Obesity
| Obesity is associated with vitamin D deficiency. The reason is that the vitamin D is trapped within the fat and cannot easily exit. As a result, obese patients need at least twice as much vitamin D as a normal weighted individual in order to maintain a normal vitamin D status with a 25(OH)D between 30-60 ng/ml.
Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000;72: 690-693.
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Lindy said,
Example: I am a light skinned MN native who does not sun bathe. I am 30 pounds overweight. May I take as much as 20,000 IU a day (vitamin D) if my tests show I am D deficitiant?
Luigi Imperatori said,
Dear dr. Hollik, are Italian-speaking Swiss and I apologize if I write in English using the Google translator. I am a naturopath obese (116 kg-the right weight should be 75 kg)), which recently has in-depth knowledge on vitamin D and is a week that I take 4000 IU (Dr. Mercola). What amount should I not take the test? For a smoker you need to calculate a higher dose?
Thank you for an email response.
Imperatori Luigi
admin said,
Dear Luigi,
I treat my obese patients with 50,000 IU of vitamin D twice a week for 8-12 weeks and check their blood level of 25-hydroxyvitamin D. I like to achieve a blood level of 25-hydroxyvitamin D between 100- 150 nmol per liter which is equivalent to 40-60 ng/mL.
Guy said,
Dear dr holick,
I was wondering if Vitamin D deficiency actually causes weight gain. I am 23 years old now and about 25 pounds overweight. Until about age 17 I was at a normal and healthy weight but after I graduated highschool I spent alot more time indoors and alot less exercise outside. I have been exercising for about a year now in a gym and have had some progress but not the progress I want. What are your thoughts/comments on my issue.
Thank you for your wonderful research,
Guy
admin said,
Dear Guy,
Vitamin D does not cause weight gain.
Laila said,
Dear Dr. Holick.
Thank you for your wonderful research.
I live in Denmark, I´m overweight and my levels on 15th of April was 21 ng/ml.
My doctor knows very little about vitamin D, so I feel quite alone. I offered to lend him your book, and his responce was: My time is too valuable to read about vitamin D!!
Since april 16th. I have taken 4000IE D3 every day and I sit for 20 minutes in the sun at 10 am before going to work.
Unfortunately the sun doesn´t shine very much i Denmark.
My question is: For how long should I take 4000IE D3 vitamin and how often should I get tested?
Thank you from Denmark.
Laila
admin said,
Dear Laila,
I typically treat my patients with an equivalent of 3000 international units of vitamin D a day to maintain vitamin D sufficiency. However for my obese patients I often have them take 4000-5000 international units of vitamin D a day. Therefore I would expect that you could stay on 4000 international units of vitamin D daily. You may want to have it checked one time to be sure it is in the range of 30-100 ng/mL for 25-hydroxyvitamin D which translates into 75-250 nmol/l.
david said,
i am a 44 year old smoker with htn which i take 2 meds for im also insulin dependent dm2, i take depakote and celexa for bipolar and prilosec for gerd. simvastatin for cholesterol take vit b and a one a day vitamin which has 700 iu of vit d. my vitamin d level fasting was 32.9 i weigh almost 270 lbs tsh was 1.0 also have elevated liver enzymes plz help i know theres still hope
david j
Becca said,
Dr. Holick,
I have stumbled upon your website while searching for prenatal vitamins as I’ve just learned that I am pregnant. I am obese and I wonder if taking the recommended 4000 IU of vitamin D is safe during pregnancy?
Thank you
admin said,
Dear Becca,
Both the Institute of Medicine and Endocrine Society have concluded that 4000 IUs of vitamin D daily is safe for all adults including pregnant women. I have my pregnant patients on a 2000 IUs vitamin D supplement along with their prenatal vitamin and other sources so that they are receiving about 3000-4000 IUs of vitamin D daily.
admin said,
Dear David,
I would recommend that you take at least 2000-3000 IUs of vitamin D a day.
Judy Lea said,
Dr. Holick,
I am confused on what dosage I need to correct my vitamin D deficiency of 18 blood level test (25-hydroxyvitamin D). I am female, 5’9″ tall and weigh 330 pounds. My doctor wanted me to take 50,000 units of Vit D a day for a month..another doctor said 50,000 units a week for a month…and my endocrinologist said to take 2,000 units a day….goodness they all are different and I do not know what to take.
At the moment, I am trusting my pharmasist and after discussinig this with him, I am presently taking 4,000 units vit D in the A.M. and 4,000 units in the P.M….. our plan is for me to do this for a month. Then, 4,000 units daily until I run out of the pills in the bottle he sold me. I will then take 2,000 units twice a day ….my pharmasist says to get my blood tested for Vitamin D in 6 months since I started this plan to see if my blood level has come up.
I have tremendous pain that has gotten slowly worse and worse…very difficult to walk…and went to doctor saying I feared ending up in wheel chair…my doc seems to feel this vitamin D could help me w/my symptoms since I am deficient….this is the doctor who scares me wanting me to take the 50,000 units a day.
Would appreciate your telling me if my pharmasist and I are on the right track/the right dosage…Thank you so very much. Judy
Judy Lea said,
Dr. Holick,
I am confused on what dosage I need to correct my vitamin D deficiency of 18 blood level test (25-hydroxyvitamin D). I am female, 5’9″ tall and weigh 330 pounds. One doctor wanted me to take 50,000 units of Viit D a day for a month..another doctor said 50,000 units a day for a month…and my endocrinologist said to take 2,000 units a day….goodness they all are different and I do not know that to take.
At the moment, I am trusting my pharmisist and after discussinig this with him, I am presently taking 4,000 units vit D in the A.M. and 4,000 units in the P.M….. our plan is for me to do this for a month. Then, 4,000 daily until I run out of the pills in the bottle he sold me. I will then take 2,000 units twice a day ….my pharmisist says to get my blood tested for Vitamin D in 6 months since I started this plan.
I have tremendous pain that has gotten slowly worse and worse…very difficult to walk…and went to doctor saying I feared ending up in wheel chair…my doc seems to feel this vitamin D could help me w/my symptoms.
Would appreciate your telling me if my pharmisist and I are on the right track/the right dosage…Thank you so very much. Judy
admin said,
Dear Judy,
I typically treat my patients for vitamin D deficiency with 50,000 IUs of vitamin D once a week for 8 weeks. For my patients who are overweight I will keep them on 50,000 IUs of vitamin D once a week forever. For my patients who have a normal weight I switch them to 50,000 IUs of vitamin D once every 2 weeks forever. After 6 years we have demonstrated that the blood levels are in the range of 25-hydroxyvitamin D 40-60 ng/mL. Often patients with vitamin D deficiency have proximal muscle weakness and the painful bone disease osteomalacia. I would expect that if your symptoms are associated with vitamin D deficiency and osteomalacia that correcting the vitamin D deficiency should result in significant improvement in your symptoms within 3-6 months.
Mital Jolapara said,
Hello Dr. Holick
My question is regarding the dosage of vitamin D3. most of the studies state that 60000 IU table per week for 8-12 weeks will help to achieve the level of 25(OH)D to > 30 ng/ml which is for skeletal benefits. for non-skeletal benefits the range is 55-70 ng/ml so to achieve this level what should be the dosage guidlines? Thankyou in advance for you help
admin said,
The recommendation from the United States Endocrine Society is to maintain blood levels of 25-hydroxyvitamin D between 40-60 ng/mL which I subscribe to. To achieve this level for normal weight individual 3000 IUs of vitamin D a day should work. It works for not only my patients but for me as well. I don’t think you have to achieve a level of 55-70 ng/mL.
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