The approaches are shifting about blood tests for vitamin D. This vitamin is important for many features that include calcium absorption, healthy bones, inflammation reduction, and immune function. Doctors debate how much D we need, and most guidelines say we don’t have enough evidence to support routine screening in healthy people. Yet many doctors regularly order the test, which measures a type of vitamin D called 25-hydroxyvitamin-D. Until recently, levels considered “sufficient” varied widely, ranging from 12.5 nanograms per milliliter (ng/mL) to 60 ng/mL. Several guidelines recommend levels above 20 or 30 ng/mL, which had been considered the “normal” range.
What’s new: The Endocrine Society, one of the main organizations that steers vitamin D practices, published new vitamin D guidelines in the August 2024 issue of The Journal of Clinical Endocrinology and Metabolism. In a major shift, the guidelines ditched the concepts of vitamin D “sufficiency’ and “deficiency” and strongly recommended against routine vitamin D testing. It might be more useful to compare blood test results with your previous numbers, rather than to standardized reference points. Exceptions include pregnant women, people with prediabetes, and people ages 75 or older. These groups may benefit from low dose vitamin D supplementation (about 1,000 IU per day), but most of us get enough of this vitamin from foods like fish, fortified dairy products, and fortified cereals. And the body can make vitamin D in the skin from just 10 to 15 minutes of sun exposure a few times per week. The recommendations are based on a lack of evidence for routine testing benefits. The Endocrine Society guidelines also say that most healthy adults don’t need vitamin D supplements.
What you should do: Talk to your doctor about the new guidelines. If you have a condition that causes vitamin D deficiency, fall into one of the above groups, or take a medication that can lower vitamin D levels, you might need periodic screenings. Otherwise, it’s unlikely that you need to be routinely tested or take a supplement. If you’re concerned that you’re not getting enough vitamin D, it’s safe to take a supplement with 1,000 to 2,000 IU daily, but large, randomized trials of vitamin D suggest that most people already get the vitamin D they need and supplements are of limited or no benefit.
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