Dr. Kenny Lin, a family physician, discusses the conflicting clinical guidelines regarding vitamin D supplementation in adults. While some organizations recommend routine supplementation for certain groups, the US Preventive Services Task Force (USPSTF) concludes that there is no net benefit for community-dwelling adults aged 60 or older. Dr. Lin weighs the evidence and ultimately advises patients to save their money on vitamin D supplements.
Associate Director, Family Medicine Residency Program, Lancaster General Hospital, Lancaster, PennsylvaniaHi, everyone. I’m Dr. Kenny Lin. I am a family physician and associate director of the Lancaster General Hospital Family Medicine Residency, and I blog atI recently went to my local pharmacy to pick up a prescription and happened to find myself in the vitamin aisle.
Standing in front of the sizable section devoted tosupplements, I faced a bewildering array of tablets, capsules, softgels, and gummies in daily doses ranging from 400 to 10,000 international units. The store was obviously doing a brisk business. Who was buying and consuming all of this vitamin D, I wondered, given the limited proof of its health benefits? There have historically been two clinical approaches to vitamin D supplementation in adults: Check blood levels of vitamin D and supplement those who are “deficient” ; or Give a standard dose of vitamin D to everyone of a certain age or in a defined population. chose the latter strategy in recommending routine supplementation for children, adults older than 75 years, pregnant patients, and adults with prediabetes, but recommends discouraging community-dwelling adults age 60 years or older from taking vitamin D supplementsthat, in contrast to the findings of the Endocrine Society, determined that regardless of dose or study duration, the benefits and harms of vitamin D supplements in this population are either nonexistent or trivial, resulting in no net benefit. Systematic reviews can be complex to dissect , but after reviewing the evidence closely, I think the Endocrine Society and USPSTF guidelines conflict, because they had slightly different study selection criteria and sliced the data in different ways. The USPSTF, for example, excluded studies of adults living in nursing homes because the focus of its guideline is primary care physicians working in offices and the patients they are most likely to see there. That decision may have obscured benefits of vitamin D in persons with dementia or cognitive impairment, frailty, and/or a history of osteoporotic fractures. So, what will I say to my next patient without obvious symptoms of a vitamin D-mediated disease who asks if it’s a good idea to take a supplement? Three words: “Save your money.” In general, I trust guidelines written by and for primary care clinicians more than those authored by subspecialists. I also do my best to adhere to the maxim to “do no harm,” even if the harm is a small portion of an older person’s monthly budget that could otherwise be allocated to life’s essentials or an activity that is more likely to improve health. Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.All material on this website is protected by copyright, Copyright © 1994-2025 by WebMD LLC. This website also contains material copyrighted by 3rd parties.
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