Vitamin D Council

By Daniel J. DeNoon
WebMD Health News

June 6, 2011 -- Noting that vitamin D deficiency is "very common in all age groups," new treatment guidelines call for many Americans to take more vitamin D than is currently recommended.

The guidelines, from the Endocrine Society, offer some contradictory advice. They say that virtually everyone in the U.S. should be taking vitamin D supplements, but that only those at risk for vitamin D deficiency should have their vitamin D blood levels checked.

Only those whose serum 25(OH)D blood levels are above 30 ng/mL are getting enough vitamin D. Lower levels are "insufficient," and those with levels below 20 ng/mL are frankly deficient.

But much higher levels are better, says guideline committee chairman Michael F. Holick, MD, PhD, director of the vitamin D skin and bone research lab at Boston University.

"The committee decided that 30 ng/mL is the minimum level, and recommended 40 to 60 ng/mL for both children and adults," Holick said at an online news conference.

So who's at risk of vitamin D deficiency? Quite a few of us:

• Children of all ages
• Pregnant and nursing women
• Obese people
• Darker-skinned Americans, particularly those of African or Hispanic descent
• Anyone with a malabsorption syndrome, such as cystic fibrosis, Crohn's disease, or inflammatory bowel disease
• Anyone who has had bariatric surgery
• Anyone with osteoporosis, osteomalacia, or an elderly person who's had a fall or fracture
• People with chronic kidney disease
• People with liver failure
• People taking antiseizure medications, glucocorticoids, AIDS drugs, or antifungal drugs
• People with granuloma-forming disorders such as tuberculosis and sarcoidosis

And even more of us are at risk of vitamin D insufficiency, as studies find that it's relatively common for people to have vitamin D levels below 30 ng/mL.

Few foods carry much vitamin D other than salmon and mackerel. Milk and some orange juice is fortified with small doses...

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