Do you get enough or too much?

The Washington Post

New Endocrine Society Guideline recommends vitamin D higher than the recommended daily allowance for children, pregnant people, adults over 75, and adults with prediabetes.
For children, pregnant people, adults older than 75 years and adults with high-risk prediabetes, the guideline recommends vitamin D higher than the IOM recommended daily allowance.
The Debate Over Vitamin D Vitamin D use and blood vitamin D levels have been associated with many common diseases.
However, whether vitamin D supplementation lowers the risk of these diseases and what vitamin D blood levels are needed for better health have been debated for years.
In this new guideline, the panel of experts established guidelines for vitamin D use and testing for vitamin D levels in healthy persons without established indications for vitamin D treatment or testing.
“The goal of this guideline was to address the vitamin D requirements for disease prevention in a generally healthy population with no underlying conditions that would put them at risk of impaired vitamin D absorption or action,” said Marie Demay, M.D., of Harvard Medical School and Massachusetts General Hospital in Boston, Mass.
“Healthy populations who may benefit from higher dose vitamin D supplements are those 75 and older, pregnant people, adults with prediabetes, and children and adolescents 18 and younger, but we do not recommend routine testing for vitamin D levels in any of these groups.” Key Recommendations The guideline’s key recommendations include: We suggest against vitamin D supplements at doses beyond the reference dietary intakes recommended by the IOM in healthy adults under 75 years old.
In adults ages 50 years and older who have indications for vitamin D supplementation or treatment, we suggest daily, lower-dose vitamin D instead of non-daily, higher-dose vitamin D. We suggest against routine testing for 25-hydroxyvitamin D levels in any of the populations studied, since outcome-specific benefits based on these levels have not been identified.

NEGATIVE

According to the New Endocrine Society Guidelines, adults with prediabetes, adults over 75, pregnant women, and children should take more vitamin D than the daily recommended amount.

A new Clinical Practice Guideline released today by the Endocrine Society states that healthy adults under 75 years of age do not need to be tested for vitamin D levels and are unlikely to benefit from taking more than the daily intake recommended by the Institutes of Medicine (IOM). The guideline suggests higher daily allowances of vitamin D than those recommended by the Institute of Medicine for People with High-Risk Prediabetes, Children, and Adults Over 75.

The Discussion Around Vitamin D.

Many prevalent diseases have been linked to the use of vitamin D and blood levels of the vitamin. There has been discussion for years regarding the blood levels of vitamin D required for optimal health and whether or not supplementation reduces the risk of these diseases.

The experts who compiled this new guideline established recommendations for the use of vitamin D and vitamin D level testing in healthy individuals who do not yet have established indications for vitamin D treatment or testing. Clinical trials were used to develop the recommendations in the guideline.

The publication and goal of the guideline.

The Endocrine Society’s Journal of Clinical Endocrinology and Metabolism (JCEM), which is published in print form in August 2024, will feature the guideline, entitled “Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline,” which was published online.

According to Marie Demay, M.D, “the purpose of this guideline was to address the vitamin D requirements for disease prevention in a generally healthy population with no underlying conditions that would put them at risk of impaired vitamin D absorption or action.”. , of Boston, Massachusetts’s Massachusetts General Hospital and Harvard Medical School. The panel that created the guidelines was chaired by Demay. “Those 75 years of age and older, pregnant women, adults with prediabetes, and children and adolescents 18 years of age and younger are healthy populations that may benefit from higher dose vitamin D supplements; however, we do not recommend routine testing for vitamin D levels in any of these groups.”. “.

Crucial Advice.

Key suggestions made by the guidelines are as follows:.

We advise against taking vitamin D supplements at amounts higher than the reference dietary intakes that the Institute of Medicine (IOM) recommends for healthy adults under 75.

Given the potential to lower particular health risks, we identified the following populations that might benefit from supplementation above the IOM recommended intakes:.

Small children and teenagers (18 years of age and under): may help lower the risk of respiratory infections and nutritional rickets.

People 75 years of age and older may have a decreased risk of death.

Pregnant women have the potential to lower their risk of neonatal mortality, preterm birth, small-for-gestational-age birth, intrauterine death, and pre-eclampsia.

People with prediabetes have the ability to delay the onset of diabetes.

We recommend daily lower-dose vitamin D over non-daily higher-dose vitamin D in adults 50 years of age and above who have indications for vitamin D supplementation or treatment.

As no outcome-specific benefits based on 25-hydroxyvitamin D levels have been found, we advise against routine testing for this level in any of the populations under study. This includes screening for 25-hydroxyvitamin D in individuals who are obese or have dark complexions.

Constraints on the Available Evidence.

The panel pointed out several shortcomings in the data that was available, despite the fact that the body of knowledge regarding vitamin D’s role in health and disease has grown over the past ten years. For instance, many of the large clinical trials were not intended for many of the outcomes they reported, and the populations under study had baseline blood levels of vitamin D that most would consider adequate. The panel was unable to establish target levels for the prevention of disease or precise blood-level thresholds for 25-hydroxyvitamin D adequacy due to a lack of evidence.

Reference: “Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline” by Paul Lips, Deborah M Mitchell, M Hassan Murad, Shelley Powers, Sudhaker D Rao, Robert Scragg, John A. Tayek, Amy M. Valent, Judith M. E. Walsh, and Christopher R. McCartney, published in The Journal of Clinical Endocrinology & Metabolism on June 3, 2024.

DOI: 10.1210/clinem/dgae290.

The co-chair of the Endocrine Society’s writing committee for this guideline, Anastassios Pittas of Boston, Massachusetts’s Tufts Medical Center, is among the other members. ; Daniel Bikle from San Francisco, California’s University of California San Francisco. Deborah Mitchell of Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts; Dima Diab of the University of Cincinnati in Cincinnati, Ohio; Mairead Kiely of University College Cork in Cork, Ireland; Marise Lazaretti-Castro of the Universidade Federal de Sao Paulo in Sao Paulo, Brazil; Paul Lips of the Amsterdam University Medical Center in Amsterdam, Netherlands. M. Hassan Murad from Rochester, Minnesota’s Mayo Clinic. ; Shelley Powers from Raleigh, North Carolina’s American Bone Health. C. Henry Ford Health’s Sudhaker Rao, in Detroit, Mich. and Lansing, Michigan’s Michigan State University. John Tayek of the Harbor-University of California Los Angeles Medical Center in Torrance, California; Robert Scragg of The University of Auckland in Auckland, New Zealand. ; Amy Valent from Portland, Oregon’s Oregon Health & Science University. Judith Walsh from the University of California, San Francisco, San Francisco, Calif. ; and Christopher McCartney from Charlottesville, Virginia’s University of Virginia. , as well as Morgantown, West Virginia University. Virginia.

The guideline was created with a strict methodology that includes many updates that were started in 2019. There can be no relevant conflicts of interest for those in charge of our guideline development panels, and over half of the members of the writing group must not have any.

The goal of the Society’s Clinical Practice Guideline Program is to offer evidence-based guidelines for the diagnosis, treatment, and management of endocrine-related conditions to endocrinologists and other clinicians. A multidisciplinary panel of subject-matter experts in the field develops each guideline. In order to develop recommendations for guidelines, guidelines development panels consult evidence-based reviews of the literature. Corporate endorsement of the Endocrine Society’s guidelines is neither requested nor accepted. The funds of the Society support each and every Clinical Practice Guideline.

The Brazilian Society of Endocrinology and Metabolism, the Endocrine Society of India, the American Association of Clinical Endocrinologists, the European Society of Endocrinology, the Pediatric Endocrine Society, the American Society for Bone and Mineral Research, the Vitamin D Workshop, the American Society of Nutrition, and the Society of General Internal Medicine co-sponsored this clinical practice guideline.

scroll to top