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Rethinking Vitamin D Deficiency: Controversies and Practical Guidance for Clinical Management.

Manuel Sosa-Henríquez1,2, Óscar Torregrosa-Suau1,3, María Jesús Gómez de Tejada-Romero1,4

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Vitamin D deficiency (VDD) management is inconsistent. This review clarifies screening, supplementation, and monitoring for optimal bone health and discusses cholecalciferol

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Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Nutritional Science

Background:

  • Vitamin D (VD) is vital for calcium homeostasis and bone health.
  • Vitamin D deficiency (VDD) is prevalent, especially in vulnerable groups.
  • Current VDD diagnosis and management lack consistent guidelines.

Purpose of the Study:

  • To review controversies in Vitamin D deficiency management.
  • To provide evidence-based recommendations for clinical decision-making.
  • To highlight areas needing further research in VDD.

Main Methods:

  • Narrative review of current literature and expert consensus.
  • Exploration of screening strategies and target populations for VDD.
  • Analysis of supplementation indications, monitoring, and therapeutic goals.

Main Results:

  • Discusses the rationale for a 30 ng/mL (75 nmol/L) threshold for adequate serum 25(OH) levels.
  • Examines the role of VD and calcium in osteoporosis treatment.
  • Highlights pharmacological advantages of cholecalciferol.

Conclusions:

  • Standardizing VDD screening and management is crucial.
  • A 30 ng/mL threshold supports skeletal health.
  • Further research is needed to refine VDD treatment protocols.