The Endocrine Society has published new Clinical Practice Guidelines for the evaluation, treatment and prevention of vitamin D deficiency.
Published in the Journal of Clinical Endocrinology and Metabolism, these guidelines for endocrinologists and other clinicians go a long way towards providing a sensible, evidence-based rebuttal of the Institute of Medicine’s (IOM’s) recently released recommendations, recommendations we have described on this site as ‘alarmist and unhelpful’.
Led by internationally renowned expert in vitamin D, Dr Michael Holick, the Taskforce concluded that substantially higher levels of supplementation than recommended by the IOM were appropriate.
It is important to note that this group was not examining the requirements for people with various diseases using vitamin D as a potentially helpful supplement, but rather the levels of vitamin D that could be regarded as normal and deficient, and the sort of level of supplementation needed to avoid deficiency.
Their recommendations, as might be expected, are very conservative, and will not go any further than robust available evidence allows, although they note the paucity of research on higher doses of vitamin D supplementation.
Given the concerns raised by many of the people on this website about their doctors’ responses to the level of vitamin D supplementation they are using, it is important to note their recommendations in Table 3.
Here they compare their recommendations based on the best available evidence with those of the IOM. It is important to note that they recommend an upper limit of vitamin D supplementation for adult males and females of 10,000 IU a day, as recommended on this site (compared with the IOM’s 4,000 IU), and for pregnant and breastfeeding women also 10,000 IU a day (compared with the IOM’s 4,000IU).
There has been a lot of discussion in the Forum on this site about the potential toxicity of vitamin D in pregnancy in particular, but this paper should reassure women with MS who plan pregnancy that continuing with their vitamin D supplements up to 10,000 IU a day is perfect.