Vitamin D3 — Supplements

Secosteroid hormone precursor critical for calcium homeostasis, immune modulation, and musculoskeletal health.

Overview

Vitamin D3 (cholecalciferol) is a secosteroid prohormone synthesized in skin upon UVB exposure and converted to 25-hydroxyvitamin D (calcidiol) in the liver and then to active 1,25-dihydroxyvitamin D (calcitriol) in the kidneys. Vitamin D receptors (VDR) are expressed in virtually all human cells, influencing >1,000 genes. Vitamin D deficiency (<20 ng/mL) affects an estimated 1 billion people worldwide. Strong evidence supports supplementation for bone health, fall prevention, immune function, and reduced all-cause mortality. The Endocrine Society recommends maintaining 25(OH)D levels of 40-60 ng/mL.

Indications

  • Vitamin D deficiency and insufficiency
  • Bone health and osteoporosis prevention
  • Immune system modulation
  • Muscle function and fall prevention
  • Mood and cognitive support

Mechanism of Action

Cholecalciferol is hydroxylated to 25(OH)D (calcidiol) in the liver by CYP2R1

Dosing

CompoundDoseFrequencyNotes
Vitamin D3 (Cholecalciferol)5,000 IUOnce daily with fat-containing mealAdjust based on 25(OH)D levels; target 40-60 ng/mL

Safety & Contraindications

  • Toxicity rare but possible at sustained doses >10,000 IU/day (hypercalcemia, nephrocalcinosis)
  • Always co-supplement with K2 to direct calcium to bones rather than vasculature
  • Monitor 25(OH)D levels to guide dosing; target 40-60 ng/mL
  • Granulomatous diseases (sarcoidosis) may cause hypercalcemia with even moderate D3 doses