The National Osteoporosis Society of the UK has released new clinical guidelines to treat vitamin D deficiency in patients.
The Society developed the clinical guidelines on the management of vitamin D deficiency due to a lack of national UK guidelines on the indications for 25(OH)D measurements and conflicting guidelines from various organizations. In consequence, there has been much confusion among health-care professionals and patients.
The guidelines were developed by a group of clinicians and scientists with expertise in vitamin D and osteoporosis. Their recommendations were largely based on the Institute of Medicine’s review from 2011.
“Pressure was mounting from clinicians to have guidance that covers the investigation, diagnosis and treatment of vitamin D deficiency. This, coupled with growing public awareness and interest in vitamin D, encouraged us to provide guidance for healthcare professionals across the UK,” explains Professor Roger Francis, Chair of the guideline’s authoring group and Honorary Medical Director of the National Osteoporosis Society.
What did they recommend? They recommended most patients testing under 50 nmol/l (20 ng/ml) be treated for vitamin D deficiency.
How to treat? They did not specify how much to take but offered some examples in their guidelines. For severe deficiency or “urgent” situations, they recommended treating with loading doses. For less urgent deficiencies, they recommend daily dosing.
For example, the guidelines suggest loading doses of either 50,000 IU/weekly or 20,000 IU/twice weekly for urgent deficiencies. For less urgent deficiencies, they recommended doses ranging from 800 IU to 2,000 IU/day, or even in some cases, as high as 4,000 IU/day. For all options, they recommended the use of vitamin D3.
The guidelines have been endorsed or adopted by the British Geriatrics Society, British Orthopaedic Association, Primary Care Rheumatology Society, Royal College of Nursing, and the British Dietetic Association. You can download their guidelines here: http://www.nos.org.uk/document.doc?id=1352
National Osteoporosis Society. Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management. http://www.nos.org.uk, 2013.
White C. First UK clinical guideline for treating vitamin D deficiency published. On Medica, 2013.