CLINICAL QUESTION

Should people without an established indication for vitamin D supplementation receive empiric treatment or undergo testing for vitamin D levels?

BOTTOM LINE

There is no need to obtain vitamin D levels. The working group did not find evidence that any specific cutoff is valuable for defining vitamin D deficiency and did not find research to support achieving a specific vitamin D level. There is no demographic group that must receive vitamin D. There are some groups that may benefit from a daily intake of vitamin D through fortified foods or vitamin D supplementation, including children and adolescents, and adults who are pregnant, have impaired glucose tolerance, or are older than 74 years. (Level of Evidence = 5)

SYNOPSIS

The guideline aimed to give guidance regarding the effect of empiric vitamin D supplementation; that is, vitamin D supplementation in people without an identified deficiency and without first checking vitamin D levels to prevent adverse patient outcomes. The authors performed a systematic review, graded the evidence quality, and specified the strength of their recommendations. The working group included content experts, a patient representative, and a methodologist. The working group chairperson and most of the members did not have any conflict of interest. The guidelines do not apply to people with identified vitamin D disorders (eg, rickets) and are relevant to people in developed countries. The group answered 10 questions regarding populations and the role of empiric vitamin D. The important recommendations include: