Guidelines recommend that healthy people under 75 years of age take their daily allowance of vitamin D

Healthy adults under 75 years of age generally do not need to exceed the daily vitamin D intake recommended by the Institutes of Medicine (IOM) and do not need to have vitamin D levels tested, according to the new Endocrine Society Clinical Practice Guidelines.

For children, pregnant women, adults over 75 and people at high risk of prediabetes, the guidelines suggest vitamin D doses higher than the IOM recommends.

Vitamin D blood levels and intake are associated with many common diseases. However, the question of whether taking vitamin D reduces the risk of these diseases and what levels of vitamin D are needed for health has been debated for a long time.

In new guidance, a panel of experts made recommendations for using vitamin D and testing its levels in healthy people without obvious medical conditions. Recommendations are based on data from clinical studies.

The guideline, entitled "Vitamin D for Disease Prevention: A Clinical Guideline from the Endocrine Society," has been published online and will appear in the August issue of The Journal of Clinical Endocrinology & Metabolism (JCEM) for 2024.

"The purpose of this guideline is to determine vitamin D requirements for disease prevention in healthy individuals who do not have conditions that would affect the absorption or action of vitamin D," said Marie Demay, MD, of Harvard Medical School and Massachusetts General Medical Institute. Hospitals in Boston. Demay led the team that developed this guide.

"Healthy groups who may benefit from higher doses of vitamin D include people over 75 years of age, pregnant women, adults with prediabetes, and children and adolescents under 18 years of age. However, we do not recommend routine testing of vitamin D levels in any these groups."

Key management recommendations:

• We do not recommend taking vitamin D supplements in doses higher than those recommended by the IOM for healthy adults under 75 years of age.

The following groups have been identified that may benefit from increased doses of vitamin D above the IOM recommendation to reduce specific health risks:

• Children and adolescents under 18 years of age - potential to prevent vitamin D deficiency and reduce the risk of respiratory infections.
• Persons over 75 years of age - potential for reducing mortality risk.
• Pregnant women—potential to reduce risk of preeclampsia, fetal mortality, preterm birth, small-for-gestational-age babies, and neonatal mortality.
• People with prediabetes—potential to reduce progression to diabetes.
• For adults over 50 years of age who are eligible for vitamin D treatment, we recommend daily low-dose vitamin D instead of non-daily high-dose vitamin D.
• We do not recommend routine testing of 25-hydroxyvitamin D levels in any of the groups studied because specific benefits associated with these levels were not identified. This includes screening for 25-hydroxyvitamin D in people who are dark skinned or obese.

Despite increasing evidence on the role of vitamin D in health and disease over the past decade, the panel noted many limitations in the available data. For example, many large clinical trials were not designed to evaluate some of the outcomes reported and the populations studied had adequate blood levels of vitamin D at baseline.

Due to insufficient evidence, the team was unable to determine specific blood levels of 25-hydroxyvitamin D for adequacy or target levels for disease prevention.

The guide was developed using a rigorous methodology that includes improvements that began in 2019. The leaders of our guideline panels cannot have any significant conflicts of interest, and more than half of the members of the writing group must be free of any significant conflicts.