Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement

Pawel Pludowski, Istvan Takacs, Mihail Boyanov, Zhanna Belaya, Camelia C Diaconu, Tatiana Mokhort, Nadiia Zherdova, Ingvars Rasa, Juraj Payer, Stefan Pilz, Pawel Pludowski, Istvan Takacs, Mihail Boyanov, Zhanna Belaya, Camelia C Diaconu, Tatiana Mokhort, Nadiia Zherdova, Ingvars Rasa, Juraj Payer, Stefan Pilz

Abstract

Vitamin D deficiency has a high worldwide prevalence, but actions to improve this public health problem are challenged by the heterogeneity of nutritional and clinical vitamin D guidelines, with respect to the diagnosis and treatment of vitamin D deficiency. We aimed to address this issue by providing respective recommendations for adults, developed by a European expert panel, using the Delphi method to reach consensus. Increasing the awareness of vitamin D deficiency and efforts to harmonize vitamin D guidelines should be pursued. We argue against a general screening for vitamin D deficiency but suggest 25-hydroxyvitamin D (25(OH)D) testing in certain risk groups. We recommend a vitamin D supplementation dose of 800 to 2000 international units (IU) per day for adults who want to ensure a sufficient vitamin D status. These doses are also recommended for the treatment of vitamin D deficiency, but higher vitamin D doses (e.g., 6000 IU per day) may be used for the first 4 to 12 weeks of treatment if a rapid correction of vitamin D deficiency is clinically indicated before continuing, with a maintenance dose of 800 to 2000 IU per day. Treatment success may be evaluated after at least 6 to 12 weeks in certain risk groups (e.g., patients with malabsorption syndromes) by measurement of serum 25(OH)D, with the aim to target concentrations of 30 to 50 ng/mL (75 to 125 nmol/L).

Keywords: cholecalciferol; guidelines; recommendations; supplementation; treatment; vitamin D.

Conflict of interest statement

All authors received honoraria from Wörwag Pharma.

Figures

Figure 1
Figure 1
Algorithm for vitamin D deficiency screening and treatment.

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