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What form of vitamin D is recommended?

4 min read

Approximately 1 billion people worldwide have a vitamin D deficiency or insufficiency. When considering supplementation to address low levels, it's essential to understand the difference between the two primary forms available: Vitamin D2 and Vitamin D3.

Quick Summary

Vitamin D3 (cholecalciferol) is the recommended form of supplementation for most people because it is more effective than D2 (ergocalciferol) at raising and sustaining blood levels.

Key Points

  • Form of Choice: Vitamin D3 (cholecalciferol) is generally the most recommended form for supplementation due to its superior efficacy in raising and maintaining blood levels.

  • Absorption Matters: For optimal absorption, take vitamin D supplements with a meal containing healthy fats, as it is a fat-soluble vitamin.

  • Vegan Options: While D2 is plant-based, effective and potent vegan D3 supplements sourced from lichen are also widely available.

  • Individual Needs Vary: Intake requirements for Vitamin D differ based on factors such as age, skin tone, geographic location, and BMI. Consult a healthcare provider to determine the right approach for you.

  • Pair with Cofactors: To ensure proper utilization, consider the roles of cofactors like Vitamin K2, which supports calcium regulation, and magnesium, which helps activate Vitamin D.

  • Toxicity is Rare: Vitamin D toxicity is uncommon and almost always results from excessive supplementation, not sun exposure.

  • Get Your Levels Checked: A blood test for 25-hydroxyvitamin D is a reliable way to assess your vitamin D status and guide your supplementation strategy.

In This Article

Understanding the Types of Vitamin D: D2 vs. D3

Vitamin D is a crucial fat-soluble nutrient essential for many bodily functions, most notably for maintaining calcium and phosphorus balance for strong bones. It also plays a vital role in immune function, mood regulation, and muscle health. For most people, the primary source of Vitamin D is direct sun exposure, which causes the skin to synthesize cholecalciferol, or Vitamin D3. However, many individuals are unable to get sufficient sun exposure due to geographic location, season, darker skin tone, or lifestyle, leading to widespread deficiency. Supplements are a common and effective way to bridge this gap, but choosing the right form, D2 or D3, is key to optimizing your intake.

Vitamin D2 (Ergocalciferol)

Vitamin D2 is derived from plant sources like mushrooms that have been exposed to ultraviolet (UV) light. It is often used to fortify foods like milk, orange juice, and cereals. For individuals on a vegan diet, D2 has traditionally been the go-to option for supplementation as it is not animal-sourced. While it can effectively increase blood vitamin D levels, research consistently shows it is less potent and less effective at maintaining those levels long-term compared to D3.

Vitamin D3 (Cholecalciferol)

Vitamin D3 is the form naturally produced in the skin upon sun exposure and is found in animal-sourced foods like fatty fish and egg yolks. For supplementation, it is typically sourced from lanolin (sheep's wool). However, vegan-friendly D3 derived from lichen is now widely available. A key advantage of D3 is its greater bioavailability and efficacy. Multiple studies and a meta-analysis have shown that D3 significantly raises and sustains serum 25-hydroxyvitamin D levels higher than D2. This makes it the preferred form for supplementation in most clinical scenarios.

Comparison: Vitamin D2 vs. Vitamin D3

Feature Vitamin D2 (Ergocalciferol) Vitamin D3 (Cholecalciferol)
Primary Source Plant-based (UV-irradiated yeast and mushrooms) Animal-based (sunlight exposure, oily fish, eggs) or lichen
Potency/Efficacy Less potent; less effective at raising and sustaining blood levels More potent; raises and sustains blood levels more effectively
Absorption Well absorbed, but less effective than D3 Better absorbed and utilized by the body
Stability Less stable and more sensitive to heat and moisture More stable, with a longer shelf life
Vegan Friendly Yes, traditionally the only vegan option Vegan options (from lichen) now widely available alongside animal-derived versions
Recommendation Suitable for vegans or those with a high BMI Recommended for most individuals to correct deficiency

Recommendations for Optimal Vitamin D Supplementation

  1. Choose D3 for Superior Efficacy: For most adults, especially those with established deficiency, Vitamin D3 is the recommended choice due to its proven superiority in raising blood levels. Vegan individuals should look for D3 derived from lichen.
  2. Take with a Meal: Because vitamin D is a fat-soluble vitamin, taking it with a meal or snack containing healthy fats significantly improves absorption. Consider pairing it with a source like avocado, nuts, or fish oil.
  3. Ensure Adequate Co-factors: Other nutrients, particularly magnesium and vitamin K2, are important for Vitamin D to function correctly. Magnesium is involved in the activation of vitamin D, while K2 helps properly use calcium, preventing it from accumulating in soft tissues.
  4. Establish Correct Intake: The appropriate intake of vitamin D varies based on age, lifestyle, and existing health conditions. A blood test for 25-hydroxyvitamin D is a useful way to determine your status and establish a proper strategy with a healthcare provider.

Factors Affecting Vitamin D Status and Needs

Several factors can influence a person's vitamin D status and their need for supplementation:

  • Geographic Location and Season: Living farther from the equator means less UVB radiation, especially during winter, and a higher risk of deficiency.
  • Skin Tone: Higher melanin content in darker skin acts as a natural sunscreen, reducing the skin's ability to produce vitamin D from sunlight.
  • Age: The skin's capacity to synthesize vitamin D decreases with age, making older adults more susceptible to deficiency.
  • Body Weight: Fat cells sequester vitamin D, meaning people who are obese often require careful consideration of their needs to achieve sufficient blood levels.
  • Malabsorption Conditions: Disorders like Crohn's, celiac disease, and gastric bypass surgery can impair fat absorption, limiting vitamin D uptake.

Conclusion

While both Vitamin D2 and Vitamin D3 can contribute to vitamin D levels, the evidence overwhelmingly points toward Vitamin D3 (cholecalciferol) as the more effective and potent form for raising and sustaining blood levels. For most individuals, particularly those needing to correct a deficiency, a D3 supplement is the optimal choice. It is crucial to remember that supplementation should be guided by a healthcare professional to avoid toxicity and ensure your personal needs are met. Supporting your intake by consuming D-rich foods and getting safe sun exposure also remains important for overall health. For those following a vegan diet, plant-based D3 from lichen provides the best of both worlds—optimal efficacy without animal products.

Optional Resource

For further information on recommended dietary allowances and upper intake levels for Vitamin D, consult the National Institutes of Health's Office of Dietary Supplements fact sheet.

Frequently Asked Questions

Vitamin D2 (ergocalciferol) comes from plant-based sources like UV-exposed mushrooms, while Vitamin D3 (cholecalciferol) comes from animal-based sources or is produced in the skin from sunlight. D3 is generally considered more effective at raising and maintaining blood levels.

For most people, Vitamin D3 is the better choice for supplementation. Evidence shows it raises blood vitamin D levels more effectively and for a longer duration than D2.

No, vegans and vegetarians can also take D3. While D2 is plant-based, vegan-friendly D3 derived from lichen is now available and offers the same benefits as animal-sourced D3.

Since vitamin D is fat-soluble, it's best absorbed when taken with a meal containing some fat. The timing, whether morning or night, is less important than taking it with food.

Yes, it is possible to experience vitamin D toxicity from taking excessively high amounts of supplements, but this is rare. Consulting with a healthcare provider can help determine appropriate amounts.

The best approach is to consult a healthcare provider, who can order a blood test to measure your current vitamin D levels. They can then recommend an appropriate approach based on your individual needs.

Magnesium is a cofactor involved in the activation of vitamin D, and vitamin K2 helps ensure that calcium is used properly in the body, primarily by the bones, and not deposited in soft tissues.

It depends on several factors, including your location, the season, skin tone, and time spent outdoors. Many people, especially in winter or with darker skin, cannot synthesize enough Vitamin D from the sun and benefit from supplementation.

References

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Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice.