Choosing the “Best” Vitamin D Supplement for Your Needs

This is a question I get all the time. “What is the best supplement for getting Vitamin D?”

Several considerations here:

1) What are you current vitamin D levels?

If you haven’t had them checked, this is the first step as this will help with dosing how much you should take. You can self order Vitamin D labwork here and take the order to any Quest Labs for the blood draw to be performed. It’s about 40 bucks, compared to many people who are charged around 300 dollars at traditional/hospital based labs, as many insurances are starting to not cover vitamin D labwork.

2) General Dosing for Vitamin D3 (the most absorbable form of vitamin D from food)

• If you blood levels show optimal levels (50-70ng/mL), usually vitamin D3 at 1000IU per day is a maintenance dose.
• If your blood levels are “normal” (30-50ng/mL) then 2000IU is generally a good vitamin D3 dose to help increase to above 50ng/mL and then drop to 1000IU daily
• If you are insufficient (30ng/mL or less) then 5000IU a day for 2-3 months is generally needed
• If you are deficient (20ng/mL or less), then 5000-10,000IU a day for 2-3 months is generally needed.
• *Always talk to your doctor before starting a supplement and always recheck the blood about 3 months after supplementing to check if your vitamin D bloodwork got up to an optimal range. If a Physician orders the labwork, he or she will sometimes opt for a prescription strength dose (50,000IU once weekly) for a patient with insufficient or deficient vitamin D labwork.

3) What else should be in the Supplement Besides Vitamin D3?

Vitamin K2 is something important to go along with Vitamin D3. Magnesium and Calcium are other minerals to consider. Synergy is important here. Let’s go into a little back story.

When Vitamin K was discovered in the early 1930s, all the attention was directed toward its role in coagulation (K1 -phylloquinone). It’s only in recent years that a big distinction was made between vitamin K1 and vitamin K2.

Vitamin K1 deficiency is rare, but vitamin K2 deficiency is common. Because of the possibility of vitamin K2 deficiency, it’s important for RDs to be aware of this minimally discussed nutrient as it influences health.

Bone Health: Vitamin D3 and Vitamin K2

Optimizing bone health isn’t as simple as “drink your milk.” One 8 ounce cup of cow’s milk has about 100IU of vitamin D, which isn’t a lot relative to an adult’s needs. Vitamin D is required to activate osteocalcin, an important protein secreted by osteoblasts (aka bone-building cells). When vitamin K2 is activated, osteocalcin can draw calcium into the bones where osteoblasts then use it. In addition, vitamin K2 when combined with vitamin D3, helps inhibit osteoclasts (which “take down” old bone). Side note – did you know bone is a living tissue?

Heart Health: Vitamin D3 and Vitamin K2

The same osteocalcin protein that vitamin K2 activates also triggers the activation of another protein that is responsible for removing excess calcium that can accumulate in soft tissues such as arteries and veins, which is important as 20% of atherosclerotic plaques are comprised of calcium. Vitamin K2 can help prevent and reverse tissue calcification involved in atherosclerosis.

Calcium Supplementation With Vitamin D3 and Vitamin K2

Calcium supplements are commonly recommended to help people meet their calcium needs. Calcium is another mineral present in the bone, but supplementing with it doesn’t necessarily result in stronger bones as the supplemental calcium is able to accumulate in veins and arteries instead of in bones. Many studies show calcium supplement alone (without plenty of vitamin K2 and vitamin D) can be risky and many medical organiations have considered changing their care algorithms. Additional studies are needed. Given this, I generally advise that if a person if taking supplemental calcium, it is important to check that adequate vitamin K2 is also being consumed.

Food Sources of Vitamin K2

Pasture raised animal products are the best food source of vitamin K2. The ideal way to obtain dietary vitamin K2 is to eat meat, especially organ meat (mainly liver), chicken, beef, bacon, and ham, and egg yolks. Animals have an ability to synthesize vitamin K2 from the vitamin K1 they obtain from grass. For this reason, meat, eggs, and dairy from pastured and grass-fed animals contain higher levels of vitamin K2 compared with animals who are grain-fed.

I no longer worry about saturated fat (from animal products) with all of the new research out there. It’s more about the quality of the animal product (animals are where a lot of saturated fats are found). The bigger question is did the animal eat grain or where they pasture raised, walking around in the sun and eating fresh grass? It is important to purchase organic, pasture raised animal meats and products to help with getting vitamin K2, which does so much along with vitamin D3 for both heart health and bone health.

This Registered Dietitian’s Opinion on Vitamin D3 and Vitamin K2 in Summary:

All things considered, I think Vitamin K2 supplementation both MK4 (synthetic) and MK-7 (natural) are options to help people meet their vitamin K2 requirements. There is currently debate over dosing, but many experts agree on 45 to 200mcg per day of vitamin K2.

So what is the “best” vitamin D supplement in summary?

There are always nuances when individualizing care for patients, but I generally will look at labwork first and then recommend a calcium, magnesium, D3 plus k2 supplement containing supplement to help patients get adequate amounts of all nutrients due to their interplay.

If vitamin D is difficult to increase?

• Check that there is enough magnesium being consumed
• Check to see if glutathione levels are low
• Check the house for toxic indoor mold in clinically significant amounts
  • An ERMI is the medically recognized way to check homes. It is an at home dust collection kit and its data correlates to medical literature. Get ERMI Kit 1 under “shop”, and if your score if 5 or higher, than you need a certified mold inspector to find the WHERE and WHY the mold grew and pursue remediation.

Need help navigating your own blood work and supplementation? Schedule a telehealth consult package! I accept many PPO health insurance plans.

Warmly,

Katie Driessens, RD, LDN, CDCES, CGN

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