What to make of the new vitamin D recommendations

Toronto-area medical doctor, Zoltan Rona, shakes his head at the Institute of Medicine's new vitamin D recommendations unveiled November 30 as the official DRI report for "the sunshine vitamin" and calcium. The report, which convened 14 experts, none of which where strong vitamin D advocates, stated that healthy adults need only 600 IU vitamin D per day, 800 IU if you're over 70 with osteoporosis. The upper tolerable limit, the amount that supposedly boosts risks for toxicity and changes in calcium metabolism, was set at 4,000 IU.

Dr. Rona, author of "Vitamin D, the Sunshine Vitamin", says his therapeutic doses of vitamin D start at 4,000 IU - and he habitually prescribes up to 10,000 IU for resolution of seasonal affective disorder (SAD), depression, muscloskeletal pain and a number of other common ailments. Rona is not alone, several traditional doctors, vitamin D researchers and alternative health experts have spoken out about the IOM's decidedly low recommendations.

During the webcast/press conference presented to the public to field concerns, the Institute's panel repeatedly stated that the numbers were based on a comprehensive review of all the current literature and that there is no conclusive evidence indicating that higher levels of vitamin D may forestall heart disease, cancer, diabetes or another other top killer. Further, the public was reminded that these recommendations were established with respect to bone health only, as vitamin D is a bonafide preventor of rickets and osteoporosis, and nothing else.

Curiously, Osteoporosis Canada recommends 800 to 2,000 IU vitamin D per day for adults over 50. If you have osteoporosis, regardless of age, a minimum of 800 IU is recommended with doses exceeding 2,000 IU advised under professional care only. Comparing bones to bones, the generally healthy public vitamin-savvy must be asking why the discrepancy? The public should also know that bone health is contingent on several other nutrients besides calcium and vitamin D.

Here's how one Toronto nutritionist explains it: Keep in mind that the IOM is a very large, prestigious (read: bureaucratic) public health organization that decides on nutrient recommendations based on what is deemed safe for the general population. The key word is general, and safe means least likely to do harm, not most likely to prevent disease. But, how many of us are part of the general healthy population with no diabetes, heart disease, cancer, thyroid problems, kidney disease, arthritis, depression, IBS, multiple sclerosis, etc. etc. in our health history?  That’s where the disease-specific public health groups come in. There’s a place for intakes of vitamin D that are higher than the IOM’s cutoffs but that’s to be determined by the individual and their health practitioner after a thorough biochemical and physical examination.

If you’re wondering how much vitamin D you should be taking, consider whether you have any of the above conditions and get an individualized recommendation from an orthomolecular health practitioner aka a registered nutrition consultant. As with all vitamins, extra vitamin may do you good, or it may do nothing, or it may do you harm. General recommendations don’t account for biochemical individuality. That’s all you have to remember when reading about the latest greatest nutrition recommendations.

Vitamin D is an odd-ball vitamin because 1) not widely available in food, and 2) it has so many systemic effects that its more like a hormone than a vitamin.