New Vitamin D Guidelines: Who Really Needs Supplements?

For years, many of us have been trying to improve our health by monitoring our vitamin D levels. Today, I'm going to discuss some new guidelines that might surprise you—they surprised me. If you've been getting regular vitamin D tests or recommending them to patients, this could actually change your approach.

The Rise of Vitamin D Testing

In recent years, vitamin D testing has skyrocketed. Data from the UK's National Health Service shows that between 2005 and 2015, the rate of vitamin D testing increased from less than 1 test to over 16 tests per 1,000 persons per year. That's a dramatic increase. And while we don't have the exact numbers for the United States, trends have definitely been observed in our healthcare system that are similar.

I think many of us believe that by checking vitamin D levels, we were doing something crucial for preventing everything from bone problems to heart disease. But in June of this year, in 2024, the Endocrine Society, which is a big group of endocrine researchers and practitioners . . . These people are dedicated to advancing this research and to excellence in clinical practice. I always like it when a guideline comes out from a society, because it tells me that a lot of really smart people have thought hard about this before they've released it.

Who Really Needs Vitamin D Supplements?

So the new guideline from the Endocrine Society says that they're recommending against routine vitamin D testing for almost all healthy adults. This includes people we often worry about, like those with obesity or darker skin tones. And besides not testing, they say that most people do not need any additional vitamin D supplementation.

They're not saying that vitamin D isn't important. It absolutely is. They're just saying that after looking at the research, our diets and lifestyle actually provide enough vitamin D without the need for testing and high-dose supplements.

They do provide specific recommendations on who should take a vitamin D supplement, and that is taking something above and beyond your diet and sunshine. There are actually four main groups:

• The first is children and adolescents between 1 and 18. There, vitamin D supplements help prevent rickets.
• For adults over 75, vitamin D might lower mortality risk overall.
• For pregnant women, they suggest vitamin D supplements because there's evidence that it reduces some pregnancy complications.
• And finally, for adults with pre-diabetes, they suggest a vitamin D supplement, because there's some evidence it can reduce the risk of progressing to diabetes.

For those groups, the recommendation is that you take that supplement regardless of a vitamin D level, so there's no need for testing first.

The Power of Sunlight: Your Body's Natural Vitamin D Production

So it turns out that for most healthy adults younger than 74, there's no reason to get a routine vitamin D test, and supplementation beyond the daily allowance is not needed. This is good news.

Your body is amazingly designed to make its own vitamin D, which makes vitamin D not really a vitamin because we can make it. Going outside for a walk or doing some gardening isn't just good for your mood or your physical strengths, but it's helping your body create exactly what it needs. And the magic about vitamin D might actually be in that conversion from sunlight into a vitamin, not in the pill. I think that's pretty cool.

Routine Vitamin D Testing Isn't Beneficial for Most Adults

I know this information might also be confusing to hear because many of us have been really diligent about checking our vitamin D and taking extra supplements. And so it's natural to worry that this might be missing something important. But that's the point of the guideline.

Over the last 20 years, there's been a lot of research, and it turns out there's no real benefit to treating low vitamin D levels. The associations that we see between conditions and low vitamin D are not improved with additional supplementation. That is, the low vitamin D is not the cause of the condition, and additional vitamin D has not been shown to change it.

So that's the research that the Endocrine Society studied carefully before making these recommendations. And if you want to, you can read more about it by just looking up Endocrine Society and vitamin D, and you'll find the guideline quite easily and you can look at all of their research.

So it is important to note that these are general guidelines and that there are some individuals with specific medical conditions, like absorption disorders, osteoporosis, or liver disease, that should consult their healthcare provider. But for most healthy young people less than 74, between 18 and 74, testing your vitamin D doesn't help solve your healthcare concerns.

The Cost of Unnecessary Testing and Supplements

And the reason I think this is really important is that unnecessary testing and supplements cost a lot of money. Vitamin D tests can cost anywhere from $25 to $100, and then there are the additional costs of an office visit, a lab draw, and the time to discuss those results with your provider. When we multiply that by millions of unnecessary tests, we're looking at significant expense to our healthcare system.

The U.S. healthcare system is pretty expensive as it is, the most expensive in the world, and we're not getting the outcomes we might expect. So I think it's a responsibility for all of us to look at the things that work and the things that don't. And vitamin D testing turns out to not be a beneficial use of our time and resources.

Of course, the Endocrine Society will continue to review and update these guidelines as new evidence emerges, so stay informed and don't hesitate to discuss your questions with your healthcare provider.

New Vitamin D Guidelines Simplified

So, as we wrap up, here are the key takeaways:

• For most healthy adults, especially those under 75, routine vitamin D testing is not necessary.
• If you're in one of those four groups that we talked about that benefit from taking a supplement, the recommended dose is 600 IUs, or international units, for people under 75, and 800 international units, IUs, for people over 75.
• You can take a little more, and most people won't get in trouble with doses under 4,000, but it's not clear that it's necessary or has any benefit beyond the lower dose taken daily.
• The Endocrine Society does not recommend super high doses intermittently for anyone, however.

This is actually liberating news. It's one less thing to worry about. For most of us, we can focus on enjoying healthy foods and outdoor activities rather than stressing about our vitamin D levels and what supplements we're taking. And for those who do benefit from supplementation, we have clear evidence-based guidelines to follow.

So here's to your health. Go outside and make some magic happen in your skin.