When patients visit the office for a physical exam, many want to know their level of vitamin D. Perhaps there is a history of osteoporosis in their family or they’ve experienced bone thinning already. The most important thing they want to know is how to make sure their bones stay strong. Vitamin D plays a major role in maintaining healthy bones. However, the proper amount of vitamin D in the blood is a hot topic in the medical research community.
Finding The Ideal Vitamin D Level For Optimal Health Is Difficult
What exactly is the level of vitamin D in the blood that is considered too low and therefore creates a risk for thinning bones and fractures? In general, researchers are using the level of 25-hydroxy-vitamin D in the blood, which is typically represented in nanogram per milliliter or ng/mL. The attempt to find this level is generating much discussion.
A report issued by the Institute of Medicine (IOM) in 2010 set a threshold of 20 ng/ml after analyzing data submitted by research experts. A level higher than 20 ng/ml is considered acceptable for bone health, and any value lower than 20 ng/mL is considered vitamin deficiency.
The following year, the Endocrine Society published a story that indicated a higher threshold for vitamin-D in the blood. They conclude that the bare minimum amount of vitamin-D should be 30 ng/mL, but a level in the range of 40 ng/mL – 60 ng/mL is strongly recommended for adults and children.
Still More Information To Consider
Most recently, several researchers at the forefront of vitamin-D research, published an article entitled “Vitamin D Deficiency: Is There Really a Pandemic?” in the New England Journal of Medicine. The article reported that the initial level of 20 ng/ML was too high to set as the acceptable standard for vitamin’s D levels in the blood.
They argued that doctors are over-screening patients and treating them for vitamin’s D deficiency when in reality they are healthy. According to their research, 12.5 ng/mL serves as a better standard for vitamin D deficiency and would end the epidemic of vitamin deficiency once and for all.
As the debate continues, a myriad of reports is being published to support both positions.
Who Should Be Screened For Vitamin D Deficiency?
Another study published by the National Institute of Health (NIH), followed 2,000 peri-menopausal women for a decade and determined that levels below 20 ng/mL resulted in a higher risk of ending up on crutches from non-traumatic fractures. Whenever there is a group of people with a higher risk for fracture, keeping the level above 20 is important, according to Dr. Joel Finkelstein, Associate Director of the Bone Density Center at Massachusetts General Hospital. Those with a lower level, even as low as 10, might show no symptoms and remain healthy.
Despite the controversy over the exact level and how much screening should occur, nearly all experts conclude that vitaminD levels in those with a higher risk for deficiency should receive proper screening. Some examples include those who have been diagnosed with malabsorption syndromes such as celiac sprue, anorexia nervosa, or those who underwent gastric bypass surgery. Anyone who has a limited amount of sun exposure, such as people with dark skin or those who wear complete skin coverings in the sun, should also have levels checked.
And of course, peri-menopausal women, as well as pregnant and lactating women, should be tested. In addition, those diagnosed with any skeletal disorder such as osteoporosis or osteopenia should have vitamin levels appropriately screened and monitored.
