In April, 2009, USA Today ran an article on vitamin D. As most newspaper articles, it contained some good information, but didn't clearly put forth the treatment of vitamin D insufficiency. I responded to the article on USA Today Online. The following should clarify some issues regarding treatment with Vitamin D.

The article points out that Vitamin D insufficience is widespread. It is a major cause of osteoporosis, and research indicates it is an important risk factor in cancer and a variety of autoimmune diseases.
I have tested 1500 patients for 25-hydroxyvitamin D levels since 2005 in my primary care internal medicine practice, and 1000 were insufficient and are being treated and cured. The normal level is 32 to 100 nanograms, but many experts believe the ideal dose is closer to 50 to 80 nanograms. (Lifeguards at the end of the summer have been shown to have levels of 150 nanograms). Either prescription or OTC vitamin D is the treatment, but too many people take just 400 units a day, too low a dose. In order to raise to a meaningful level and receive major health benefit, a daily dose of 2000 to 5000 Units of daily OTC Vitamin D is needed, or a weekly 50,000 Vit. D capsule by prescription. The dose may seem high, but sunbathers produces 10,000 units of vitamin D in half an hour.
Because of so many variables, only a blood test can determine if the dose is correct. Close to 100% of the 1000 patients have had to increase their dose to approach an ideal level.
Correction of vitamin D deficiency represents the most profound step Americans can take in preventing diseases and reducing the cost of the nation's health care.
Robert Baker MD

RE: Regarding walking outside and drinking milk as a solution for vitamin D.
1) I have tested several year round joggers who were surprised that their level was below normal. The lowest was 18 nanograms, but levels in the 20's were common. I have tested
several mailpersons and construction workers who work outside everyday; their levels were frequently below normal.
2)I have tested hundreds of people who told me they not only drank 4 glasses of milk a day, but ate a lot of additional dairy food, They have the same 2/3rds incidence of insufficiency. Milk contains 100 units of vitamin D per 8 ounce glass. 400 units of vitamin D has shown in studies to only raise the blood level 5 nanograms, an insufficient increase in most people.
3)I have also tested hundreds of mainly females who take 400 units of vitamin D a day. Again, the most common result is below normal.
Although D is called a vitamin, humans never received most of it from food. It came from the sun, but distance from the equator, sunscreen and "protective" clothes have caused this widespread and damaging hidden epidemic.
Robert Baker MD