Who should have their vitamin D measured?
Routine screening for vitamin D deficiency in healthy people with no risk factors for deficiency is not recommended; it is likely to identify people with mild, often seasonal, deficiency who are unlikely to benefit from supplementation. Screening is only funded by the Medicare Benefits Schedule for select patients1.
Measure serum 25-hydroxyvitamin D concentration in people at increased risk of vitamin D deficiency, such as those who:
- are institutionalised or housebound (eg chronic illness, disability)
- wear clothing that covers most of the skin (eg for cultural or occupational reasons)
- have dark skin (Fitzpatrick skin types V and VI2)
- have a medical condition (eg end-stage liver disease, kidney disease, hyperparathyroidism) or take a drug (eg rifampicin, antiepileptics) that affects vitamin D metabolism and storage in the liver
- have fat malabsorption (eg due to cystic fibrosis, coeliac disease or inflammatory bowel disease) or gastrectomy.
If a patient is found to be vitamin D replete on testing, repeated (eg annual) testing is not recommended—it is unlikely to reveal subsequent deficiency unless the patient’s risk factors have changed substantially.
Women with a risk factor for deficiency who become pregnant should have their serum 25-hydroxyvitamin D concentration measured at their first antenatal visit.