In June 2024, the Endocrine Society released updated clinical practice guidelines regarding Vitamin D testing and supplementation aimed at disease prevention, drawing from a wealth of recent research. The new guidelines recommend restricting Vitamin D supplementation above the daily recommended levels to certain high-risk groups and advise against the routine testing of 25-hydroxyvitamin D [25(OH)D] in healthy people.
In June 2024, the Endocrine Society released updated clinical practice guidelines regarding Vitamin D testing and supplementation aimed at disease prevention, drawing from a wealth of recent research. The new guidelines recommend restricting Vitamin D supplementation above the daily recommended levels to certain high-risk groups and advise against the routine testing of 25-hydroxyvitamin D [25(OH)D] in healthy people.
In a recent review published in the journal Endocrine Practice, Michael Holick, PhD, MD, a professor at Boston University Chobanian & Avedisian School of Medicine, compares the Endocrine Society’s 2024 Clinical Guidelines on Vitamin D with the ones he contributed to in 2011.
“The 2011 guidelines provided instructions for healthcare providers on evaluating and treating vitamin D deficiency to prevent it from returning, while the 2024 guidelines focus on the healthy population for the benefits of Vitamin D for bone and overall health. This change may confuse doctors and healthcare workers regarding how to assess if at-risk patients are indeed deficient in Vitamin D, especially since the new guidelines do not recommend screening for vitamin D status in children and adults,” Holick explains.
Key distinctions include:
- The 2011 Guidelines offered specific advice on when to assess a patient’s vitamin D levels, a feature absent in the 2024 Guidelines.
- The 2011 Guidelines outlined the necessary vitamin D intake to treat and prevent deficiencies across all ages. The 2024 Guidelines suggest vitamin D supplementation levels as outlined by the Institute of Medicine in 2010, applicable only to individuals aged one year and older, omitting details for infants.
- Although the 2024 Guidelines recognize that a daily intake of 2500 IUs of vitamin D could help reduce risks linked to adverse pregnancy outcomes such as preeclampsia, premature births, low birth weight, neonatal death, and cesarean deliveries, they do not recommend monitoring vitamin D levels in pregnant women. Furthermore, they do not suggest increasing the daily intake above the established reference of 600 IUs for all adults.
Holick criticizes the 2024 Guidelines for neglecting observational studies and relying heavily on randomized controlled trials, many of which lacked placebo control. “Consequently, these guidelines fail to address the numerous health benefits associated with vitamin D, such as reducing cancer mortality by over 25%; the risk of metastatic and fatal cancers by 38%; autoimmune diseases by 39%, including an 88% reduction in type 1 diabetes; the progression from prediabetes to type 2 diabetes by 76%; peripheral vascular diseases by 88%; and a 58% decline in respiratory illnesses. For COVID-19 outcomes, hospitalizations and mortality rates saw reductions of 74%, 22%, and 45%, respectively, while the rate at which COVID-positive patients recovered improved by 66%; preterm birth risk dropped by 62%, and both preeclampsia and cesarean sections were reduced by over 50%,” he states.
