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.