Vitamin D: Controversies and Facts
AUGUST 18, 2017
Emily Seamans, 2018 PharmD Candidate, the University of Connecticut
Two-thirds of the US population had sufficient vitamin D status from 2001 to 2006, according to the CDC. But during that time, one-fourth were at risk of vitamin D inadequacy and 8% were at risk for vitamin D deficiency.
Health care providers often prescribe vitamin D and calcium supplementation to older patients to reduce their risk of fractures. Severe nutritional rickets and osteomalacia are uncommon diseases that can be caused by vitamin D or calcium deficiencies.
The results of the Vitamin D Assessment Study showed that a 100,000 IU monthly oral vitamin D dose doesn’t improve bone mass unless serum 25-OHD levels are below 30 nmol/L. Vitamin D supplementation is effective when targeted to high-risk groups: patients with compelling risk factors for vitamin D deficiency and documented low serum 25-OHD.
References
Abrahamsen B. Bespoke or one size fits all-vitamin D fortification, targeted
supplementation in risk groups or individual measurement? Maturitas. 2017;103:1-2.
Looker AC, Johnson CL, Lacher DA, et al. Vitamin D status: United States 2001–2006. NCHS data brief, no 59. Hyattsville, MD: National Center for Health Statistics. 2011.
Health care providers often prescribe vitamin D and calcium supplementation to older patients to reduce their risk of fractures. Severe nutritional rickets and osteomalacia are uncommon diseases that can be caused by vitamin D or calcium deficiencies.
The results of the Vitamin D Assessment Study showed that a 100,000 IU monthly oral vitamin D dose doesn’t improve bone mass unless serum 25-OHD levels are below 30 nmol/L. Vitamin D supplementation is effective when targeted to high-risk groups: patients with compelling risk factors for vitamin D deficiency and documented low serum 25-OHD.
- Patients may avoid sun exposure because of cultural reasons, personal preferences, comorbidities, or because they take photosensitizing medications. These patients are appropriately prescribed vitamin D supplementation without measuring serum vitamin D levels.
- Providers should check a patient’s vitamin D status if they present with nonspecific symptoms such as fatigue, muscle weakness, or muscle pain. Supplementation is only appropriate if serum vitamin D levels are low.
- No evidence exists for measuring serum 25-OHD in patients who are asymptomatic and lack risk factors for vitamin D deficiency.
References
Abrahamsen B. Bespoke or one size fits all-vitamin D fortification, targeted
supplementation in risk groups or individual measurement? Maturitas. 2017;103:1-2.
Looker AC, Johnson CL, Lacher DA, et al. Vitamin D status: United States 2001–2006. NCHS data brief, no 59. Hyattsville, MD: National Center for Health Statistics. 2011.