• Vitamin D Screening: Who, Why, And When

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    Vitamin D is critical for bone mineralization. Over the previous decade, vitamin D deficiency has received significant media attention for its association with many adverse health outcomes beyond bone health, including cancer, autoimmune diseases, infections, diabetes mellitus, and cardiovascular health. Because of this attention, there has been a notable increase in screening for vitamin D deficiency.

    Serum levels of vitamin D, a prohormone synthesized in the skin, are influenced by a multitude of factors, including sun exposure, skin pigmentation, age, adiposity, and dietary intake. The dominant function of vitamin D in its active hormonal form (1,25-dihydroxyvitamin D) is to maintain calcium and phosphate homeostasis. Measurement of serum 25-hydroxyvitamin D levels is the best current measure of vitamin D status.

    A robust and rapidly growing body of research clearly shows that vitamin D is absolutely essential for good health and disease prevention, in part due to the fact that it influences about 10 percent of all your genes.

    The US Preventive Services Task Force recently proposed new guidelines for vitamin D screening, which can be crucial for a number of different health conditions.

    Unfortunately, the task force claims there's “inadequate evidence” to make a determination about the value of routine vitamin D screening for people with asymptomatic vitamin D deficiency. …

    When calcium is high or a person has a disease that might produce excess amounts of vitamin D, such as sarcoidosis or some forms of lymphoma (because immune cells may make 1,25-dihydroxyvitamin D), 1,25-dihydroxyvitamin D usually is ordered. Rarely, this testing may be indicated when abnormalities of the enzyme that converts 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D or renal disease are suspected. When vitamin D, calcium, phosphorus, or magnesium supplementation is necessary, vitamin D levels are sometimes measured to monitor treatment effectiveness.

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