Question 1

What is vitamin D deficiency?

Accepted Answer

Vitamin D deficiency is a nutritional state in which the body's stores of vitamin D are too low to meet its metabolic needs, most notably the absorption of dietary calcium. It is identified with a blood test that measures serum 25-hydroxyvitamin D. Many clinicians use a level below 20 ng/mL (50 nmol/L) to define deficiency and 20 to 29 ng/mL to define insufficiency, though laboratory reference ranges and expert guidelines differ, and only your physician can interpret your result. Vitamin D is unusual among nutrients because the skin synthesizes it from UVB sunlight, so low levels commonly reflect limited sun exposure rather than diet alone. Contributing factors include living at higher latitudes, darker skin pigmentation, older age, obesity, consistent sunscreen use, malabsorption conditions such as celiac disease, Crohn's disease, or bariatric surgery, and kidney or liver disease, which can impair the two-step conversion of vitamin D into its active form.

Question 2

What are the symptoms of vitamin D deficiency, and when should I see a clinician?

Accepted Answer

Vitamin D deficiency is often silent, and many people have no noticeable symptoms at all. When symptoms are reported they tend to be nonspecific and easy to attribute to something else: fatigue and low energy, aching or weak muscles, and bone or lower back discomfort. Low mood and more frequent infections have also been reported in association with low vitamin D status, though those associations are still under study and are not established as specific signs of deficiency. Prolonged, severe deficiency is associated with osteomalacia, a softening of bone in adults, and with rickets in children. Because none of these signs are specific to vitamin D, symptoms alone cannot confirm the condition. Only a serum 25-hydroxyvitamin D blood test ordered by a clinician can. It is worth asking your physician about testing if you have limited sun exposure, darker skin, are older, are living with obesity, have a malabsorption condition, have kidney or liver disease, or take medications that affect vitamin D metabolism.

Question 3

How do medical foods support the dietary management of vitamin D deficiency?

Accepted Answer

Medical foods are a category defined by the FDA as foods formulated to be consumed under the supervision of a physician for the specific dietary management of a condition with distinctive nutritional requirements. They are neither drugs nor dietary supplements. In the case of vitamin D, the relevant mechanism is nutritional. Iaomai's EB-S5 provides vitamin D3 as cholecalciferol, the form the liver and kidneys convert into calcitriol, the biologically active form that binds vitamin D receptors. It is delivered with cofactors that participate in the same calcium and bone pathways: calcium, magnesium glycinate, and vitamin K2 as MK-7, which is involved in activating proteins that participate in incorporating calcium into the bone matrix. A medical food supplies these nutrients in bioavailable forms as one part of a dietary plan your physician designs and monitors, typically alongside blood testing. It does not act on the condition the way a medication does, and it is not intended to diagnose, treat, cure, or prevent any disease.

Question 4

How much does Iaomai's medical food for the dietary management of vitamin D deficiency cost?

Accepted Answer

EB-S5, the delayed-release medical food that provides vitamin D3 as cholecalciferol along with calcium, magnesium glycinate, and vitamin K2 (MK-7), is $149. That is a 270-count bottle, which is a three-month supply at the suggested use of 3 capsules daily with food, so it works out to roughly $50 per month. No prescription is required, because a medical food is not a drug. Medical foods are, however, intended for use under the ongoing supervision of a physician, so we recommend discussing EB-S5 with your healthcare provider and having your vitamin D level tested before you begin and while you continue. Orders are fulfilled through our partner EBM Medical's secure store.

Question 5

Can I take a vitamin D medical food alongside my medications?

Accepted Answer

Review it with your physician or pharmacist first, and do so before you start rather than after. EB-S5 contains vitamin K2 as MK-7, and vitamin K can interfere with warfarin and other anticoagulant medications, which makes this conversation especially important if you take a blood thinner. Vitamin D is fat-soluble and accumulates in body tissue rather than being cleared daily, so intake should be matched to your measured blood level rather than estimated. The formula also contains calcium, which can interact with thiazide diuretics and can affect the absorption of certain other medications when taken at the same time of day. Separately, several medication classes, including corticosteroids, some anticonvulsants, and lipase inhibitors, are known to affect how the body absorbs or metabolizes vitamin D. Bring the full ingredient list to your provider along with everything else you take, including other supplements.

Vitamin D Deficiency

How Medical Foods Can Help

Cholecalciferol, the D3 Form

A Role in Calcium Absorption

Vitamin D Receptors Beyond Bone

Common Symptoms

What Causes Vitamin D Deficiency?

Struggling with Vitamin D Deficiency?

Frequently Asked Questions

Related Conditions

Bone Healing

Nail Disorders

Wound Healing