Dr Holick says no difference between D2 and D3

[CassandraM]

I have a client with MS who is taking high doses of D2 prescribed by an MD.

There is a recent study by Dr. Holick (author of the Vitamin D Health) showing no difference between the two forms, but I have read in many other places that D3 is preferred.

 If she goes back to her doc, is there a prescribable form of D3?

 If not, does anybody have a recommended brand when someone is doing high doses? I believe she is at 15000IU per week.

Thanks for your time, Cassandra

[jodi f.]

Thank you for bringing up what has turned out to be a fascinating journey into vitamin D research. I checked out the Holick study, which is from 2008. Here's the reference if you don't have it:

Holick, M.F., Biancuzzo, R.M., Chen, T.C., Klein, E.K., Young, A., Bibuld, D…Tannenbaum, A.D. (2008, Mar). Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D [Abstract]. J Clin Endocrinol Metab, 93(3):677-81. Epub 2007 Dec 18. PMID:18089691

Then I went looking for further information. In 2004, there was a well-designed study that came to a different conclusion, but it used injected high doses of each (50,000). It found that serum levels rose at the same rate for both D2 and D3 up to day 14, at which time the D2 peaked but the serum D3 continued to rise. They concluded that vitamin D2 potency was 1/3 that of D3. Here's the reference for this study:

Armas, L.A.G., Hollis, B.W. & Heaney, R.P. (2004, Nov 1). Vitamin D2 is much less effective than vitamin D3 in humans [Abstract]. The Journal of Clinical Endocrinology & Metabolism, 89(11): 5387-5391. DOI: 10.1210/jc.2004-0360

Happily, there's a brand new study (2011) that decided to test 1,600 IU daily of oral D2 and D3 and 50,000 IU monthly of injected D2 and D3. Their conclusion was that supplementation with vitamin D3 had a small but significant advantage over D2. But they also noted that supplementation with D2 produced a decline in serum D3. Here's the reference for this study:

Binkley, N., Gemar, D., Engelke, J., Gangnon, R., Ramamurthy, R., Krueger, D., & Drezner, M.K. (2011, April 1). Evaluation of ergocalciferol or cholecalciferol dosing, 1,600 IU daily or 50,000 IU monthly in older adults [Abstract]. The Journal of Clinical Endocrinology & Metabolism, 96(4): 981-988. DOI: 10.1210/jc.2010-0015

If you copy out this information for your client to bring to her doctor (make sure the study references are included), her doctor will either be open to supplementing with D3 or will get very angry and defensive, so proceed with caution.

As for supplements, if you have an account with Emerson Ecologics, there are several high-dose supplements available. Since many people with autoimmune diseases have vitamin D receptor issues, I like to use liquid supplements because you can put them on the skin. Some practitioners believe this works better.

You might also want to do some research into receptor issues, as they may arise from bacterial infections and not too little vitamin D. (But that's a whole 'nother issue.) You can find at least a little of this information at www.townsendletter.com.

Much luck to you and your client.

[kristid788]

Hi,
I know I am a little late to the game in answering this question but I wanted to share my experience with Vitamin D and a Vitamin D3 product I would recommend from personal experience. When I was first tested, my initial level of vitamin D was 9, normal levels start in the 30's-40's with optimal being much higher than that. I was put on high dose oral Vitamin D supplementation for approximately 3 months. After 3 months of supplementation I was retested only to find out that my Vitamin D level had dropped to 7    I was having an absorption issue that turned out to be related to allergies.  In the course of this, I discovered a great product that I still use.  It's an emulsified Vitamin D3 from Biotics (here's the link):  http://www.bioticsresearch.com/node/1570   After supplementing with this product my levels went up to 45!  I do not know if you have to get it through an ND or not, they may need to order it, but the product works well and comes as easily absorbed drops under the tongue.
Hope this helps!
In good health ... Kristi