The Endocrine Society 'Clinical Practice Guideline on Evaluation, treatment and prevention of vitamin D deficiency' lists indications for 25(OH)D measurement (candidates for screening):3
Indications for 25(OH)D measurement include:
Chronic kidney disease
Inflammatory bowel disease
Antifungals, e.g. ketoconazole
|Obese children and adults (BMI 30 kg/m2)
The Endocrine Society suggests that all adults who are vitamin D deficient i.e. <50nmol/L be treated with 50,000 IU of vitamin D once a week for 8 weeks to achieve a blood level of 25(OH)D above 50nmol/L, followed by maintenance therapy of 1500-2000 IU/day.3
National Osteoporosis Society (NOS) recommendations for treatment of vitamin D deficiency:2
1. Loading regimens for treatment of deficiency up to a total of approximately 300,000 IU over several weeks.
2. Maintenance regimens may be considered one month after loading with doses equivalent to 800 to 2000 IU daily (occasionally up to 4,000 IU daily), given either daily or intermittently at a higher equivalent dose.
1. https://www.fsai.ie/faq/vitamin_d.html accessed 24th October 2017
2. National Osteoporosis Society. Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management. April 2013. V1.1.
3. Holick M et al. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab; July 2011; 96(7): 1911-30.
4. Recommendations Abstracted from the American Geriatrics Society Consensus Statement on Vitamin D for Prevention of Falls and Their Consequences. J Am Geriatr Soc 62: 147-152, 2014.
5. Hanley D et al. Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada (summary). CMAJ 2010, Sep 7; 182(12): 1315-1319.
6. Wagner C et al. Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. Paediatrics Vol 122: No. 5 November 1, 2008, 1142-1152.
7.Godel J et al. Recommendations for Canadian mothers and infants. Paediatr Child Health 2007; 12(7): 583-9.
8. Tangpricha V et al. An Update on the Screening, Diagnosis, Management and Treatment of Vitamin D Deficiency in Individuals with Cystic Fibrosis: Evidence-Based Recommendations from the Cystic Fibrosis Foundation. J Clin Endocrinol Metab April 2012, 97(4): 1082-1093.