New Endocrine Society guidelines were recently presented at the Endocrine Society annual meeting and published in the Journal of Clinical Endocrinology and Metabolism. The guidelines suggest limiting vitamin D supplementation to specific risk groups and advise against routine testing for 25-hydroxyvitamin D levels in healthy individuals.
According to the guidelines, certain groups may benefit from vitamin D supplementation. These include children aged 1-18 years to prevent rickets and lower the risk of respiratory tract infections, pregnant individuals to reduce the risk of complications, adults over 75 to lower mortality risk, and adults with prediabetes to lower the risk of type 2 diabetes. For these groups, daily vitamin D supplementation above the previously recommended amounts is advised.
However, the guidelines recommend against exceeding the recommended daily intake of vitamin D for most healthy adults under 75 years old. Additionally, routine testing for blood vitamin D levels in the general population, including those with obesity or darker skin tones, is not recommended.
Guideline author Dr. Anastassios G. Pittas emphasized that the guidelines are intended for healthy individuals without specific indications for vitamin D supplementation, such as those with osteoporosis. Dr. Marie B. Demay, the panel chair, highlighted the need for more clinical trial evidence to answer questions about optimal vitamin D levels.
While the guidelines were praised for their rigor, some experts expressed disappointment that they focused solely on healthy individuals. Dr. Simeon I. Taylor noted the lack of guidance for managing vitamin D status in patients with certain diseases and suggested considering alternative testing strategies for a more accurate assessment.
The guidelines also address the impact of skin pigmentation and race on vitamin D metabolism. The panel stressed the importance of distinguishing between skin pigmentation as a biological variable and race and ethnicity as socially constructed concepts to improve the validity of recommendations.
Overall, the guidelines recommend adherence to dietary recommended intakes for most populations, with certain groups benefiting from higher levels of intake. The recommendations aim to provide clarity on vitamin D supplementation for specific risk groups while discouraging unnecessary testing and supplementation in healthy individuals.