Vitamin D: Recent Recommendations and Discoveries

The evidence continues to mount for the important role of vitamin D as a hormone that provides protective benefits to the immune system. Guidelines have been developed recommending routine vitamin D supplementation in order to optimize bone health, including aiming for a goal 25(OH)D concentration greater than 30 ng/mL among select patient groups who are at risk for skeletal deficits or vitamin D deficiency itself. Whether this level is the optimal one that confers the extraskeletal benefits of vitamin D remains unknown. Whether healthy children and adolescents may benefit from maintenance of 25(OH)D levels at higher thresholds also is unknown and under study. Adolescence is a critical time for the accrual of peak bone mass, and optimizing vitamin D during this important developmental period and throughout the life cycle may be beneficial for and beyond the skeleton. Although routine screening of 25(OH)D levels is not currently recommended, those individuals at higher risk for insufficiency/deficiency should be screened and appropriately supplemented.