50,000 IU? Doctor, are you out of your mind?

Factual Questions
1

Actually, it appears to be a common treatment but it still seems odd, and I’m curious about a couple things.

I was due for a physical, and the doctor had scrawled “Vitamin D” something or another on the lab request in addition to the usual lipid panel, etc. So he informs me that my vitamin D level is way too low, and wants me to take 50,000 IU of the stuff twice a week for a month, then use an OTC supplement. The 8 50,000 IU pills he prescribed are each equivalent to about a dozen OTC pills in the largest size I could find (4000 IU), and 50 of the more common 1000 IU size. It seems to be 250 times RDA, or 125 times for my age.

Why do this, rather than just have me take a larger OTC supplement for a while, then reduce to a maintenance dose?

Vitamin D deficiency seems to be some sort of medical hot topic. What’s up here? Have we really all sunscreened and stay-inside-in-front-of-screen’ed ourselves into horribly serious problems because of it?

(It’s also another case of what I referred to in this thread. Cholestyramine I’m prescribed will absorb vitamin D (and A and E and K …). He didn’t say anything about it, and I wouldn’t have known it without reading inserts. In this case, the cholestyramine is HIS prescription. I wonder if the stuff is a contributory factor to being D deficient in the first place.)

2

We actually just did a thread on this–interesting reading.

3

It’s standard practice to supplement with high doses of Vitamin D2 for severe deficit, usually 50,000 IU 3 x a week for 6 to 12 weeks, then convert the person to Vitamin D3 1000 or so units a day.

The reason is that Vitamin D2 will more rapidly become metabolically active, and will raise the levels up to normal, restoring normal calcium absorption and metabolism in weeks or less, while it would take months of dosing with vitamin D3 to achieve the same effect. D3 lasts longer in the system, but builds up and becomes metabolically active more slowly.

So, your doctor is quite sane, and practicing good solid medicine. Though use of cholestyramine is problematic with nearly every medicine, and that issue should have been covered with you by your doc and/ or pharmacist.

Check out this article from NEJM for a good review of Vitamin D: Custom Built House Exhibition Hall

4

Thanks.

Yeah, I get that about cholestyramine, but it’s my only regular prescription, and seemingly works really well for the condition it was prescribed for. It can be spaced away from doses of anything else.