Endocrine Society guideline: Most adults do not benefit from additional daily vitamin D
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Key takeaways:
- A new clinical practice guideline recommends adults aged 19 to 70 years receive 600 IU of daily vitamin D.
- The guideline states that the general population should not receive routine vitamin D testing.
BOSTON — Most adults should follow the National Academy of Medicine recommendations for daily vitamin D intake, though some populations could benefit from higher intake levels, according to a new clinical practice guideline.
In a paper published in The Journal of Clinical Endocrinology & Metabolism, a multidisciplinary panel of experts composed new guidance for how much vitamin D healthy people with no underlying conditions should receive daily. Authors for the guideline writing committee presented key recommendations at ENDO 2024.
“There is no single question or single answer about vitamin D,” Anastassios Pittas, MD, associate director of the endocrinology fellowship program and co-director of the diabetes clinic at Tufts Medical Center and co-chair of the Endocrine Society writing committee for the guideline, said during a press briefing. “There are many questions, and the panel could not possibly answer all possible questions. So we identified 14 questions that we thought were clinically relevant about the role of vitamin D that apply to specific groups of people and specific health outcomes.”
For most people, the guideline recommends following the National Academy of Medicine’s recommended daily empiric vitamin D allowance. The National Academy of Medicine states that adults aged 19 to 70 years should receive 600 IU daily vitamin D increasing to 800 IU for adults older than 70 years. That recommended level includes vitamin D intake from dietary and supplemental sources.
The guideline spotlighted four groups of people who may possibly benefit from more vitamin D than what the National Academy of Medicine recommends. Children and adolescents aged 18 years and younger may benefit from more vitamin D to reduce their risk for rickets and respiratory infections. Higher vitamin D intake may lower risks for maternal and fetal complications during pregnancy. Adults older than 75 years may reduce their mortality risk with additional vitamin D intake. Finally, adults at high risk for prediabetes may lower that risk with higher vitamin D intake.
The authors acknowledged the optimal dose of vitamin D for those four populations is not known. Pittas said the guideline provides a weighted average dose for each group based on data from previously published studies.
The guideline also addresses vitamin D supplementation. For adults aged 50 years and older who have indications for vitamin D supplementation or treatment, daily vitamin D doses are recommended instead of intermittent high doses of more than 50,000 IU.
The guideline recommends against routine testing of 25-hydroxyvitamin D levels for the general population. That recommendation includes people with obesity and those with skin of color.
“We did not find clear evidence in favor of testing,” Pittas said.
During the Q&A portion of the press briefing, Marie Demay, MD, professor of medicine at Harvard Medical School and Massachusetts General Hospital and chair of the guideline writing committee, said more research is needed to build stronger evidence regarding vitamin D intake and discussed some of the challenges with conducting that research.
“Ideally, we want to do clinical trials in people with different [vitamin D] levels and target different levels,” Demay told Healio. “The challenge would be not only doing that, but also considering the natural history of diseases. For example, respiratory infections would be trials that would take a year. Others would be trials that would take decades, especially if you are looking at interventions during childhood to prevent outcomes in adulthood.”
Reference:
Demay MB, et al. J Clin Endocrinol Metab. 2024;doi:10.1210/clinem/dgae290.
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Pittas A, et al. CPG02. Presented at: ENDO annual meeting; June 1-4, 2024; Boston.
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