Table 2.
Current Vitamin D Screening and Supplementation Recommendations from Major Institutions
| Screening Recommendations | |||||
|---|---|---|---|---|---|
| Institute of Medicine, 201028 | Endocrine Society, 201129 | European AIDS Clinical Society, 201130 | |||
| Screen | No screening | At-risk patients | At-risk patients | ||
| HIV-specific criteria | NA | HIV medication | Some antiretroviral drugs | ||
| General criteria | • African American or Hispanic | • Dark skin • Chronic kidney | |||
| • Chronic kidney | disease | ||||
| disease | • Malabsorption | ||||
| • Malabsorption | • Fracture risk | ||||
| • Fracture/fall risk | • Low BMD | ||||
| • Osteoporosis | |||||
| • Obesity | |||||
| • Hepatic failure | |||||
| Supplementation Recommendations | |||||
| 25(OH)D target level | ≥ 20 ng/mL (50 nmol/L) | 30 ng/mL (75 nmol/L) | 20 ng/mL (50 nmol/L) | ||
| RDA (age 18-70 years) | 600 IU | 600 IU | 800-2000 IU | ||
| RDA (age > 70 years) | 800 IU | 800 IU | |||
| Daily requirement with antiretroviral therapy | NA | 1500-2000 IU | |||
| Daily upper limit | 4000 IU | 10,000 IU | |||
| Loading dose for 25(OH)D < 30 ng/mL | 50,000 IU vitamin D2 weekly or 6000 IU daily for 8 weeks | ||||
25(OH)D indicates 25-hydroxyvitamin D; BMD, bone mineral density; NA, not available; RDA, recommended daily allowance. Data from Institute of Medicine,28 Holick et al,29 and European AIDS Clinical Society.30