Therapy with Vitamin D

Vitamin D insufficiency or deficiency is a worldwide health problem, especially in western countries. Vitamin D is obtained from UV irradiation and limited dietary sources. Dietary intake of vitamin D is usually too low to maintain a sufficient vitamin D status and solar irradiation varies with latitude and time of year. The 25-hydroxyvitamin D level is the best indicator of vitamin D status. Levels of > 30 ng/ml 25(OH) D are optimal for skeletal health and should be measured in risk groups including older patients with chronic disease, immigrants, and persons with specific diseases causing decreased absorption or increased loss of vitamin D. Vitamin D supplementation needed to achieve a determined 25(OH) concentration depends on baseline levels, sun exposure, and dietary habits. Although an 800-IU daily dose of vitamin D may be sufficient to prevent falls and fractures, higher doses may be required to achieve an optimal outcome. Doses up to 4000 IU/d are safe. It is useful, easy, inexpensive, and safe to prevent or treat chronic vitamin D deficiency.