Vitamin D Insufficiency and Epistemic Humility: An Endocrine Society Guideline Communication.
J Clin Endocrinol Metab
; 109(8): 1948-1954, 2024 Jul 12.
Article
in En
| MEDLINE
| ID: mdl-38828961
ABSTRACT
A long-held precept is that vitamin D supplementation primarily, if not exclusively, benefits individuals with low circulating 25-hydroxyvitamin D (25[OH]D) concentrations at baseline. However, the most appropriate 25(OH)D threshold to distinguish unacceptably low vs reliably adequate concentrations remains controversial. Such threshold proposals have largely been based on observational studies, which provide less robust evidence compared to randomized clinical trials (RCTs). Since the Endocrine Society's first vitamin D-related guideline was published in 2011, several large vitamin D-related RCTs have been published, and a newly commissioned guideline development panel (GDP) prioritized 4 clinical questions related to the benefits and harms of vitamin D supplementation in generally healthy individuals with 25(OH)D levels below a threshold. The GDP determined that available clinical trial evidence does not permit the establishment of 25(OH)D thresholds that specifically predict meaningful benefit with vitamin D supplementation. The panel noted important limitations in the available evidence, and the panel's overall certainty in the available evidence was very low. Nonetheless, based on the GDP's analyses and judgments, the Endocrine Society no longer endorses its previously proposed definition of vitamin D "sufficiency" (ie, at least 30â
ng/mL [75â
nmol/L]) or its previously proposed definition of vitamin D "insufficiency" (ie, greater than 20â
ng/mL [50â
nmol/L] but lower than 30â
ng/mL [75â
nmol/L]). The Endocrine Society's rationale for such is the subject of this Guideline Communication.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vitamin D
/
Vitamin D Deficiency
/
Practice Guidelines as Topic
/
Dietary Supplements
Limits:
Humans
Language:
En
Journal:
J Clin Endocrinol Metab
Year:
2024
Document type:
Article
Affiliation country:
United States