Vitamin D Deficiency - Diagnosis and Treatment in Denmark

Vitamin D deficiency and insufficiency is common in Denmark for three reasons: a) Denmark is located at high Northern latitude with sparse sunshine during winter and moderate during summer, b) dietary vitamin D intake is low, and c) there is no fortification programme. During puberty 28-38% of girls have plasma 25hydroxyvitamin D (250HD) levels < 50 nmol/l during autumn and 93% during winter. Similarly, 28 and 57% of boys have reduced values in autumn and winter, respectively. In adult women 70% have reduced levels in winter and 63% in summer. In a population of adult males and female the corresponding figures were 76% to 53%. Among elderly home living people 82% to 78% have reduced levels in winter and summer, respectively. Immigrants and Inuit's in Greenland have special problems. Around 50% of elderly Danes use multivitamins containing 2,5-5 mu g D(3). Over the counter drugs used mainly for supplementary osteoporosis treatment include tablets combining 250-500 mg calcium (as carbonate) with 5-19 mu g of vitamin D(3). Vitamin D(3) tablets or pearls containing 20, 25 and 35 mu g of vitamin D(3) are also available.. Treatment schedules vary between departments and doctors with a trend towards higher closes. Problems related to doses and treatment goals are discussed.