The Vitamin D Debate: Conundrums and Complexities
Vitamin D deficiency is regarded as extremely common in the American population.1 Many primary care clinicians routinely measure vitamin D concentrations, often recommending high doses of vitamin D supplementation.1 Vitamin D is currently being recommended for the prevention or treatment of a wide range of conditions, including cancer, cardiovascular disease (CVD), diabetes, autoimmune disorders, and cognitive decline.1
But is Vitamin D deficiency as ubiquitous as it appears? According to a recent editorial, “clinical enthusiasm for supplemental vitamin D has outpaced available evidence on its effectiveness.”1 The authors cite the conclusions of the US Preventive Task Force's (USPSTF) 2015 Task Force Recommendation Statement2 and the Institute of Medicine (IOM)'s 2011 Dietary Reference Intakes for Calcium and Vitamin D.3 Both sets of recommendations concluded that “data are insufficient to recommend vitamin D screening in routine clinical practice or to assess the effectiveness and overall balance of benefits and risks of supplemental vitamin D taken for the lowering of the risk of nonskeletal conditions.”1 Additionally, no national professional organization recommends population-wide screening for vitamin D deficiency, although individual researchers have disagreed with the conclusions of the USPSTF and the IOM recommendations.4
A summary of conclusions and recommendations of the USPSTF's statement can be found in Table 1.