Should vitamin D levels be measured and supplements taken?

Many tests that are not included in medical recommendations are often performed on “healthy” people who do not have symptoms that indicate the possibility of a problem. When other doctors notice any unusual changes in him, they deal with them in a therapeutic way.

Vitamin D screening and testing

The issue of Vitamin D is one of the clearest examples of questions and differences within the medical community regarding the need to perform a blood test (25-Hydroxyvitamin D Levels), and regarding intake Vitamin D levels are higher. which is needed every day, for all healthy people. This question has been raised in medicine for many years, but many people, and many doctors, are still asking for this test regularly and are worried about its results.

To clarify just one point about “clinical efficiency versus financial cost,” 2014 statistics in the United States reported that testing vitamin D levels was the fifth most common laboratory test prescribed for Medicare patients, with a total revenue of 323 million dollars. Currently, Medical Economics reports that the size of the global market for Vitamin D testing is estimated to be 918 million dollars in 2023. On the other hand, the size of the global Vitamin D drug market is estimated to be USD 2840.96 million by 2022. E. is expected to grow at a CAGR of 10.42 percent.

Useless pills and supplements

A few years ago, Dr. Michael Lefevre, of the Department of Family Medicine at the University of Missouri, published in the February 15, 2018 issue of the journal Am Fam Physician his study entitled “Evaluating Vitamin D and Taking Its Supplements (Therapeutic ) for Adults.” : Frequently Asked Questions. In its introduction, he made the following statements: “Measuring vitamin D levels and taking oral supplements are now common medical practices, although clinical trials and studies have not proven any health benefits. The usefulness of measuring vitamin D levels in the blood is hampered by differences in measurement method and accuracy. Regular vitamin D supplementation does not prolong life, reduce the risk of cancer or heart disease, and does not reduce fracture rates. Screening asymptomatic individuals for vitamin D deficiency, and treating those with deficiency, does not reduce the risk of cancer, type 2 diabetes, death in adults, or fractures in non-risk populations. of breaking.

“Randomized, controlled clinical studies of vitamin D supplements for the treatment of depression, fatigue, osteoporosis, and chronic pain show no benefit, even among people with conditions low to begin with.”

These very accurate statements are based on clinical experiences that support the establishment of this view among the medical community.

Guidelines and procedures

On July 24, Dr. Kenneth W. Lane contributed his medical article to the medical website Medscape entitled “How the new vitamin D guidelines will change my practice, or they won’t change?” Dr. Lin is a Family Medicine Consultant and Assistant Director of the Family Medicine Training Program at Penn Medicine. He said: “I wrote an editorial questioning the large increase in vitamin D testing because of uncertainty about what is the ideal level for good clinical trials, showing that there is supplements (deficiency) in people with low levels (of vitamin D in the blood), benefits for various medical conditions.

“Our recent review of results from prospective clinical studies of vitamin D supplementation concluded that most associations between vitamin D levels and clinical outcomes (in patients) are unlikely to be cause.” That is, the relationship is not of the “cause and effect” type.

What is new in this matter is what was accepted by the latest medical guidelines issued by the American Society of Endocrinology in its recommendation against the usual method of testing the level of vitamin D in the blood in healthy people. Although it was long overdue, it arrived at a time when we needed it most. As last updated in 2011.

These clinical guidelines, titled, “Sources of guidance on the use of vitamin D for disease prevention,” were published in the August issue of the “Journal of Clinical Endocrinology & Metabolism.” As its preparatory committee (consisting of 15 doctors) said: “The 2024 guidelines on vitamin D for disease prevention are an update and replacement of the 2011 guidelines for the diagnosis, treatment and prevention of vitamin D deficiency. vitamin D, and focuses on the use of vitamin D. vitamin D.” To reduce the risk of disease in people without symptoms is necessary for treatment with vitamin D. In addition to the American Society of Endocrinology, these new guidelines are supported by the American Clinical Association Endocrinology, European Society of Endocrinology, Pediatric Endocrine Society, American Society for Bone and Mineral Research, and American Society for Nutrition.

“The goal of this guideline was to address the needs of vitamin D for disease prevention in people who are healthy in general without low levels,” said Dr. Mary DeMay, steering committee chair and consultant at Harvard Medical School and Massachusetts General Hospital in Boston. This can put them at risk of not absorbing or processing vitamin D properly.”

Important guidelines

“Healthy people who may benefit from high-dose vitamin D supplements include those 75 or older, pregnant women, adults with diabetes, and children and adolescents under 18 or more,” Demay added. But we do not recommend routine testing of vitamin D levels in any of these groups.”

Under the heading “Important Points,” the new guidelines stated the following:

Many studies show a link between blood levels of vitamin D and a variety of common problems, including musculoskeletal disorders, metabolic disorders, diseases of the heart, malignant tumors, autoimmune diseases and infectious diseases. This has led to the spread of vitamin D supplements and increased laboratory testing for vitamin D in the general population.

The “benefit to risk” ratio for this increase in most people receiving vitamin D supplements is unclear. The optimal amount of vitamin D intake and levels of the vitamin to prevent disease are still unknown.

This guideline provides clinical guidance for the use of vitamin D to reduce the risk of disease in people without symptoms for vitamin D therapy or vitamin D testing.

5 aspects of what the new vitamin D guidelines accept

According to the American College of Endocrinology’s reading of the 2024 guidelines on vitamin D, it reported on its official website the following major facts:

*We recommend not taking vitamin D supplements in doses higher than those recommended by the Institute of Medicine for healthy adults under the age of 75.

* Healthy adults under the age of 75 do not need to have their vitamin D levels checked.

*We have identified the following people who may benefit from vitamin D supplements above the IOM recommended levels because of the potential to reduce certain health risks:

– Children and young people aged 18 or over – The possibility of preventing nutritional rickets and reducing the possibility of respiratory infections.

– People aged 75 or older – Chance to reduce the risk of death.

– Pregnant women – Potential to reduce the risk of pre-eclampsia, intrauterine disease, premature birth, low birth weight for pregnancy, and fetal death.

– Adults with a high risk of prediabetes – The possibility of reducing the progression of the condition to diabetes.

However, we do not recommend routine testing of vitamin D levels in any of these groups.

*For adults age 50 or older who are symptomatic for vitamin D supplementation or treatment, we suggest taking a low daily dose of vitamin D instead of higher rate than every day.

*We suggest not routinely testing vitamin D levels in any study population, as the benefits of results based on these levels have not been determined.

The latest medical advice is not to do a routine test to measure the level of vitamin D in the blood of healthy people.