Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline.
J Clin Endocrinol Metab. 2011 Jun 6.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM.
Boston University School of Medicine (M.F.H.), Boston, Massachusetts 02118; University of Wisconsin (N.C.B.), Madison, Wisconsin 53706; University Hospital Zurich (H.A.B.-F.), CH-8091 Zurich, Switzerland; Children's Hospital Boston (C.M.G.), Boston, Massachusetts 02115; University of Calgary Faculty of Medicine (D.A.H.), Calgary, Alberta, Canada T2N 1N4; Creighton University (R.P.H.), Omaha, Nebraska 68178; Mayo Clinic (M.H.M.), Rochester, Minnesota 55905; and Purdue University (C.M.W.), West Lafayette, Indiana 47907.
Objective: The objective was to provide guidelines to clinicians for the evaluation, treatment, and prevention of vitamin D deficiency with an emphasis on the care of patients who are at risk for deficiency. Participants: The Task Force was composed of a Chair, six additional experts, and a methodologist. The Task Force received no corporate funding or remuneration. Consensus Process: Consensus was guided by systematic reviews of evidence and discussions during several conference calls and e-mail communications. The draft prepared by the Task Force was reviewed successively by The Endocrine Society's Clinical Guidelines Subcommittee, Clinical Affairs Core Committee, and cosponsoring associations, and it was posted on The Endocrine Society web site for member review. At each stage of review, the Task Force received written comments and incorporated needed changes.
Conclusions: Considering that vitamin D deficiency is very common in all age groups and that few foods contain vitamin D, the Task Force recommended supplementation at suggested daily intake and tolerable upper limit levels, depending on age and clinical circumstances. The Task Force also suggested the measurement of serum 25-hydroxyvitamin D level by a reliable assay as the initial diagnostic test in patients at risk for deficiency. Treatment with either vitamin D(2) or vitamin D(3) was recommended for deficient patients. At the present time, there is not sufficient evidence to recommend screening individuals who are not at risk for deficiency or to prescribe vitamin D to attain the noncalcemic benefit for cardiovascular protection.
Download the PDF from VitaminDWiki
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Defines Vitamin D insufficiency as 20-29 nanograms/ml
- continue with Deficiency as < 20 nanograms/ml - as voted on by Institute of Medicine Nov 2010
Chronic kidney disease
Inflammatory bowel disease
Antifungals, e.g. ketoconazole
African-American and Hispanic children and adults
Pregnant and lactating women
Older adults with history of falls
Older adults with history of nontraumatic fractures
Obese children and adults (BMI > 30 kg/m2)
Dr. Hollick, a powerful member of the Endocrine Society, is one of the few doctors around the world who still believes that D2 is as good as D3
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