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A GRAVE statistical error has kept vitamin D recommendations DANGEROUSLY LOW for DECADES. A peer-reviewed study found 8,895 IU/day is needed for 97.5% of people to reach ≥50 nmol/L — NOT a mere 600 IU/day. The Institute of Medicine "misread" its own analysis, using values meant for group averages... show more

Nicolas Hulscher, MPH

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Vitamin D mistake A Statistical Error in the Estimation of the Recommended Dietary Allowance for Vitamin D (2014) US, nearly 15 times too low UK, 0ver 22 times too low IOM calculation 600 units (15 mcg), 97.5% of people will achieve 63 nmol/L (25.2 ng/ml) Correct calculation 600 units (15 mcg), 97.5% of people will achieve 26.8 nmol/L (10.7 ng/ml) Requirements based on correct calculation 8,895 IU of vitamin D per day may be needed to accomplish that 97.5% of individuals achieve serum 25(OH)D values of 50 nmol/L or more. The "Average" vs. "Individual" Mistake Canada studies Diet gives 232 IU of vitamin D per day Institute of Medicine (IOM), RDA vitamin D 600 IU per day, (aged 1 to 70 years) Now called the National Academy of Medicine UK is even worse 400 iu or 10 mcg 600 iu per day to achieve serum 25-hydroxyvitamin D (25(OH)D) levels of 50 nmol/L or more in 97.5% of healthy individuals. Levels of 50 nmol/L or more have been shown to benefit bone health and to prevent disease and injury. The IOM based their RDA for vitamin D on an aggregation of 10 supplementation studies, (32 dose protocols) carried out during winter months, at locations above 50th parallel IOM regressed the 32 study averages, dose: plasma ratio On the basis of this, IOM estimated that 600 IU of vitamin D would achieve an average 25(OH)D level of 63 nmol/L Requirements based on correct calculation 8,895 IU of vitamin D per day This dose is well in excess of the current RDA of 600 IU per day and the tolerable upper intake of 4000 IU per day. The public health and clinical implications of the miscalculated RDA for vitamin D are serious. With the current recommendation of 600 IU, bone health objectives and disease and injury prevention targets will not be met. We recommend that the RDA for vitamin D be reconsidered to allow for appropriate public health and clinical decision-making. The Big Vitamin D Mistake Explanation of the statistical error The "Average" vs. "Individual" Mistake The Institute of Medicine’s goal was to find a vitamin D dose that ensures 97.5% of individual people reach a healthy blood level (50 nmol/L). The statistical error occurred because the IOM analysed the averages of different studies rather than the data of individual participants. They looked at 10 studies and took the average blood levels achieved in those studies. They calculated a statistical range (Confidence Interval) based on those averages. They found that with 600 IU, 97.5% of the study averages would hit the target. The Problem There is much less variation between "averages" than there is between "individuals." By using the averages, the IOM accidentally "smoothed out" the data. They assumed that if the average person in a study was fine, then almost everyone was fine. The Classroom Analogy Imagine you want to ensure every student passes a test. The IOM method They looked at the average scores of 30 different classrooms. They set a curriculum so that 97.5% of classrooms would have a passing average. The Reality Even in a classroom with a passing average, there are students who fail. The Correction To ensure 97.5% of students pass, you have to look at the lowest-performing students, not the class average. The Consequence When the authors of this paper re-calculated the numbers using the variation of individuals (rather than study averages), they found that the current RDA of 600 IU does not cover 97.5% of the population. Instead, it only ensures that 97.5% of people reach a blood level of 26.8 nmol/L (far below the target of 50 nmol/L). To actually get 97.5% of the population to the healthy target of 50 nmol/L, the math suggests you would need a dose of 8,895 IU per day.

Vitamin D mistake A Statistical Error in the Estimation of the Recommended Dietary Allowance for Vitamin D (2014) US, nearly 15 times too low UK, 0ver 22 times too low IOM calculation 600 units (15 mcg), 97.5% of people will achieve 63 nmol/L (25.2 ng/ml) Correct calculation 600 units (15 mcg), 97.5% of people will achieve 26.8 nmol/L (10.7 ng/ml) Requirements based on correct calculation 8,895 IU of vitamin D per day may be needed to accomplish that 97.5% of individuals achieve serum 25(OH)D values of 50 nmol/L or more. The "Average" vs. "Individual" Mistake Canada studies Diet gives 232 IU of vitamin D per day Institute of Medicine (IOM), RDA vitamin D 600 IU per day, (aged 1 to 70 years) Now called the National Academy of Medicine UK is even worse 400 iu or 10 mcg 600 iu per day to achieve serum 25-hydroxyvitamin D (25(OH)D) levels of 50 nmol/L or more in 97.5% of healthy individuals. Levels of 50 nmol/L or more have been shown to benefit bone health and to prevent disease and injury. The IOM based their RDA for vitamin D on an aggregation of 10 supplementation studies, (32 dose protocols) carried out during winter months, at locations above 50th parallel IOM regressed the 32 study averages, dose: plasma ratio On the basis of this, IOM estimated that 600 IU of vitamin D would achieve an average 25(OH)D level of 63 nmol/L Requirements based on correct calculation 8,895 IU of vitamin D per day This dose is well in excess of the current RDA of 600 IU per day and the tolerable upper intake of 4000 IU per day. The public health and clinical implications of the miscalculated RDA for vitamin D are serious. With the current recommendation of 600 IU, bone health objectives and disease and injury prevention targets will not be met. We recommend that the RDA for vitamin D be reconsidered to allow for appropriate public health and clinical decision-making. The Big Vitamin D Mistake Explanation of the statistical error The "Average" vs. "Individual" Mistake The Institute of Medicine’s goal was to find a vitamin D dose that ensures 97.5% of individual people reach a healthy blood level (50 nmol/L). The statistical error occurred because the IOM analysed the averages of different studies rather than the data of individual participants. They looked at 10 studies and took the average blood levels achieved in those studies. They calculated a statistical range (Confidence Interval) based on those averages. They found that with 600 IU, 97.5% of the study averages would hit the target. The Problem There is much less variation between "averages" than there is between "individuals." By using the averages, the IOM accidentally "smoothed out" the data. They assumed that if the average person in a study was fine, then almost everyone was fine. The Classroom Analogy Imagine you want to ensure every student passes a test. The IOM method They looked at the average scores of 30 different classrooms. They set a curriculum so that 97.5% of classrooms would have a passing average. The Reality Even in a classroom with a passing average, there are students who fail. The Correction To ensure 97.5% of students pass, you have to look at the lowest-performing students, not the class average. The Consequence When the authors of this paper re-calculated the numbers using the variation of individuals (rather than study averages), they found that the current RDA of 600 IU does not cover 97.5% of the population. Instead, it only ensures that 97.5% of people reach a blood level of 26.8 nmol/L (far below the target of 50 nmol/L). To actually get 97.5% of the population to the healthy target of 50 nmol/L, the math suggests you would need a dose of 8,895 IU per day.

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Your doctor says your vitamin D level of 22 is "normal" — but what if that cutoff was based on a statistical error? A peer-reviewed study found the IOM miscalculated the RDA by 15x: it should be ~8,800 IU/day, not 600. And vitamin D isn't even a vitamin — it's a steroid hormone that regulates 200+ genes. Here's what the science actually shows.

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