90-95% yield in Vit D assay; Another field where primary care practitioner has to look for vague symptoms eg minor aches and pains all over; some bone pains, discomfort in virtually any posture and ask for an assay.

Deficiency will be on the rise largely due to lesser consumption of milk/ milk products, less exposure to direct sun light and avoiding egg yolk, by all and sundry, on fear of cholesterol (consuming all other junk foods).

Team@CMHF

Healthy individuals do not need to be screened for vitamin D deficiency, according to guidelines released today by the Endocrine Society.

“We do not recommend screening for vitamin D deficiency in individuals not at risk. That’s an important message. So we’re recommending screening for those at risk for vitamin D deficiency – those who are obese, African Americans, pregnant and lactating women, patients with malabsorption syndromes, and a whole list that we have provided in the guidelines,” lead author Dr. Michael F. Holick said at the annual meeting of the Endocrine Society.

The task force recommended that those at risk for vitamin D deficiency be screened by measuring serum 25-hydroxyvitamin D levels using a reliable assay.

Causes of vitamin D deficiency include

• obesity,
• fat malabsorption syndromes,
• bariatric surgery,
• nephrotic syndrome,
• wide range of medications (anticonvulsants and anti–HIV/AIDS drugs),
• chronic granuloma-forming disorders,
• some lymphomas, and
• primary hyperthyroidism.

“All available evidence suggests that children and adults should maintain a blood level of 25(OH)D above 20 ng/mL to prevent rickets and osteomalacia, respectively. However, to maximize vitamin D’s effect on calcium, bone, and muscle metabolism, the 25(OH)D blood level should be above 30 ng/mL,” the group wrote.

In the new guidelines, vitamin D deficiency is defined as a 25(OH)D concentration less than 20 ng/mL (50 nmol/L).

Daily requirements: The task force suggests:
– Infants and children aged 0-1 year require at least 400 IU/day (IU = 25 ng) of vitamin D to maximize bone health.
– Children 1 year and older require at least 600 IU/day.
– Adults aged 19-50 years require at least 600 IU/day.
– Adults aged 50-70 years require at least 600 IU/day.
– Adults 70 years and older require 800 IU/day.
– Pregnant and lactating women require at least 600 IU/day.

Read more: http://www.internalmedicinenews.com/news/diabetes-endocrinology-metabolism/single-article/healthy-people-don-t-need-vitamin-d-screen-guidelines-say/7936cf6264.html