not entirely innocent of. Therefore, large parts of the population suffer from vitamin D deficiency.

Vitamin D is a fat-soluble vitamin

Along with vitamins A, vitamin E, and K, vitamin D is one of the fat-soluble vitamins. That means two things:

• Some fat is always required for the absorption of vitamin D from the intestine (see below under “Always add some fat to vitamin D”).
• Vitamin D can be stored in the body (in adipose tissue and in the liver), which is almost never the case with water-soluble vitamins (B, C).

The advantage is that you don’t have to take vitamin D every day once your stores have been filled. The organism can draw on a full store for weeks or even months.

The downside is that you can overdose on fat-soluble vitamins. Because while excess water-soluble vitamins are simply excreted through the urine, this is not the case with fat-soluble vitamins. For example, cases of vitamin A overdoses are reported from time to time, for example in areas where the fish liver is eaten. This contains a particularly large amount of vitamin A.

Vitamin D – What Dose Leads to Overdose?

As far as vitamin D is concerned, there is usually only a risk of overdose if very high doses are taken in the form of dietary supplements over a longer period of time.

50 µg or 2,000 IU per day is the recommended maximum dose in Europe and North America. However, clinical studies show that a long-term intake of 10,000 IU daily does not entail any risks. An overdose could occur at 50,000 IU per day and serum levels greater than 150 ng/ml, in the form of hypercalcemia (too much calcium in the blood), according to a May 2011 analysis by Indian researchers in the Oman Medical Journal.

Ideally, the blood levels of vitamin D should be below 100 ng/ml, since primitive peoples rarely reach higher levels, even though they spend little time in the sun with little clothing. The toxic range clearly begins at 300 ng/ml.

Vitamin D overdose: from 50,000 IU per day over several months

Various case reports from 2011 have also become known in which a vitamin D overdose had led to symptoms. A 70-year-old woman who took 50,000 IU daily for three months developed the typical symptoms of hypercalcemia: tiredness, difficulty walking, and confusion. However, after stopping the vitamin D, she made a full recovery over the course of five months. It should be noted here that she had also consumed more than 3 g of calcium per day.

Another case describes a man who accidentally took approximately 2,000,000 IU of vitamin D per day for two months and then also suffered from confusion, fatigue, excessive thirst, and frequent urination.

And in a third case, the typical symptoms of hypercalcemia were also observed in a man who took 50,000 IU of vitamin D daily for six months:

• Excessive thirst and frequent urination
• Stomach discomfort, nausea, vomiting, and constipation
• bone pain, muscle weakness
• Confusion, lethargy, and exhaustion

Vitamin D overdose from food or sun?

Since vitamin D is hardly found in food, it is almost impossible to eat a vitamin D overdose.

It is also almost never possible to get a vitamin D overdose from exposure to the sun. Apparently, the body has protective measures that stop vitamin D formation through the skin as soon as a sufficiently high serum value is reached.

On a sunny summer day, the body rarely absorbs more than 10,000 IU of vitamin D – and only if you spend the whole day in the sun with almost no clothing (swimming trunks/bikini).

Unfavorable consequences of a vitamin D overdose could only occur in the case of extreme solar radiation (years and years in hot regions on the beach all day long) but only if there is a vitamin K2 deficiency and possibly a well-intentioned calcium supply at the same time.

Vitamin D and vitamin K2 belong together

For this reason, it is always recommended when taking vitamin D to ensure a healthy vitamin K2 supply at the same time. Vitamin K2 is the vitamin that fulfills two major tasks in the body:

• Vitamin K regulates blood clotting so that no one bleeds to death from even the smallest wound.
• Vitamin K conducts excess calcium in the blood into the bones, thus ensuring that the calcium is not deposited on the blood vessel walls or in the form of kidney stones.
• Since vitamin D promotes the absorption of calcium, the amount of calcium absorbed increases with the intake of vitamin D. If vitamin K2 is missing, the problems mentioned above can occur, i.e. a maldistribution of calcium in the body.

The recommended doses of vitamin K2 for vitamin D supplementation vary considerably among experts. There you will find information on how

• 100 µg vitamin K2 per 5,000 IU vitamin D,
• 100 µg of vitamin K2 per 10,000 IU of vitamin D or even
• 100 µg of vitamin K2 per 1,000 IU of vitamin D.

We recommend the following vitamin K2 intake

• 100 µg of vitamin K2 with up to 2,500 IU of vitamin D per day
• 200 mcg of vitamin K2 for vitamin D doses over 2,500 IU per day

If you want to dose the vitamin K2 more individually, you can use this formula: 2 – 3 µg vitamin K2 per kilogram of body weight.

However, also note the vitamin K2 content of your food. If you get enough vitamin K2 from food, you may only need to take vitamin K2 for the first few weeks of your vitamin D intake.

Vitamin K2 is available in different forms, we recommend menaquinone-7, also abbreviated as MK-7, as a dietary supplement. It is vegan and is considered the best absorbable and most usable form of vitamin K2.

Anyone who takes blood thinners or other medications that do not go well with vitamin K must discuss vitamin K administration with their doctor as a precaution.

Vitamin D and vitamin A work together

Vitamin D works better in the presence of vitamin A, and vitamin D levels also rise higher when vitamin A is taken at the same time – at least according to a study from August 2020. You can read more about this in our article Vitamin D needs vitamin A. Be careful i.e. a good supply of vitamin A (about 1 mg per day).

Vitamin A can be absorbed via beta-carotene, which is contained in many types of vegetables because the organism can produce vitamin A from beta-carotene. However, you should also eat beta-carotene-rich vegetables every day, because the organism needs at least 6 times the amount of beta-carotene to produce 1 mg of vitamin A, i.e. 6 mg. The following vegetables are among the best sources of beta-carotene:

• Carrots raw 9.8 mg beta carotene (1.6 mg vitamin A)
• Spinach raw 4.7 mg beta carotene (0.8 mg vitamin A)
• Kale raw 5.1 mg beta carotene (0.8 mg vitamin A)
• Lamb’s lettuce raw 3.9 mg beta carotene (0.65 mg vitamin A)
• red peppers raw 2.1 mg beta carotene (0.35 mg vitamin A)

The content does not change noticeably during cooking because beta-carotene is not heat-sensitive; the bioavailability could even increase through cooking.

In the study mentioned, even the vitamin A level of the participants was originally normal. Nevertheless, an additional intake of vitamin A (together with the vitamin D intake) resulted in a higher vitamin D level and also an improved effect of vitamin D.

Especially in the case of acute illnesses and a simultaneous vitamin D deficiency or if the vitamin D level does not rise satisfactorily despite all efforts in the case of a vitamin D deficiency, the additional intake of vitamin A or beta-carotene could be of great help.

Vitamin D and magnesium belong together

Since magnesium is needed in the body to activate vitamin D and is also consumed in this process, taking vitamin D requires an optimized supply of magnesium.

The daily requirement of magnesium for an adult is about 400 mg. Anyone who takes in this amount of magnesium through their diet should be well supplied with a vitamin D supplement of up to 5,000 IU.

However, those who take more vitamin D should also take magnesium with this higher dose of vitamin D, between 200 – 300 mg – depending on the magnesium content of the diet.

• Vitamin D has no effect in the absence of magnesium
• Vitamin D and calcium only advisable in certain situations
• Vitamin D is THE bone vitamin par excellence and is therefore often taken in combination with calcium. However, this only seems to make sense in certain cases,

e.g. B. The aim is to specifically reduce the risk of osteoporosis during menopause,
if osteoporosis is already present and the risk of fractures should be reduced or
if a low-calcium diet is practiced that provides significantly less than the daily recommended 1,000 mg of calcium.
However, if you consume enough calcium, you should not take any additional calcium in addition to vitamin D intake, especially if you are taking a very high amount of vitamin D. This could increase the risk of hypercalcemia.

Before taking vitamin D: measure the vitamin D level!

Before you decide to take vitamin D, you should have your vitamin D level measured. Otherwise, it could be that you are taking far too little and therefore not feeling any effect. Or you take much more than necessary, which in turn would put unnecessary strain on your body.

You should only take as much vitamin D as you personally need. To find the right dose for you, measure your current vitamin D level. This can be done by your family doctor or naturopath. However, you can also carry out a vitamin D home test yourself at home. However, to be on the safe side, you should also discuss the result with a doctor or naturopath.

The test can be ordered online, costs around 30 euros, and requires little effort. You prick your finger (the necessary accessories are included in the test), put a few drops of blood in the test tube, close it and send it to the named laboratory in the enclosed mailing bag. You will receive the result by post within 5 to 7 working days, namely your personal vitamin D value.

With the help of the tables listed in this article (your vitamin D level – what you need to know) you can then determine the vitamin D dose you need (have it approved by your doctor/alternative practitioner) and get the right preparation. (Be sure to read on, however, as we describe another method of individual dose determination in the next section).

After two to three months, you should test your vitamin D level again, firstly to see how it has risen and secondly to adjust your vitamin D dose to the new value.

Which vitamin D dose is the right one?

The goal should be a blood value of at least 30 ng/ml, better about 40 to 50 ng/ml vitamin D3 (25(OH)-vitamin D3). The vitamin D dose that is right for you is now calculated from your current value and your desired value – taking your body weight into account.

In the case of a massive vitamin D deficiency, the procedure described in the article linked above may not lead to healthy vitamin D levels quickly enough. Therefore we present you the method according to Dr. medical Raimund von Helden, author of the recommended booklet Healthy in Seven Days – Success with Vitamin D Therapy.

Dr von Helden divides vitamin D therapy into two parts: initial therapy and long-term or maintenance therapy.

• After a deficiency, the initial therapy serves to replenish the vitamin D stores, which should happen as quickly as possible so that the deficiency symptoms that are usually present can also be remedied as quickly as possible. It is a single dose. This is followed by the dose of long-term therapy.
• Maintenance therapy provides the amount of vitamin D needed to make up for daily losses and maintain healthy vitamin D levels over the long term.

The calculation of the vitamin D dose for the initial therapy

To raise the vitamin D level by 1 ng/ml, you need 10,000 IU for a body weight of 70 kilograms. If the body weight is different, recalculate the value proportionally. 7,000 IU per kilogram of body weight should not be exceeded.

For example, if you weigh 70 kg, have a current vitamin D level of 15 ng/ml, and want to reach a level of 35 ng/ml, then select a single dose of 200,000 IU as the starting therapy. If you only weigh 60 kg, then take about 170,000 IU.

Calculating the vitamin D dose for long-term therapy

Assuming a body weight of 70 kilograms, 3,333 IU of vitamin D per day or 23,000 IU of vitamin D per week is required. Again, if the body weight is different, the dose is calculated proportionally.

Anyone who spends a lot of time in the sun in summer can take a break from taking vitamin D during this time. However, it would probably not develop into an alarmingly high value if you continue to take it despite sunbathing.

Always take vitamin D with a little fat

If you take vitamin D preparations, which are available as a powder in capsules, with coffee, water, or juice, this leads to absorption of the vitamin, but to a rather low level of absorption. As a fat-soluble vitamin, vitamin D should always be taken with a little fat.

Too much fat is not a good idea either. So if you take your vitamin D with thick bread or greasy cheese, you can’t get the ideal dose either. Excessive amounts of fat appear to inhibit absorption.

A 2013 study found that taking vitamin D with 11 grams of fat resulted in 16 percent higher absorption than taking 35 grams of fat and 20 percent higher absorption than taking 0 grams of fat.

It doesn’t matter whether you eat a fat made from polyunsaturated fatty acids (hemp oil, linseed oil, sunflower oil), monounsaturated fatty acids (olive oil, avocados, almonds), or saturated ones (coconut oil).

Vitamin D can also be applied to the skin

Anyone who cannot tolerate vitamin D preparations or whose vitamin D level simply does not want to rise despite taking vitamin D preparations can also apply vitamin D to the skin. Because vitamin D can apparently also be absorbed through the skin.

For this one chooses – as it should of course also be the case for oral intake – a liquid preparation without unfavorable additives, e.g. B. Vitamin D3 drops, which consist only of vitamin D3 and MCT fats (medium-chain fats from coconut oil).

But here, too, you only dose according to your own needs and wear the drops, e.g. B. on the forearm, where the skin is particularly receptive.