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First clinical guideline on management of vitamin D deficiency

Published on 23 April 2013
First clinical guideline on management of vitamin D deficiency

The UK's first clinical guideline on the identification and treatment of vitamin D deficiency has been published.

Developed by a group of clinicians and scientists, the National Osteoporosis Society's guideline is designed to address widespread uncertainty about the best ways to detect and treat vitamin D deficiency, a problem that is common in the UK.

'Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management' addresses three key areas: who to test for deficiency; how to interpret vitamin D measurements; and how to treat deficiency.

It recommends that the best way to assess a patient's vitamin D status is to measure their levels of serum 25 hydroxyvitamin D (25OHD).

A patient should be deemed deficient if their serum 25OHD is less than 30 nanomoles per litre, while serum 25OHD of 30-50 nanomoles per litre may be inadequate for some people and higher than 50 nanomoles per litre should be sufficient for almost everyone.

The treatment of choice for vitamin D deficiency is oral vitamin D3, with patients in need of rapid treatment receiving fixed loading doses, followed by regular maintenance therapy.

The new vitamin D guideline also recommends only testing those patients with symptoms of vitamin D deficiency or where low levels of the vitamin could affect treatment for the bone-thinning disease osteoporosis.

It is hoped that the guidance should provide clarity for doctors and help to improve bone health in patients with vitamin D deficiency.

Professor Roger Francis, chairman of the guideline's authoring group and honorary medical director of the National Osteoporosis Society, revealed: "Pressure was mounting from clinicians to have guidance that covers the investigation, diagnosis and treatment of vitamin D deficiency.

"This, coupled with growing public awareness and interest in vitamin D, encouraged us to provide guidance for healthcare professionals across the UK."

Dr Alan Nye, president of the Primary Care Rheumatology Society, welcomed the guidelines, saying that they provided "excellent advice on the importance of vitamin D in maintaining good bone health for all members of society".

Arthritis Research UK, the biggest funder of research into osteoporosis in the UK, has officially endorsed the new guidelines.

The charity is currently funding research aiming to reduce vitamin D deficiency in people over 70 during the winter months, caused by lack of sunlight.

Download the new osteoporosis guidelines HERE.

Medical director of Arthritis Research UK, Professor Alan Silman, said: “The importance of vitamin D for bone health cannot be under-estimated. However, we need to understand much more about how people can achieve the appropriate level of vitamin D, and this research will provide some very practical help for this important public health topic.”

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