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UK considers Vitamin D tests appropriate for only 4 existing health problems, – June 2018

Vitamin D: too much testing and treating?

Clin Med (Lond). 2018 Jun;18(3):196-200. doi: 10.7861/clinmedicine.18-3-196.


Some places disagree with the UK

Many places want to lower the costs by reducing Vitamin D testing
   (which will raise long-term total medical costs)

Tests for Vitamin D category listing has 127 items has the following overview/opinion
  • Fact: Many countries no longer pay for more than 1 or even any Vitamin D tests
      They feel that vitamin D testing is not needed except for a few conditions
  • Fact: Vitamin D tests are not very accurate/consistent: typically +- 5 nanograms
  • Opinion: Home blood spot tests have similar accuracy/repeatability as the lab tests
  • Fact: Low cost vitamin D tests are coming, but are not available in the US yet
       Low-cost test by Nanosys is available outside of the US
       both yes/no 35 ng and quantitative ($13 in quantity)
       update Low-cost Vitamin D testers (about 13 dollars in quantity) – Feb 2018 including cost of readout device
  • Fact: 3 major gene problems are not noticed by standard Vitamin D tests
       ~ 20% of Vit D tests show OK levels in blood when genes restrict VitD getting to cells
       Hint that Vit D not getting to cells: Vit D related diseases run in your family
  • Fact: A vitamin D test will rarely (<1 in 1000) indicate that you are getting too much
  • Opinion: If only getting a single test, wait till after supplementing with Vit D
       3 months after starting a maintenance dose or 4 weeks after a loading dose

PDF is available free at Sci-Hub

Woodford HJ1, Barrett S2, Pattman S3.
1 North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, UK henry.woodford at nhct.nhs.uk.
2 North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, UK.
3 North Tyneside General Hospital Northumbria Healthcare NHS Foundation Trust, North Shields, UK.

There is clinical uncertainty as to the testing of serum 25 Hydroxy vitamin D (25OHD) concentrations and when to use high-dose supplementation. Data show that there has been a rapid increase in the number of tests performed within the Northumbria Healthcare NHS Foundation Trust over the past 8 years and an increase in high-dose supplementation over the past 5 years. We performed a retrospective analysis of the 25(OH)D test requests over the period from January to -October 2017. A total of 17,405 tests were performed in this time period. The overall average concentration was 57.5 nmol/L and this figure was similar across age groups, although a larger proportion of patients aged over 75 had a concentration <25 nmol/L.
Test requests were classified into 'appropriate', 'inappropriate' and 'uncertain' categories based on current expert opinion.
We found that between 70.4% and 77.5% of tests could be inappropriate, depending on whether the 'uncertain' categories of falls and osteoporosis are considered to be justified. Tiredness, fatigue or exhaustion was the reason for testing in 22.4% of requests. We suggest that a more rational approach to testing, and subsequent treating, could lead to reductions in costs to the healthcare system and patients.

Created by admin. Last Modification: Sunday June 3, 2018 15:39:57 GMT-0000 by admin. (Version 2)
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