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With vitamin D look to total number not individual types

Published on 13 February 2018 back to previous

Dear Dr. Roach • I recently received my blood test results. My overall vitamin D was 40 (within the target range of 30 to 60 listed), but I noticed that it was broken up into vitamin D-3 (also 40) and vitamin D-2 (less than 4, and presumably 0 based on the overall score). What is vitamin D-2, and should I be taking supplements or eating certain foods to boost its levels? — P.S.

Answer • Both vitamin D-2 and vitamin D-3 are found in diet and in supplements. D-2 is found at low amounts in vegetables; D-3 is found in some fish. Both D-2 and D-3 are used to fortify milk and other dairy products. The body normally makes vitamin D-3 when your skin is exposed to sunlight. Without adequate sunlight (such as in the winter north of the line from Los Angeles to Atlanta), it’s very difficult to get adequate vitamin D without supplementation. The fact that your D-3 is much higher than your D-2 suggests that you are taking supplemental D-3 or you are getting adequate sunlight (or a combination).

Both D-2 and D-3 are converted in the kidney to the active form of vitamin D, called 1,25-dihydroxyvitamin D. (Only people with kidney disease require this form of vitamin D supplementation.) This is the form that is necessary for bone health and has a role in maintaining many other processes in the body. It is not yet clear whether supplemental vitamin D will reduce the risk of heart disease and cancer, but an ongoing study hopes to answer that question.

It’s the overall vitamin D number that you need to be concerned about, not the individual components, so there is no need for a D-2 supplement. I generally prefer D-3 for supplementing; it seems to provide better levels and lasts longer. The target overall blood level remains controversial, with some experts saying that over 20 is adequate, while others recommend levels of 40 (or even higher). However, virtually everyone would agree that your level of 40 does not need treatment. I would not recommend further supplementation or changing your diet for the sake of vitamin D.

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