Ann Biol Clin (Paris). 2015 Dec 29. [Epub ahead of print]
Souberbielle JC1, Deschenes G2, Fouque D3, Groussin L4, Guggenbuhl P5, Jean G6, Linglart A7, Thomas T8.
The 25-hydroxyvitamin D (25OHD) serum concentration should not be measured to everybody but recommendations for this measurement in several clinical situations are available from numerous guidelines and expert positions. It can be proposed to measure 25OHD in diseases where a target range of 25OHD concentrations associated with better outcomes is defined with a sufficient level of evidence, and when this target concentration is difficult to reach without previous measurement (or may be exceeded in case of too large doses are provided). Many National and International Medical Societies recommend to measure 25OHD at least in any situation of « bone fragility » (defined by a low bone mineral density and/or a low energy fracture), in malabsorptions, in chronic kidney disease, in any « phosphocalcic pathology, in patients with clinical signs of profound vitamin D deficiency or excess, and, more generally in any biological exploration of calcium/phosphorus metabolism that includes the measurement of PTH. Although these recommandations may seem discordant with the recent French restriction in the reimbursment of 25OHD measurement, they may still be reimbursed.
VitaminDWiki was unable to get details on the French restriction of vitamin D tests
France joins several other countries (Canada, Australia, US, etc) in trying to restrict costs of vitamin D testing. This restriction in testing ignores the benefits of increased vitamin D levels due to patient awareness of vitamin D deficiency. They fail to notice that majority of people do not request a second test because they have felt the increase in vitamin D levels and so have no requested a subsequent test.
- France restricts Vitamin D testing to 4 health problems, paper proposes 5 more – Nov 2016
- Medicare now pays for just one vitamin D test , but 20 CT scans for smokers – Feb 2015
US Medicare pays for only 1 vitamin D test per lifetime
- No longer debating vitamin D supplementation, now debating need for testing first – April 2013
- Low cost vitamin D Blood Tests
- 50,000 IU monthly safe to take without any vitamin D testing – RCT Dec 2013
VitaminDWiki suggests 50,000 IU twice a month
- After 245,000 vitamin D tests 121,000 supplemented but only 5,400 had 2nd test – Oct 2011
- VA showed increased vitamin D associated with lower health costs - Lancet May 2012
- Task force confirms - not much benefit from low Vitamin D supplementation – Nov 2014
Note – we agree – supplementing with 800 IU does not provide any measurable benefit
- 80 X increase in Vitamin D testing in Australia in a decade - June 2013
They may have stopped the increase direct costs by greatly restricting testing
Chart of actual increase and the left Chart of extrapolation if quota had not been imposed.is on the right