Ever wondered how much vitamin D you need or if a supplement could help ease your menopause symptoms? Vitamin D deficiency is extremely common – one study suggests that it affects as many as 42% of US adults. Read on to find out the benefits of vitamin D, why it is important during menopause, and how to top up on this essential nutrient.
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What is vitamin D?
Most of the vitamin D your body needs is made when your skin is exposed to sunlight.
Some foods do contain vitamin D, but only in small amounts. This is why many people turn to supplements.
How much vitamin D per day is recommended?
The recommended daily amount of vitamin D is 15 micrograms – written as mcg or μg – or 600IU per day for adults under 70.
If you want to know how much vitamin D is stored in your body, ask your healthcare provider for a blood test.
Vitamin D is measured in nanomoles/liter:
- Normal levels: 50-125nmol/L
- Potential deficiency: 23-50nmol/L
- Deficiency: Under 30nmol/L
Do you need a supplement?
Many people can make enough vitamin D through sun exposure, but some might struggle based on the following factors:
- Geographical location. Limited sunshine in certain places or during certain seasons can reduce vitamin D production
- Skin color. It is more difficult for darker skin to make enough vitamin D
- Age. Your skin’s ability to make vitamin D reduces as you get older, so if you are over 65 you are at higher risk of vitamin D deficiency
- Mobility. You’ll struggle to get enough sunshine if you are housebound or can’t get outside often
- Clothing choice. Clothing that covers nearly all of your skin will reduce your sun exposure significantly
Consider a supplement if you:
- Are 65 or over
- Have low sun exposure
- Have darker pigmentation in your skin. For example you have an African, Afro-Caribbean or South Asian background
- Have problems with absorbing nutrients from your gut. For example you have coeliac or Crohn’s disease
- Have severe liver or kidney disease
- Are pregnant or breastfeeding
- Are obese (BMI of over 30)
Vitamin D supplements may also be recommended if you have thinning of the bones, also known as osteoporosis or osteopenia.
That said, those with normal levels of vitamin D who are otherwise healthy probably don’t benefit from a vitamin D supplement. There isn’t yet any evidence that taking a supplement will help prevent fractures, cancer, cardiovascular disease, falls, or type 2 diabetes for this group of people.
Vitamin D supplements aren’t suitable for everyone, and should only be used with clinical supervision. Examples of people who should avoid extra Vitamin D include people with some types of kidney stones, problems with the parathyroid gland, or severe liver or kidney disease.
Symptoms of vitamin D deficiency
Low levels of vitamin D can lead to symptoms including:
- General aches and pains
- Muscle weakness
- Feeling generally unwell
- Tiredness and fatigue
These symptoms are very non-specific, but see your healthcare provider and get tested if you think you might be vitamin D deficient.
If supplements are safe for you and a blood test shows that you are vitamin D deficient, you may be advised to take a supplement.
What is the best vitamin D supplement to take?
Vitamin D is often found in two main forms: vitamin D3 and vitamin D2. Vitamin D3 is more effective at raising levels of vitamin D in the bloodstream. It is made from animal products and it is also the form your body makes from sunshine.
Vitamin D2 is made from plant products, so you may choose this type if you are vegan or vegetarian.
D3 is usually the first choice if you are vitamin D deficient. D2 can also be prescribed by your healthcare provider if needed.
What dose of vitamin D supplement is best?
Your dose depends on why you are taking it and your healthcare provider can advise you.
Bear in mind that vitamin D supplements aren’t suitable for everyone. Speak to your healthcare provider before taking them if you have liver problems, kidney problems, abnormal calcium levels, cancer, or any other chronic medical issues.
If you are vitamin D deficient
Your healthcare provider will initially prescribe a higher dose if you are vitamin D deficient. This is to refill your body’s stores of the vitamin. This is to refill your body’s stores of the vitamin. There are several different ways to do this. They may prescribe:
- 1250 micrograms (50,000 IU) once a week for six weeks
- 1000 micrograms (40,000 IU) once a week for seven weeks
- 100 micrograms (4,000 IU) every day for 10 weeks
Talk to your healthcare provider if you think you are vitamin D deficient – don’t try to treat it yourself. They can advise what products to take and at what dose. Depending on your general health and other results, they may also want to run some further tests.
If you want to prevent deficiency
A 10 microgram or 400 IU supplement per day is generally considered enough to keep vitamin D stores topped up if you are struggling to get enough sunlight.
Speak to your healthcare provider if you have any symptoms that you think might be related to low vitamin D, even if you are already taking a supplement at this dose. They may want to run some tests or give you a higher, prescribed dose of the vitamin.
Why vitamin D is important during menopause
Estrogen helps to maintain good bone health, including bone density. When estrogen levels decline during menopause, your bone health can be affected. This is why you are more likely to develop thinning of the bones – known as osteoporosis – after menopause.
Getting both enough calcium and vitamin D supports bone health, as these nutrients play a key role in bone growth. Vitamin D helps your body to absorb calcium, which provides the strength and much of the mineral content in your bones.
How to get more vitamin D naturally
There are two ways you can top up your vitamin D levels naturally.
1. Spend time outdoors
Your body produces the majority of its required vitamin D in response to sun exposure. It is therefore important to get enough sunshine, but this needs to be carefully balanced with the need for sun safety to prevent sunburn and skin cancers.
Estimates vary, but as a guide, aim for the following daily sun exposure:
- Nine minutes for pale skin
- Up to 25 minutes for darker skin
Keep in mind that the amount of time needed depends on the sun’s intensity, which is at its strongest at midday, and how much of your skin is uncovered.
2. Eat vitamin D-rich foods
While not as effective as sun exposure, diet is still important for maintaining healthy vitamin D levels.
What foods are highest in vitamin D?
Foods rich in vitamin D include:
- Oily fish like salmon, mackerel, and sardines
- Eggs
- Red meats
- Liver
- Dairy
- Fortified foods such as breakfast cereals and plant milks
These foods are relatively good sources of vitamin D, but it is hard to get enough vitamin D from what you eat alone. You’ll also need to see some sunlight and/or take a supplement.
Can you take vitamin D on HT?
Yes, it’s safe to take hormone therapy (HT) and vitamin D at the same time. As always, you should stick to recommended doses.
Final word
Vitamin D is an essential nutrient and is as important as ever during perimenopause and postmenopause. Recent evidence shows it might even contribute to a healthier menopause, as it can have a positive impact on bone density.
But remember, more isn’t always better! Your healthcare provider will advise you on the best treatment for your symptoms, as well as the best dose of vitamin D for you.
Find out more about menopause on our blog or in our symptoms library.
- Bauer SR, Hankinson SE, Bertone-Johnson ER, Ding EL 2013, ‘Plasma Vitamin D Levels, Menopause, and Risk of Breast Cancer’, Medicine, vol. 92, pp. 123–131
- Bouillon R, Manousaki D, Rosen C, Trajanoska K, Rivadeneira F, Richards JB 2021, ‘The health effects of vitamin D supplementation: evidence from human studies’, Nature Reviews Endocrinology, vol. 18, pp. 96–110
- Casseb GAS, Kaster MP, Rodrigues, ALS 2019, ‘Potential Role of Vitamin D for the Management of Depression and Anxiety’, CNS Drugs, vol. 33, pp. 619–637
- Kamronrithisorn T, Manonai J, Vallibhakara SA-O, Sophonsritsuk A., Vallibhakara O 2020, ‘Effect of Vitamin D Supplement on Vulvovaginal Atrophy of the Menopause’, Nutrients vol. 12, no. 9, p. 2876
- LeBoff MS, Chou SH, Ratliff KA, Cook NR, Khurana B, Kim E, Cawthon PM, Bauer DC, Black D, Gallagher JC, Lee I-M, Buring JE, Manson JE 2022, ‘Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults’, New England Journal of Medicine, vol. 387, pp. 299–309
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