21 reasons why doctors are reluctant to accept Vitamin D

AI summary of this page

Doctors’ reluctance to embrace vitamin D supplementation is shaped by a complex web of myths, outdated training, institutional dogma, and systemic interests.

This page compiles 21 reasons why even well-intentioned physicians hesitate to recommend higher-dose vitamin D—including fears of toxicity, legal liability for exceeding conservative guidelines, and a lack of consensus among experts regarding optimal dosing.

Many doctors receive little nutrition education, often rely on less-effective vitamin D2 prescriptions, and confront insurance and pharmaceutical incentives misaligned with broad preventive health.

Broader barriers, such as the belief that “nothing can be that great,” the inertia of established medical practice, and concerns that empowered, healthier patients might reduce demand for services, all contribute to this resistance.

With tests for vitamin D still plagued by accuracy issues and dosing guidelines slow to reflect emerging evidence, the paper makes clear that those seeking the benefits of optimal vitamin D may need to take initiative—because waiting for the healthcare system to catch up could mean missed opportunities for better health.

1. Myth: Excess vitamin D will turn the human body into marble

   • Until recently, medical students were told that > 2,000 IU of vitamin D could cause toxicity and Calcifications
   • It is difficult to unlearn something.

   • See Myth for 50 years: 2000 IU of vitamin D is toxic - still taught as fact in 2010

     • Williams Syndrome mistaken diagnosis

     • Or. perhaps due to an ancient translation error 1000 IU of vitamin D (per kg) can indeed be toxic – 1947

2. Would require ignoring the position of the medical profession on supplements.

   • Medical societies first supported, then reversed themselves on the need for supplements
   • Doctors got burned by first telling patients to take supplement X and then later having the patients stop taking supplement X
   • Doctors are reluctant to endure yet another supplement reversal
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3. Risk of being sued if exceeding guidelines
   • Increase risk of being sued for Malpractice if it exceeds current medical guidelines
   • Example: prescribe 6,000 IU of vitamin D during pregnancy instead of the 400 IU in most guidelines
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4. Experts do not agree on how much is needed
   • There is a worldwide agreement that 400 IU of vitamin D is needed to prevent Rickets, but little else is agreed upon
   • (Raised to 600 IU in the US in 2010, most countries are still at 400 IU, and some are still at 200 IU)
   • Some improvement: 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018
   • 10 years of Vitamin D guidelines, no consensus - Aug 2025
   •  
5. Doctors are rarely trained in nutrition
   • When I went to medical school, nutrition was not really on the radar,
   •        and taking vitamins was even trivialized by some as a great way to “make expensive urine.”
   • Vitamin D is arguably the most complex supplement - the amount needed varies with:
   •      Weight, Skin color, Latitude, Season, Co-factors, Current meal, Recent surgery/trauma, Neighborhood, etc.
   •       see also Why isn’t nutrition a bigger part of conventional medical school education? The question at Research Gate 2013 with > 400 responses
   •  
6. Medical training has an emphasis on treatment, not prevention
   • Medical training and practice emphasizes treatment, not prevention.
   • The primary benefit of vitamin D is prevention. (but Vitamin D does treat 70+ diseases) but typically need >5,000 IU
   • They have learned that most patients are either reluctant to change to prevent a future problem (lose weight, stop smoking, . . )
   • or will often not continue with the change. So why should the doctor try?
   •  
7. Doctors have tried prescribing small vitamin D doses recommended by govts., but with minimal success
   • A frequent sequence of events:
   • 1) A doctor hears that people might have low Vitamin D
   • 2) The doctor recommends a vitamin D test for some of his patients
   • 3) The test result often shows low
   • 4) The doctor prescribes the RDA (far too little)
   • 5) Retesting finds that the levels did not rise and patient-reported no health improvement (too little dose or test too soon)
   • 6) The country/health profession decides that tests are costly and do not improve health
8. Doctors often can only prescribe D2 anyway (true in US before March, 2012)
   • Kaiser Health research continues to only use Vitamin D2 (2019)
   • Some doctors are aware that D2 does not help nearly as much as D3
   • And, in some cases, Vitamin D2 actually lowers levels of D3
   •  
9. Doctors have too little time to read outside of their specialty
   •  
10. Seems like too much of a “wonder drug”
    • ‘Nothing can be that great’
    •  

11. Fear possible loss of income

    • If Vitamin D is truly a ‘wonder drug’, it would reduce the number of patient visits, and therefore reduce income.

    • Note: in 2012 one doctor reduced patient visits from 4 per year to 1 per year by getting all 2,000+ patients to have >80 ng       Net result of vitamin D: Lost too much business and retired early.

      • "It is difficult to get a man to understand something when his salary is dependent upon his not understanding it”  Upton Sinclair

      • See also Do not expect a doctor to recommend a pill which will eliminate his job (vitamin D)

      • Note: getting everyone >40 ng should not endanger medical jobs the way that >80 ng does

12. Might fear the loss of control and respect if people can deal with some of their own health problems

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13. Reduces Big Pharma profit, so doctors not rewarded
    •  
14. The Vitamin D dose needed often varies by 50X between individuals for the same health problem
    • Varies with weight, gut health, skin color, latitude, genes,
    • Doctors prefer using a single dose of a drug for all patients
    •  
15. Doctors indoctrinated to not prescribe >4,000+ IU of vitamin D
    •  
16. in many countries doctors can only prescribe D2 (which does not work as well), not D3
    •  
17. Doctors often prefer using a monotherapy
    • Reluctant to also prescribe Zinc or Resveratrol or Magnesium or Omega-3. etc. when needed
    •  
18. One level (e.g. 30 ng) does not treat all diseases
    • Is 50 ng of vitamin D too high, just right, or not enough
    • Revisiting Vitamin D Guidelines – Holick Oct 2024 chart 20 ng to 60 ng needed
    •  
19. Vitamin D tests are NOT accurate indications of Vitamin D levels in blood
    • Tests for Vitamin D
    • What is a significant vitamin D level change: ~8 if at 30 ng, ~18 if at 50 ng
    • Vitamin D test result can vary by 40 ng (10 reasons) – July 2024
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20. Vitamin D tests do NOT show Vitamin D levels in cells
    • 30% of the time genes restrict the amount of vitamin D that gets to cells
    •  
21. Low recommended doses rarely show benefits
    • 400 IU takes 6+ months to show a possible benefit in adults
    • Patients will often give up taking it daily when no benefits are noticed after months

See also VitaminDWiki

• Would you be opposed to my getting more vitamin D a question to your doctor that minimizes his risk

• 20 reasons for not taking Vitamin D debunked

• Do not expect your doctor to know about vitamin D

• Do not expect a doctor to recommend a pill which will eliminate his job (vitamin D)

• Overview Evidence for vitamin D

• Curing patients is not a sustainable business model – Goldman Sachs – April 2018

• VITAMIN D: Public Shouldn’t Wait For Doctors To Usher In New “Golden Era” Of Preventive Medicine

• Let 1000 die from vitamin D deficiency rather than incur 1 lawsuit

• Survey Shows Dogma Not Data Can Dictate Doctors' Decisions - June 2010

• Consensus Vitamin D category listing has items along with related searches

• Hospitals do not want to lose income

  • Insurance companies would also lose income if medical costs were reduced since their income is a % of the billing

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