Vitamin D in adults: update on testing and supplementation

Area of Science:

• Endocrinology
• Nutritional Science
• Geriatrics

Background:

• Hypovitaminosis D is common in adults, leading to skeletal and non-skeletal health issues.
• Current guidelines require an update on vitamin D testing and supplementation strategies.

Purpose of the Study:

• To provide an updated overview of vitamin D testing and supplementation indications in adults.
• To define target serum 25-hydroxyvitamin D (25(OH)D) concentrations and supplementation protocols.

Main Methods:

• Review of current literature and clinical guidelines on vitamin D deficiency.
• Analysis of different adult populations (healthy, sick/frail, elderly) and their specific needs.
• Proposal of updated recommendations for vitamin D testing and supplementation.

Main Results:

• Healthy middle-aged adults require no routine vitamin D testing or supplementation; target 25(OH)D is 50 nmol/L.
• Sick, frail, or dependent middle-aged adults may need supplementation targeting 75 nmol/L 25(OH)D.
• Adults over 65 should receive systematic supplementation targeting 75 nmol/L 25(OH)D.

Conclusions:

• Vitamin D testing and supplementation strategies should be tailored to specific adult populations.
• Systematic supplementation is recommended for older adults, with maintenance phases crucial for sustained efficacy.
• Monitoring 25(OH)D levels after 9 months can help adjust long-term supplementation as needed.