- The guidelines were developed after examination of systematic reviews of vitamin D intake, and the authors also incorporated suggestions from members of The Endocrine Society after a draft document was posted on the society’s Web page.
- Screening for vitamin D deficiency should only be done in high-risk patients, including patients with known bone disease, kidney disease, cirrhosis, and malabsorption syndromes. Pregnant women may be screened for vitamin D deficiency.
- Clinicians should use a 25(OH)D level to screen for vitamin D deficiency. A level of 20 ng/mL or less constitutes vitamin D deficiency.
- Infants younger than 1 year should receive at least 400 IU/day of vitamin D,
- Older children and adolescents should receive at least 600 IU/day.
- Adults between 19 and 65 years old should receive at least 600 IU/day of vitamin D.
- Adults 65 years and older should receive at least 800 IU/day.
- Pregnant women should receive at least 600 IU of vitamin D per day.
- Obese children and adults should receive vitamin D at least 2 to 3 times more than the recommended daily values for individuals at a normal weight.
- Very high doses of vitamin D are associated with hypercalcemia and other complications. The maintenance dose of vitamin D should not exceed 2500 IU/day for children between 1 and 3 years old, 3000 IU/day for children between 4 and 8 years old, and 4000 IU/day among individuals older than 8 years.
- However, treatment of vitamin D deficiency requires higher doses of vitamin D (2000 IU/day for 6 weeks among infants, children, and adolescents; 6000 IU/day for 8 weeks among adults). In general, the dose of vitamin D in the treatment of deficiency should be approximately 50,000 IU/week.
- Either vitamin D2 or D3 may be used to treat vitamin D deficiency.
- Maintenance therapy after treatment of vitamin D deficiency requires higher doses of vitamin D (1500 – 2000 IU/day among adults
These recommended values are designed to maximize bone health, and the guidelines also recommend vitamin D to help prevent falls among older adults. However, the authors found insufficient evidence to recommend the use of vitamin D supplements for other health-related goals, such as cardiovascular disease prevention or improvement in the quality of life.
Development of the clinical practice guideline was supported solely by The Endocrine Society. Dr. Holick has disclosed financial or business/organizational interests with Merck, Novartis, Nichols-Quest Diagnostics, Bayer, Aventis, Warner Chilcott, Amgen, the UV Foundation, DMI, and the Mushroom Council. A complete list of disclosures for the task force is listed with the original article.http://jcem.endojournals.org/content/early/2011/06/03/jc.2011-0385.abstract?rss=1