Vitamin D is an essential nutrient, necessary for healthy bones, muscles and immune function. It’s also linked to improved mood and reduced inflammation. The body manufactures vitamin D from sunlight—hence, the nickname “sunshine vitamin.”
Unfortunately, it’s difficult to get enough vitamin D from just sunlight. This is partly because enough of the body must be exposed for a long enough time—5-30 minutes per day with the face, arms, hands and legs exposed. And with today’s focus on sunscreen (for good reason), many UV rays don’t reach the skin—although there is some debate on this topic. Cloud cover, skin color and time of day can also affect how much vitamin D your body can produce. Then there are the colder months when we’re covered with clothing and indoors more.
Very few foods naturally contain vitamin D. The ones that do include egg yolks, mushrooms, cod liver oil, beef liver and fatty fish (tuna, herring, salmon, swordfish and sardines). And some foods, like cow’s milk, yogurt, cheese, orange juice and cereals, are fortified with vitamin D.
All in all, you can see why 1 out of 4 people have vitamin D levels that are too low to support good health and strong bones. Add to that, the confusion and debates over the years of how much vitamin D is needed. The U.S. Food & Drug Administration (FDA) currently lists 20 mcg as the daily recommended intake for most people. But the National Institutes of Health (NIH) recommends 15 mcg for people aged 1-70, including during pregnancy and breastfeeding, and doesn’t bump it up to 20 mcg until age 71.
Hoping to cut through some of the confusion, the Endocrine Society has provided new guidelines, detailing who would benefit from supplementing vitamin D. They’re outlined in The Journal of Clinical Endocrinology & Metabolism, published on June 3, 2024. The Guideline Development Panel was made up of multidisciplinary clinical and research experts. They combed through studies that had previously been done on vitamin D to construct these recommendations. While these guidelines are for clinical practitioners, below we’ve broken down the basic recommendations they’re now making.
Routine Screening for Vitamin D Deficiency Is Unnecessary
The panel states that unless someone has signs and symptoms of vitamin D deficiency, such as depression or high blood pressure, it is unnecessary to routinely screen for deficiency.
Most Do Not Need to Supplement
In the general healthy adult population, 70 and younger, the panel suggests against supplementing vitamin D and sticking with the Institute of Medicine’s (IOM) recommendation of 15 mcg/day.
Adults 70 and Older Need a Little More Vitamin D
This recommendation is due to evidence that a little more vitamin D at this age may lower the risk of dying, especially for those 75 and older. The IOM already recommends 20 mcg/day for those aged 70 and older, and based on the research, the panel makes the same recommendation.
Children and Adolescents Need More Vitamin D
Kids and teens aged 1 to 18 should take more than the recommended daily intake of vitamin D. The panel states that this is to prevent rickets—a bone disease—and potentially lower the risk of respiratory tract infections. They’re recommending 30 mcg per day based on the studies they evaluated.
Pregnancy Requires More Vitamin D
The panel states that, based on the evidence, about 63 mcg/day of vitamin D during pregnancy may help lower the risk of pre-eclampsia, intrauterine mortality (stillbirth), preterm birth, small-for-gestational-age birth (a baby that is smaller than expected for its birth age) and neonatal mortality (baby dying after birth).
Pre-Diabetes May Be Helped with More Vitamin D
Based on the evidence, the panel recommends that people with pre-diabetes increase their vitamin D intake. This is in addition to lifestyle modifications, like diet, exercise and stress management. The reason is that it may help prevent pre-diabetes from becoming diabetes. The average total amount from the available studies was 88 mcg/day. They state that the average amount supplemented was 25 mcg/day. That was in addition to eating vitamin-D-fortified foods.
Supplementation Recommendations
According to the panel, the total intake per day of vitamin D can come from fortified foods, vitamins that contain vitamin D and/or vitamin D supplements. The general recommendation is to take a smaller amount each day versus taking a larger amount less frequently. In other words, don’t load up on vitamin D supplements once a week or once a month.
The Bottom Line
The new guidelines state that, for most people, routine screening for vitamin D levels is unnecessary. They also recommend slightly more vitamin D for certain populations, including kids, teens, adults over 70, adults at risk for diabetes and during pregnancy.
It could get tedious and confusing when trying to figure out the amount of vitamin D in the foods you’re eating, especially if you include those that naturally contain vitamin D. Plus, how do you know how much vitamin D your body is producing from sunlight? This is why it’s important to work with your medical practitioner and a registered dietitian to ensure you’re getting the amount of vitamin D your body needs, especially if you’re in one of the populations where supplementation is recommended, as too much vitamin D can have negative health consequences.