Vitamin D for the Prevention of Disease

Publication Date: June 3, 2024

Last Updated: October 23, 2024

Objective

The purpose of this patient summary is to help the patinets and caregivers to learn about how to improve outcomes when using vitamin D to lower the risk of disease in adults and children ages 1 year and older. This patient summary is intended for general healthy populations who do not have a known risk of vitamin D deficiency.

Background

Vitamin D is an essential nutrient that our bodies need to stay healthy. It helps our bones stay strong by allowing us to absorb calcium, which is a mineral that keeps our bones and teeth healthy.
Vitamin D levels are monitored through blood work, with ranges for normal vitamin D levels vary by age and gender.
Vitamin D naturally comes from both your diet and from sun exposure, but some patients require additional supplementation.
Empiric vitamin D supplementation means that your healthcare provider might recommend giving you vitamin D without doing a test first.
Supplemental vitamin D can come in the form of fortified foods (food that contains added vitamin D), multivitamins containing vitamin D, and/or a vitamin D supplement in the form of pills or drops.
Risk factors for vitamin D deficiency include female sex, alcohol use, smoking, season (winter versus summer), medication use, no vitamin use, and limited outdoor activities such as gardening and bicycling.
Factors that influence whether your healthcare provider may suggest screening for vitamin D deficiency, testing vitamin D levels, or empiric supplementation of vitamin D include:
- Your age
- Conditions like pregnancy, prediabetes, and/or obesity
- Skin complexion.

Vitamin D Testing and Treatment

Routine Screening

This means checking for a health problem in people who don’t have any signs of it. It’s like doing a test just to see if something is wrong, even if you feel fine.
- Example: annual mammograms to screen for breast cancer

Routine Testing

This is a broader term that can include any tests your healthcare provider orders. Sometimes it’s done because you have specific symptoms or risks, or to keep track of your health.
- Example: when a patient has symptoms like fatigue or bone pain, a healthcare provider may routinely get blood work to check for low vitamin D

Children Ages 1-18 years

Nutritional rickets is a bone disease that occurs in children due to a lack of essential nutrients, particularly vitamin D, calcium, or phosphate. This deficiency leads to weak and soft bones, which can result in deformities, delayed growth, and pain.
- Rickets often affects children who do not get enough sunlight, have poor dietary intake of these nutrients, or have conditions that affect nutrient absorption.

In children and adolescents aged 1 to 18 years, vitamin D supplementation is suggested to prevent nutritional rickets and potentially lower the risk of respiratory tract infections.
- Supplements can be taken in the form of fortified foods, with pills or liquids.

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Non-Pregnant Adults Younger than 50 Years of Age

For adults 50 years of age or younger:
- Routine 25(OH)D testing is not suggested.
- Empiric vitamin D supplementation is not suggested.
- The daily recommended allowance for vitamin D for adults in this age group is 600 IU [15 µg] daily.

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Adults Ages 50-74 years

For adults 50 to 74 years of age:
- Routine 25(OH)D testing is not suggested.
- Empiric vitamin D supplementation is not suggested.
- The daily recommended allowance for vitamin D is 600 IU [15 µg] daily for those aged 50 to 70 years.
- The daily recommended allowance for vitamin D 800 IU [20 µg] daily for those older than 70 years

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Adults 75 Years of Age and Older

To potentially lower the risk of mortality, empiric vitamin D supplementation is suggested for adults 75 years of age and older.
- Daily vitamin D supplementation at a lower dose is preferred over taking non-daily, higher doses.
- However, routine 25(OH)D testing is not suggested for adults 75 years of age or older.

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Pregnancy

Empiric vitamin D supplementation is suggested for pregnant individuals to help potentially lower the risk of complications during pregnancy (such as preeclampsia and preterm birth).
Routine 25(OH)D testing is not suggested for pregnant individuals.

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Adults with Pre-Diabetes

For pre-diabetic adults considered high risk for developing diabetes, empiric vitamin D supplementation to reduce the risk of progression to diabetes is suggested.

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Dosing

For adults 50 years of age and older who do require vitamin D supplement or vitamin D deficiency treatment:
- Daily vitamin D supplementation at a lower dose is preferred over taking non-daily, higher doses.

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Vitamin D Deficiency Screening for Healthy Adults

In healthy adults, routine screening for 25(OH)D levels is not suggested.

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Adults with Dark Complexion

In adults with dark complexion, routine screening for 25(OH)D levels is not suggested.

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Adults with Obesity

In adults with obesity (BMI greater than 30), routine screening for 25(OH)D levels is not suggested.

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Source Citation

Demay MB, Pittas AG, Bikle DD, et al. Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2024

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.