Doubts Emerge About Widespread Use of Vitamin D Supplementation

Asked by audience members what she does about vitamin D in her own practice, Dr. Buckley said she generally tries to get patients into the 20-29 ng/mL range, while in African Americans and patients with known cardiovascular disease, she aims for 15 ng/mL or slightly more—“and I worry that might be too high sometimes.”

She reserves expedited supplementation—50,000 IU weekly for 8 weeks—mainly for vitamin D–deficient elderly patients at high risk for fracture or fall. There is no evidence to support supplementation in young or middle-aged patients, whose increased fracture risk is decades away.

Updated recommendations on vitamin D from the Institute of Medicine, due this spring, will likely recommend an increase in the currently recommended supplemental 400 IU/day for 50- to 70-year-olds not getting sufficient vitamin D from the sun. Dr. Buckley said she hopes the IOM will address the thorny issues of who should receive supplementation, and how quickly.

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Disclosures: Dr. Buckley reported having no relevant financial relationships.

The vitamin D assay is one of the most-ordered tests, despite questions about its reliability.

Source DR. BUCKLEYPASCAL/FOTOLIA.COM

This Month's Talk Back Question

What is your approach to advising patients about vitamin D and calcium supplementation?