Wouldn’t life be a breeze if there was a calculation telling us how much to prescribe of a given nutrient for every different patient to take them out of deficiency, into repletion or even optimal?
Well there is. Kinda
If the nutrient in question is Vitamin D there have been several different loading dose calculations proposed and studied. You just plug in your patient details, such as their Vitamin D result and their weight…out pops the ‘total amount of Vit D required’ to get them from there to over that finish line, as well as a prediction for how long that will take. So is it really that simple?
Ahhhhhh….no
There are 5 factors we need to consider in every decision about dose and these formulas only account for a few. There are plenty of patients for whom the predicted dose and duration would be incorrect but it works well for others. And there’s the rather small GIANT issue of Vit D assay inaccuracy to contend with too. And what happens when we choose to use a different form? Instead of using cholecalciferol which these formulas are based on, we’re employing calcifediol or, we go all ala ‘Nature Cure’ and prescribe sunshine!!☀️😎🤯 How very retro?!
Do you always know how to answer the questions, “How much?”
“How often & for how long?”
Like how many minutes of sun exposure (before 10am and after 2pm) produces the equivalent of 1000 IU D? If you’re in Townsville Vs Tassie? If it’s March Vs May? The failure to recognise ambient UVB as the single greatest contributor to meeting our Vit D requirements is like giving someone a protein shake under the illusion that’s their ‘protein requirements done’! And not knowing how to prescribe sunshine safely and effectively – means we’re unnecessarily prescribing yet more pills instead. Just sayin’ 🤓
Vitamin D Decisions – What Dose Delivers The Benefit
In this continued unpacking of how to personalise & potentise our prescriptions we introduce a framework to aid us in our decisions about dose. Current beliefs about supplemental Vitamin D purport the benefit occurs when we attain a given blood level. While this suggests a certain simplicity: how big is the deficit – therefore how much D do we need – this is far from the whole story. In this episode we introduce and debate the merits of Loading Dose Calculations as a means to determine the dose and duration of treatment required for each individual – looking at who these do(n’t) apply to but also discuss dose issues specific to other forms including sunshine.
You can purchase Vitamin D Decisions – Which Dose Delivers The Benefit here. If you are an Update in Under 30 Subscriber, you will find it waiting for you in your online account. You can become an Update in Under 30 Subscriber to access this episode and the entire library of Update in Under 30 audios and resources here.