Question 242 of 433
Vitamin D: should everyone take it?
The short answer
No. Treat established deficiency and specific clinical indications. For generally healthy people, routine testing and a universal “optimal” blood target are not supported.
The Endocrine Society’s 2024 disease-prevention guideline advises against routine 25-hydroxyvitamin D screening in generally healthy populations and no longer endorses 30 ng/mL as a universal prevention target. It also advises against routine testing solely because of obesity or dark complexion. This guidance does not replace care for osteoporosis, malabsorption, or other established indications.
Most healthy adults under 75 should meet the usual recommended intake: 600 IU daily through age 70 and 800 IU after 70, from food and supplements combined. The guideline suggests empiric supplementation in some groups, including adults over 75, pregnancy, and certain people with high-risk prediabetes; the amount should fit the clinical situation.
In VITAL, 2,000 IU daily did not reduce overall cancer incidence or major cardiovascular events. Findings involving autoimmune disease or telomeres address different outcomes and do not establish longer life or justify chasing a blood level.
When deficiency or a bone disorder is present, testing, dose, and follow-up are individualized. Excess vitamin D can cause hypercalcemia and harm. A deficiency treatment plan is different from a general disease-prevention recommendation.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
GUIDELINE / ROBUST HUMAN TRIALS — Healthy adults: no routine target or screening; deficiency and bone disorders are separate indications.Evidence grade (draft mapping)GGuideline-based / consensusPart 17, Q242 · Sources: R2
Sources cited
- R2 Demay MB et al. Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism. 2024;109:1907–1947. doi:10.1210/clinem/dgae290. PubMed 38828931DOI 10.1210/clinem/dgae290✓ Verified
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.