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Experts Unable to Recommend Screening Most Adults for Vitamin D Deficiency

vitamin D on pink backdrop.

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Key Takeaways

  • Experts don’t recommend screening the general population for vitamin D deficiency.
  • More research is needed to determine what tools are the best way to measure vitamin D levels.
  • Optimal levels of vitamin D may vary from person to person depending on many factors including; medical condition, race, ethnicity, sex, and geography.

The benefits of screening for vitamin D deficiency in asymptomatic adults are still unclear according to a recent recommendation statement issued by the U.S. Preventive Services Task Force (USPSTF), which remains unchanged since its last update in 2014.

The statement, which highlights a systematic review on screening for vitamin D deficiency, concludes that there is still insufficient evidence to prove that routine vitamin D screening benefits community-dwelling, non-pregnant, asymptomatic adults and therefore does not recommend it.  

“This is a call for further research to determine a screening recommendation,” John B. Wong, MD, USPSTF member and chief scientific officer of the department of medicine at Tufts Medical Center, tells Verywell. “We could not find studies that looked at vitamin D screenings that included a follow-up to see if any important patient health outcomes had improved.”

Currently, there is no standard guideline for general vitamin D screening of patients not at risk for a deficiency. The statement reported that the American Academy of Family Physicians agrees there is insufficient evidence to recommend screening the general population, while the American Association of Clinical Endocrinologists recommends only screening people at high risk of vitamin D deficiency. 

Vitamin D Research Gaps

Data on laboratory test trends show that testing for vitamin D levels substantially increased over the years despite the lack of research and evidence surrounding its positive health outcomes.

USPSTF reports that vitamin D research gaps leave questions to be answered like:

  • Is the total serum 25 (OH)D blood test the best measure of vitamin D?
  • Does the best measure of vitamin D vary by specific populations; race, ethnicity, or sex?
  • What is the cutoff serum level that defines a vitamin D deficiency? Is this different for different groups?
  • Studies to evaluate the benefits and harms of screening the general public

Because sufficient vitamin D levels can vary from person to person, routine screening can potentially over-diagnose people who don’t need treatment, or underdiagnose and miss the opportunity to correct a vitamin D deficiency in someone that needs it. 

What Is Vitamin D?

Vitamin D is a fat-soluble vitamin that promotes calcium absorption and helps keep bones strong. It also helps the body maintain healthy levels of phosphate. Vitamin D deficiency can lead to brittle bones, rickets, and osteoporosis. While bone health is the primary benefit of vitamin D, it also produces a slew of other health benefits like reduces inflammation, boosts the immune system, and promotes heart health. Research has also found that low levels of vitamin D are associated with depression and multiple sclerosis.

Who Is At Risk for Deficiency?

While the Endocrine Society does not recommend screening asymptomatic low-risk individuals, they do recommend routinely testing people who are at high risk for vitamin D deficiency. 

People at high risk for vitamin D deficiency include:

  • Breastfed infants
  • Older adults
  • People with dark skin
  • People with limited sun exposure
  • People with conditions that limit fat absorption 
  • Obesity and those that have undergone gastric bypass surgery
  • Certain medications

On average, 97.5% of the population will be vitamin D sufficient at the recommended 20 ng/ml, however, reaching that threshold can be a challenge since very few foods contain vitamin D and sun exposure is dependent on weather, location, and time of day. 

“Many people can’t get adequate vitamin D levels naturally,” Michael Holick, MD, director of the Vitamin D Skin and Bone Research Laboratory at the Boston University School of Medicine, tells Verywell. “Because of this, I would recommend people use supplements to help meet their vitamin D needs.”

What This Means For You

Regularly consuming foods that are high in vitamin D as well as getting healthy levels of sun exposure can help you maintain healthy bones and muscles. Reach out to your doctor if you believe you may be deficient in vitamin D. Dietary supplements can also help you maintain healthy levels.

How to Boost Your Vitamin D Levels

You can boost your vitamin D levels naturally through sun exposure as well as in foods. Some foods that contain a good source of vitamin D include:

  • Salmon
  • 2% Milk
  • Soy, almond, and oat milk
  • Eggs
  • Cod liver oil
  • Bananas
  • Apples
  • Orange juice
  • Dairy products made from milk
  • Beef, pork, chicken

Talk with your doctor if you are at high risk for vitamin D deficiency, or have a medical condition that interferes with your absorption of vitamin D.  They can help you find the correct supplement dosage that will keep you at optimal health.

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Article Sources
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  1. Screening for vitamin D deficiency in Adults: US Preventive Services Task Force Recommendation Statement. Journal of the American Medical Association. doi:10.1001/jama.2021.3069

  2. Shahangian S, Alspach T, Astles J, Yesupriya A, Dettwyler W. Trends in laboratory test volumes for Medicare Part B reimbursements, 2000-2010. Archives of Pathology and Laboratory Medicine. doi:10.5858/arpa.2013-0149-OA

  3. National Institutes of Health. Vitamin D fact sheet for health professionals. Updated March 26, 2021.

  4. Holick M, Binkley N, Bischoff-Ferrari, Gordon C, Hanley D, Heaney R. Evaluation, Treatment, and Prevention of Deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. doi.org/10.1210/jc.2011-0385

  5. National Institutes of Health. Vitamin D fact sheet for health professionals. Updated March 26, 2021.

  6. Screening for vitamin D deficiency in Adults: US Preventive Services Task Force Recommendation Statement. Journal of the American Medical Association. doi:10.1001/jama.2021.3069