Loading...
 
Translate Register Log In Login with facebookLogin and Register

Grade A recommendations for vitamin D - May 2009

from guideline.gov

University of Texas at Austin, School of Nursing, Family Nurse Practitioner Program.
Recommendations for the diagnosis and management of vitamin D deficiency in adults. Austin (TX): 2009 May. 16 p. 40 references

  • Chronic musculoskeletal pain including fibromyalgia (Grade A, Evidence Good)
    • (Cannell & Hollis, 2008; Holick, 2007; Lyman, 2005; Leventis & Patel, 2008; Bischoff-Ferrari, Orav, & Dawson-Hughes, 2006)
  • Osteoporosis (Grade A, Evidence Good)
    • (Holick, 2007; Lyman, 2005; Leventis & Patel, 2008; Cannell & Hollis, 2008; Bischoff-Ferrari et al., 2009; Bischoff-Ferrari, Orav, & Dawson-Hughes, 2006; Autier and Gandini, 2007)
  • Rheumatoid arthritis (Grade A, Evidence Good)
    • (Leventis & Patel, 2008; Holick, 2007; Cannell & Hollis, 2008; Mouyis et al., 2008; Plotnikoff & Quigley, 2003)
  • Malabsorption syndromes (Grade A Evidence Good)
    • (Holick, 2007; Agus & Drezner, 2008; Johnson et al., 2006)
  • Cardiovascular disease (Grade A, Evidence Good)
    • (Martins et al., 2007; Autier & Gandini, 2007; Lee et al., 2008)
  • High risk population such as elderly (over 71 years of age) and dark-skinned individuals (Grade A, Evidence Good)
    • (Bischoff-Ferrari et al., 2004; Agus & Drezner, 2008; Cannell & Hollis, 2008; Holick, 2007; Lyman, 2005; National Institutes of Health, 2008)
  • Chronic use of corticosteroids (Grade A, Evidence Good)
    • (Holick, 2007; Lyman, 2005; Leventis & Patel, 2008; Cannell & Hollis, 2008)
  • Personal/social history of inadequate sun exposure (e.g., working indoors, homebound, living in higher latitude, wearing excessive clothing, dark skinned and use of sun block) and insufficient dietary intake of vitamin D fortified foods (Grade A, Evidence Good)
    • (Holick, 2007; Lyman, 2005; Leventis & Patel, 2008; Cannell & Hollis, 2008; Cranney et al., 2007)
  • Nutritional deficiency (25OHD <20 ng/ml (Grade A, Evidence Good) requires initial treatment with 50,000 IU of vitamin D2 or D3 orally once per week for six to eight weeks (may take longer depending on starting 25OHD level), and then 800 to 1000 IU of vitamin D3 daily thereafter
    • (Dawson-Hughes, 2008; Lyman, 2005; Holick, 2007).
    • Intramuscular cholecalciferol (300,000 U) in one or two doses per year is also an option for increasing serum 25OHD levels (de Torrente de la Jara, Pecoud, & Favrat, 2006)
  • Obesity, metabolic syndromes, and type II diabetes (Grade B, Evidence Fair)
    • (Holick, 2007; Giovannucci et al., 2008; Cannell &amp; Hollis, 2008; Konradsen et al., 2008; Rodriguez-Rodriguez et al., 2009; Pittas et al., 2007; Mattila et al., 2007; Melamed et al., 2008)
  • Chronic kidney disease and hyperparathyroidism (Grade B, Evidence Fair)
    • (Holick, 2007; Agus &amp; Drezner, 2008; Cuppari &amp; Garcia-Lopez, 2009; Dusso, Brown, &amp; Slatopolsky, 2005)
  • Depression (Grade B, Evidence Fair)
    • (Berk et al., 2007; Wilkins et al., 2006; Murphy &amp; Wagner, 2008; Holick, 2007)


Grading of Recommendations(Based on U.S. Preventive Services Task Force [USPSTF] Ratings)

  • A. The USPSTF strongly recommends that clinicians provide the service to eligible patients.
    The USPSTF found good evidence that the service improves important health outcomes and CONCLUDES THAT BENEFITS OUTWEIGH HARMS.
  • B. The USPSTF recommends that clinicians provide this service to eligible patients.
    The USPSTF found at least fair evidence that the service improves important health outcomes and CONCLUDE THAT BENEFITS OUTWEIGH HARMS
    .


Quality of Evidence (Based on U.S. Preventive Services Task Force [USPSTF] Ratings)

  • Good: Evidence includes consistent results from well-designed, well-conducted studies in representative populations that directly assess effects on health outcomes.
  • Fair: Evidence is sufficient to determine effects on health outcomes, but the strength of the evidence is limited by the number, quality, or consistency of the individual studies, generalizability to routine practice, or indirect nature of the evidence of health outcomes.


- - - - - - - - -

Comment by VitaminDWiki

The evidence has gotten much stronger since 2008 when this report was made, and much higher doses are now being used

Grade A recommendations for vitamin D - May 2009        

2084 visitors, last modified 07 Nov, 2011, URL:

Printer Friendly PDF this page! Follow this page for updates
See any problem with this page? Report it (FINALLY WORKS)