Authors:
Lucas R, Neale R
Authors notes:
Australian Family Physician 43(3): 119-122.
Keywords:
endocrine system diseases, epidemiology, general practice, health promotion, prescriptions, drugs
Abstract:
Vitamin D deficiency is thought to be common in Australia.
It is unclear when vitamin D supplementation should be prescribed.
We assess the evidence that guides clinical decision-making on supplementation with vitamin D following a vitamin D test result.
Vitamin D assays are inconsistent and inaccurate and there is weak evidence around the level of 25-hydroxyvitamin D (25(OH)D) that is optimal.
Evidence of links between vitamin D deficiency and disease come from observational studies and there is little support from randomised controlled trials of vitamin D supplementation.
Where there is evidence of a link, increased risk is largely confined to very low 25(OH)D levels, with minimal health gains for 25(OH)D levels greater than 50 nmol/L.
New evidence indicates that both high and low 25(OH)D levels may be associated with increased health risks.
Taken together these considerations present a considerable challenge to clinical decision making around treatment on the basis of 25(OH)D levels.