New Vitamin D Guidelines

Further to my recent posts on how to determine your Vitamin D levels and how much is enough, I note today that The Endocrine Society has released a Clinical Practice Guideline on the evaluation, treatment, and prevention of vitamin D deficiency.
The new guidelines, which are to assist clinicians in treating vitamin D deficiency, were developed by vitamin D experts Drs Michael Holick and Robert Heaney along with 5 other scientists.
Key points from the report are:
  • a minimum blood level of 30 ng/mL is recommended and to guarantee sufficiency between 40 and 60 ng/mL for both children and adults
  • high risk groups should be screened for deficiency including; obese individuals, blacks, pregnant and lactating women, and patients with malabsorption syndromes
  • Screening should be performed using a reliable assay for 25-hydroxy-vitamin D (25[OH]D), not 1,25-dihydroxy-vitamin D (1,25[OH]2D), “which tells you nothing about vitamin D status” [see the correct Vitamin D test here. Ed].
  • Vitamin D deficiency is defined as 25[OH]D levels below 20 ng/mL
  • Supplementation at the suggested daily intake and upper tolerable level is recommended, considering that vitamin D deficiency is very common in all age groups and that few foods contain vitamin D
  • For bone health, infants and children up to 1 year of age require at least 400 IU/day vitamin D, and children 1 year and older need at least 600 IU/day, the guideline states. However, at least 1000 IU/day of vitamin D may be needed to raise the blood level of 25(OH)D consistently above 30 ng/mL
  • Adults aged 19 to 70 years require at least 600 IU/day of vitamin D to maximize bone health and muscle function. However, getting 25(OH)D levels consistently above 30 ng/mL may require at least 1500 to 2000 IU/day of vitamin D
  • Adults 70 years and older require at least 800 IU/day of vitamin D for bone health and fall prevention; at least 1500 to 2000 IU/day of supplemental vitamin D may be needed to keep 25(OH)D levels above 30 ng/mL
  • Pregnant and lactating women need a minimum of 600 IU/day of vitamin D; 1500 IU/day may be needed to maintain blood levels of 25(OH)D higher than 30 ng/mL.
  • Obese children and adults and children and adults on anticonvulsant medications, glucocorticoids, antifungals such as ketoconazole, and medications for AIDS need at least 2 to 3 times more vitamin D for their age group to satisfy their body’s vitamin D requirement
  • Tolerable upper limits of vitamin D, which “should not be exceeded without medical supervision,” include the following:
    o 1000 IU/day for infants aged up to 6 months,
    o 1500 IU/day for infants aged 6 months to 1 year old,
    o 2500 IU/day for children aged 1 to 3 years,
    o 3000 IU/day for children aged 4 to 8 years, and
    o 4000 IU/day for everyone older than 8 years.
  • individuals who are vitamin D deficient, higher levels of vitamin D (2000 IU/day for children up to age 1 year; 4000 IU/day for children aged 1 – 18 years, and up to 10,000 IU/day for adults aged 19 years and older) may be necessary to correct, treat, and prevent vitamin D deficiency
  • Both vitamin D2 and vitamin D3 are equally fine in treating and preventing vitamin D deficiency [not sure about this one – I would always advise D3. Ed]

    Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2011 Jun 6. [Epub ahead of print] Source Nutri June 11


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