Do you need your vitamin D level checked? The US Preventive Services Task Force just weighed in on this and gave a “final recommendation statement.”
Sounds impressive, huh? Well, actually the USPSTF has said that to check vitamin D levels is an “I” recommendation. This means that we have insufficient evidence to asses the balance of benefits of checking vitamin D level and harms of screening in asymptomatic adults. Keep in mind that an A recommendation means we SHOULD do it. B we PROBABLY SHOULD do it. C recommendation that we should WEIGHT THE RISKS AND BENEFIT of checking. D recommendation we SHOULD NOT do it. And, then an “I” is insufficient evidence for or against.
Who does NOT need to have vitamin D checked? People who live in the community (versus a nursing home), non-pregnant adults, those with no signs or symptoms of vitamin D deficiency, or for those who do not have a condition requiring vitamin D.
Who may consider having vitamin D checked? Patients who are hospitalized or living in institutions (like nursing homes), those with a bone condition such as osteoporosis, osteomalacia or rickets.
Why should we not check? Because we need more research on WHAT LEVEL of vitamin D people need to be healthy. We do not know the level.
Generally, I suggest to patients that most of us have low or low-normal vitamin D levels. We get vitamin D from the sun (but we are often indoors or outdoors wearing protective clothing) and from foods (fortified milk or salmon) but often we could use more. Vitamin D3 is available over the counter, is inexpensive, and 2000 international units (IU) a day increases our levels.
I warn patients that oftentimes their insurance will not pay for Vitamin D labs and the patient should call her insurer to see what their “out of pocket cost for the vitamin D lab is.” Insurers always know what they pay for… physicians don’t.