Epoch HealthVitamin D Dilemma: New Guidelines Flip the Script on Sunshine Supplements

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The Endocrine Society’s 2024 guidelines on vitamin D supplementation and testing mark a significant shift from previous recommendations. These new guidelines, based on an analysis of randomized controlled trials, suggest a more targeted approach to vitamin D supplementation and advise against routine screening for most adults.

Key Points:

• The guidelines recommend against routine vitamin D screening and supplementation for non-pregnant adults aged 19-74, contrary to the 2011 guidelines.
• For children, adolescents, adults 75 and older, and pregnant women, vitamin D supplementation is suggested through fortified foods, vitamin formulations, or supplements.
• The Endocrine Society no longer endorses specific 25(OH)D levels to define vitamin D sufficiency, insufficiency, and deficiency.
• For adults with high-risk prediabetes, vitamin D supplementation is recommended alongside lifestyle modifications to reduce the risk of diabetes progression.
• The guidelines emphasize targeted supplementation strategies over universal supplementation, recognizing potential benefits in specific populations and those with low baseline levels.
• Optimal daily vitamin D doses are not specified due to wide variations in clinical trials.
• Some health care providers disagree with the new guidelines, citing clinical evidence of vitamin D’s benefits in various conditions.

In a study from 2019, neither intermittent nor daily dosing with standard doses of vitamin D alone was associated with reduced risk of fracture, but daily treatment with both vitamin D and calcium was a more promising strategy.

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