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Is It Necessary For People With Graves Disease and Hashimoto’s Thyroiditis To Supplement With Vitamin D?

Many people are aware of the benefits of vitamin D, as this “vitamin” plays an important role in bone health, neuromuscular function,  immunity, and it has many other important functions.   As a result, it’s no surprise that many of my patients are already taking vitamin D3 upon consulting with them for the first time.  Some are taking 1,000 IU per day, others 5,000 IU, and some even 10,000 IU per day.  Just as is the case with most other supplements people take, most people who take vitamin D on their own don’t know how much they should be taking.  In many cases the person is taking too small of a dosage for their needs, while every now and then someone will be taking too much.  And some people don’t need to take any vitamin D through supplementation.  But since vitamin D is extremely important for a healthy immune system, it is necessary for people with Graves’ Disease and Hashimoto’s Thyroiditis to have adequate levels.

Before I discuss how to determine the dosage of vitamin D one should take if they choose to supplement with this, I’d like to briefly discuss some of the different forms of the supplement.  Vitamin D3, also known as cholecalciferol, is what people should be taking when supplementing with this vitamin.  Vitamin D3 is the same substance the body manufacturers when being exposed to sunlight.  Even though it’s called a “vitamin”, it actually is a hormone.  Vitamin D2 is a different form of vitamin D, and is not the same as the vitamin D3 that is manufactured by the body.  Some medical doctors prescribe vitamin D2 to their patients who show a deficiency on the blood tests.  Sometimes they will prescribe synthetic calcitrol.  If you have a vitamin D deficiency, ideally you want to supplement with vitamin D3.  I typically recommend the brand by Biotics Research Labs to my patients, which is a high quality emulsified form of vitamin D.  But many times you can find something equivalent in a local health food store.

Don’t Pay Attention To The Typical Reference Ranges

When you get your vitamin D levels tested, in most labs, the lower end of the reference range will be around 30 ng/mL.  And so if your vitamin D levels are at least 30 ng/mL, most medical doctors won’t consider you as being deficient.  But as I’ve been telling my patients for years, according to the Vitamin D council and other reputable sources, one ideally wants these levels to be at least 50 ng/mL.

So with that being said, if someone’s vitamin D levels are below 50 ng/mL, is it necessary to supplement with vitamin D3?  With most people it probably is a good idea, and this is especially true for those who have levels below 40 ng/mL.  But if someone hasn’t been getting much sun and wants to try increasing their levels without taking supplements, then they of course can give this a try.  So they can spend 15 to 30 minutes daily in the sun for a few months (without sunscreen of course, as this will block the absorption of vitamin D) and then retest, and if their levels are above 50 ng/mL then there probably isn’t a need to supplement with vitamin D3.  However, they will need to continue getting regular sun exposure in order to maintain these levels.

Although getting regular sun exposure is ideally the best method of manufacturing vitamin D, some people seem to have problems absorbing it, even when getting plenty of sun exposure without putting on any sun screen.   I’ve consulted with numerous patients in sunny areas (Florida, California, etc.) who claim they get plenty of sun exposure, but still are deficient in this vitamin.  Sometimes this can be due to deficiencies of one or more of the cofactors that are important for the proper absorption of vitamin D, such as magnesium.  But I wonder whether in some people there is a genetic problem with absorbing this vitamin.  One’s skin color also will determine how well one absorbs vitamin D from the sun, as the darker the person’s skin, the longer they will need to be exposed to the sun in order to get an adequate amount of vitamin D manufactured.  In any case, if someone is getting adequate sun exposure and doesn’t have a deficiency in any of the cofactors, then supplementation usually is necessary.

Determining The Proper Dosage Of Vitamin D3

So if someone has a vitamin D deficiency and needs to supplement with vitamin D3, how much is it necessary for that person to take?  Well, it admittedly can be challenging to know exactly how much vitamin D3 someone needs to take, which is why retesting is important.  For example, if someone has a moderate to severe deficiency, then I’ll commonly have them take 10,000 IU per day for a few months, and then reduce the dosage in half for a few months, and then have them retest.

If someone has a mild deficiency and if we determine that supplementation is the best course of action, then I will start them with a lower dosage (i.e. 4,000 to 6,000 IU per day), and of course will still have them retest after a few months.  Some people are concerned about vitamin D toxicity due to taking too high of a dosage.  This is rare, as if someone has a deficiency they would need to take extremely high dosages of vitamin D3 for many months before it would reach toxic levels.  And while some people would consider 10,000 IU per day to be too high, I personally have never encountered a problem with a patient taking such a dosage.  Once again, you want to have the person retest after a few months just to make sure the blood levels don’t go too high.

So while it is important for anyone with a vitamin D deficiency to get this addressed, it arguably is even more important for anyone who has an autoimmune thyroid condition, such as those people with Graves’ Disease and Hashimoto’s Thyroiditis, to make sure they have adequate Vitamin D levels.  If you haven’t been tested recently to determine if you have a vitamin D deficiency, then I highly recommend you doing so, as increasing these levels can be a very important part of your recovery.  For more information on vitamin D, I highly recommend visiting the Vitamin D Council website at www.vitamindcouncil.org.