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. Author manuscript; available in PMC: 2016 May 23.
Published in final edited form as: Semin Respir Crit Care Med. 2010 Jul 27;31(4):474–484. doi: 10.1055/s-0030-1262215

Table 3.

Henry Ford Hospital Multidisciplinary Recommendations for the Assessment and Management of Vitamin D in Patients with Sarcoidosis*

  1. 25-hydroyxvitamin D and 1, 25-dihydroxyvitamin D levels should be assessed at least once to determine if pharmacological supplementation is needed.

  2. Pharmacological doses (50,000 IU) of vitamin D should not be used for the primary purpose of reducing autoimmune disease or cancer risk.

  3. In patients with an estimated glomerular filtration rate (eGFR) of >60 mL/min/1.73 m2 and sarcoidosis:
    1. Treatment of osteoporosis or osteopenia. Pharmacological vitamin D therapy (50,000 IU) should be considered only if 1, 25-dihydroxyvitamin D levels are low and there is no evidence of hypercalciuria (>300 mg/24 h) or hypercalcemia.
    2. Primary prevention of glucocorticoid-induced osteoporosis. Bisphosphonate therapy should be utilized as the primary treatment strategy in patients starting glucocorticoid therapy. As with treatment of osteoporosis, nonpharmacological doses of vitamin D (200 to 400 IU) or calcium supplementation can be used in patients without hypercalciuria or hypercalcemia.

  4. Pharmacological doses of vitamin D should not be used in patients with an eGFR <60 mL/min/1.73 m2 without frequent assessment of serum calcium and multidisciplinary consultations (nephrology, bone, and mineral).

*

Level of evidence: expert opinion. No published observational or randomized clinical data are available to determine the safety of pharmacological vitamin D dosing (50,000 IU) in the sarcoidosis population.