Reviews and Perspectives with Hobart Lee: All Things Vitamin D

Reviews and Perspectives with Hobart Lee: All Things Vitamin D

Hobart Lee, MD, and Heidi James, MD

Hoby and Heidi discuss all things vitamin D. From the complete lack of studies on screening to the wide and varied dosing recommendations and its insipid impact on fall prevention, our fearless family docs let us know what the evidence shows. 

• Routine screening for vitamin D deficiency is common practice despite a lack of studies looking at the benefits and harms of screening.
• The US Preventive Services Task Force (USPSTF) recommends against screening for vitamin D deficiency (hypovitaminosis D).
• There is no consensus on what constitutes a “deficiency.”
• Studies show that correcting hypovitaminosis D does not improve
  • Overall mortality
  • Fracture
  • Diabetes
  • Cardiovascular disease
  • Cancer
  • Depression
• Vitamin D supplementation did result in a very slight improvement in fall risk in community-dwelling older adults.
• Studies used multiple different supplementation doses; there is no gold standard.
• It's hard to justify screening patients for vitamin D deficiency given the limited data to show improvement on any measure. 

PEARL: Don’t screen for vitamin D deficiency and take care to ensure that data support the endpoint you’re hoping to achieve with supplementation. 

REFERENCES:

Screening for vitamin D deficiency in adults: updated evidence report and systematic review for the US Preventive Services Task Force
Kahwati LC, LeBlanc E, Weber RP, et al. JAMA. 2021;325(14):1443-1463. doi: 10.1001/jama.2020.26498. https://jamanetwork.com/journals/jama/fullarticle/2778488

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ROP 2019 December: Reviews & Perspectives with Dr. Hobart Lee: Vitamin D