Correspondence (letter to the editor): Appeal for Vitamin D Therapy

Stefan Schilling reported that most geriatric patients in a rehabilitation facility had severe vitamin D deficiency (1).

Our observations in women in nursing homes are rather similar (2). Although the optimal 25-hydroxyvitamin D (25[OH]D) concentrations and the potentially multiple health benefits of vitamin D are the subject of intense discussions, the general consensus is that 25(OH)D concentrations below 10 ng/mL (25 mmol/L) affect the skeletal system and require immediate treatment. In view of the fact, however, that 25(OH)D concentrations in most patients in care homes are below 10 ng/mL (25 mmol/L) and meta-analyses of randomized, placebo controlled studies have shown that vitamin D supplementation results in a significant reduction in bone fractures, we wish to point out that existing guidelines actually recommend a daily vitamin D supplementation of 800 IU in such patients.

In agreement with Stefan Schilling we therefore wish to make an appeal for introducing vitamin D supplementation as a routine treatment in care homes. This recommendation is also supported by a meta-analysis of randomized, placebo controlled trials, which shows a significant reduction in mortality as a result of vitamin D supplementation (3).

Although the many questions surrounding vitamin D remain unanswered, and although what we know about vitamin D is likely to be modified in the future, we now carry the responsibility to treat according to the current best evidence, which says very clearly that vitamin D deficiency in the elderly patients described above should be treated.