Tracey O’Shea: So the first question is “What is the optimal vitamin D range for those with IBD or another autoimmune condition, and what about those who do not have an autoimmune condition?” Then, there’s also a subquestion here, “Do you use a form that contains K2?”
So I’ll answer the first question here. For the optimal vitamin D range for those with autoimmune conditions, I would say that I do, with autoimmune conditions, we try to keep vitamin D on this upper range of the functional range that we see, around 60 to 70 is kind of the upper range for us [from] a Functional Medicine perspective. There has been some research and some correlation with two high levels of vitamin D and then actually having some negative consequences, so we try to kind of find the sweet spot. And as you know with vitamin D, there’s just [a] pretty wide range from a conventional standpoint, and so, with Functional Medicine, we really try to narrow this down, so I would say for autoimmune disease, I would try to keep it toward the higher range of 60. For someone who doesn’t have [an] autoimmune condition, I think it depends. I like to try to keep it around 40 to 50, but again, I would really focus on using that parathyroid hormone, the PTH, as kind of your gauge. So we know that when [PTH] is suppressed below 30, that gives us some information that that patient’s vitamin D is good and metabolically is enough for them as an individual, so I really utilize that PTH value in trying to ensure that the vitamin D is adequate for that patient. That being said, more often than not, we do have a PTH that is nice, below 30, it’s in the 28 to 29 [range], but the patient’s vitamin D is still pretty low, like 31 to 32. In that case, I think there’s a lot of wiggle room, especially for autoimmune disease, so even if the [PTH] is nice and suppressed, indicating that the patient has enough vitamin D, I’ll still push that vitamin D level up to the 50s and 60s, especially with autoimmune disease, and even for patients who don’t have [an] autoimmune condition, I’ll still try to get it between 40 and 50 because I think there’s little risk for being at that level and there’s a lot of benefit for having an adequate vitamin D level. Then, “Do you use a form that contains K2?” Yes, I use Ortho Molecular vitamin D with K2, normally. That’s my go-to because I think you get 1,000 with one drop versus some of the other ones, where you have to use two to three drops to get 1,000 IUs, so I do prefer K2. I think K2 is a really important vitamin nutrient, and the higher dosing you go with vitamin D, like, if you’re getting up into the 3-4-5-6 and higher IUs [per] day, that K2 value is even more important. I think there’s little risk to adding K2 to the vitamin D, so that is my preference, doing both, and the Ortho Molecular is the one that we’re currently using in drops.