Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA
Published in Journal of Clinical Endocrinology & Metabolism
Abstract
Clinical practice guideline providing evidence-based recommendations for vitamin D supplementation to optimize bone health and prevent fractures across the lifespan.
Methodology
Expert task force clinical practice guideline using the GRADE system and commissioned systematic reviews.
Key Findings
The guideline defines deficiency as 25(OH)D below 20 ng/mL and insufficiency as 21-29 ng/mL, recommends 600-800 IU/day as a dietary minimum for bone health, and notes that 1,500-2,000 IU/day may be needed for adults to exceed 30 ng/mL. Screening is recommended only for at-risk groups, and the tolerable upper limit for adults is set at 4,000 IU/day (up to 10,000 IU/day under supervision for correcting deficiency).
Conclusions
Vitamin D repletion targets and dosing for skeletal health are well defined; recommendations for non-skeletal outcomes were not supported by sufficient evidence at the time of publication.
Limitations
Consensus guideline rather than primary research; many recommendations were graded weak with low-to-moderate quality evidence, and its 30 ng/mL threshold is higher than the Institute of Medicine's population-based recommendation.
Supplements Studied
The guideline defines deficiency as 25(OH)D below 20 ng/mL and insufficiency as 21-29 ng/mL, recommends 600-800 IU/day as a dietary minimum for bone health, and notes that 1,500-2,000 IU/day may be needed for adults to exceed 30 ng/mL. Screening is recommended only for at-risk groups, and the tolerable upper limit for adults is set at 4,000 IU/day (up to 10,000 IU/day under supervision for correcting deficiency).
Outcomes Measured
Vitamin D is essential for calcium absorption and bone mineralization. Supplementation significantly reduces fracture risk, particularly in individuals with deficiency.
Related Health Concerns
Study Details
Access Study
Disclosures
Funding
The Endocrine Society; several authors disclosed industry relationships.
This information is for educational purposes only. Always consult a healthcare professional before starting any supplement regimen.