Vitamin D supplementation: guidelines and evidence for subclinical deficiency.
Level 5 - mechanism / opinion, no new human data
Narrative review summarizing and comparing guideline recommendations without primary data or systematic review methodology.
PubMed 22274617 · doi:10.1097/MOG.0b013e32835004dc
What was done
This review summarized and compared vitamin D recommendations from the 2011 US Institute of Medicine (IOM) report and the US Endocrine Society clinical practice guideline, focusing on prevention and treatment of deficiency, including in patients with inflammatory bowel disease and prior gastric bypass.
What was found
The US Institute of Medicine established a Recommended Dietary Allowance of 400 IU/day for infants under 1 year, 600 IU/day for ages 1 to 70 years, and 800 IU/day for adults over 70 years, concluding serum 25(OH)D of 20 ng/ml or more covers 97.5% of the population. The Endocrine Society recommended 400–1000 IU/day for infants under 1 year, 600–1000 IU/day for ages 1 year and older, and 1500–2000 IU/day for adults aged 19 and older to keep 25(OH)D above 30 ng/ml. Patients with quiescent inflammatory bowel disease or prior gastric bypass malabsorb vitamin D and require higher doses.
Why it matters
The paper clarifies why major clinical and public health guidelines disagree on target serum vitamin D levels and recommended daily intakes, underscoring areas where high-quality outcome evidence is still lacking.
Limits
This is a narrative review of existing guidelines rather than a systematic review or primary clinical study. The abstract provides no primary data, sample size, or specific quantitative dosing regimens for the malabsorptive patient populations discussed.
Cited by
- supports The Endocrine Society defines 25-hydroxyvitamin D blood levels below 20 ng/mL as deficient and below 30 ng/mL as insufficient based on the threshold where parathyroid hormone begins to elevate.