Vitamin D Replacement

Objective: Monitor for and manage vitamin D

Patient population: Individuals with known diagnosis of IBD and low serum 25-hydroxyvitamin D

IBD Provider:

1. Check serum Vitamin D annually.

Adult	Pediatrics
If 75-125 nmol/L - recommend 2000 IU daily	If level >80 nmol/L: recommend 1000 IU per day
Replace if <75 nmol/L	If 50-80 nmol/L: recommend 2000 IU per day
	If <50 nmol/L, loading dose, followed by 1000 IU per day

*loading dose (IU) = (80 nmol/L - serum vitamin D level) x 40 x body weight

2. Generate a vitamin D replacement Rx  as per options for replacement below and give to support staff

Support Staff:

1. Use letter templates for low vitamin D and send to the patient and one to the patient's GP.

2. Print bloodwork requisition to test vitamin D and calcium levels, for the patient to complete in 4 months. 

Table 1 Options for replacement

Table 2 Recommended dose

Note: Vitamin D3 may have a longer half-life than vitamin D2 and may be more potent, causing two- to threefold greater storage of vitamin D.

Other resources:

Vitamin D supplementation evidence https://www.rxfiles.ca/rxfiles/uploads/documents/Vitamin-D-Overview-QandA.pdf

Patient education: Vitamin D deficiency (Beyond the Basics) (freely accessible)
https://www.uptodate.com/contents/vitamin-d-deficiency-beyond-the-basics#H13

Easy to read list of common foods reach in vitamin D https://osteoporosis.ca/bone-health-osteoporosis/calcium-and-vitamin-d/vitamin-d/

Download PDF version

Go Back to IBD Clinical Care Pathways