Table 4.

Statement regarding screening of vitamin D deficiency in adults.

Consensus Statement	Consensus Voting Scale	Level of Agreement
Screening of vitamin D deficiency should be considered in the following patients/individuals or conditions: Osteoporosis; Osteomalacia; Musculoskeletal pain; Chronic kidney disease; Hepatic failure; Malabsorption syndromes (e.g., cystic fibrosis, inflammatory bowel diseases, bariatric surgery, radiation enteritis); Hyperparathyroidism; Chronic treatment with medications that influence vitamin D metabolism (e.g., antiseizure medications, glucocorticoids, AIDS-medications, antifungal agents, cholestyramine); Chronic autoimmune diseases (e.g., multiple sclerosis, rheumatoid arthritis); Pregnant and lactating women; Institutionalized or hospitalized patients; Older adults (>65 years) in general; Older adults with history of falls or nontraumatic fractures; Granuloma-forming disorders (e.g., sarcoidosis, tuberculosis, histoplasmosis, berylliosis, coccidiomycosis); Obesity (BMI ≥ 30kg/m2); dark skin pigmentation. 25(OH)D is recommended as a laboratory marker for the diagnosis of vitamin D deficiency. In patients with diagnosed vitamin D deficiency (25(OH)D < 20 ng/mL (<50 nmol/L)) and suspected related health issues, serum calcium, phosphate, alkaline phosphatase, parathyroid hormone (PTH), creatinine, and serum magnesium levels should be considered for evaluation; in particular in individuals with a 25(OH)D concentration of <10 ng/mL (<25 nmol/L). A 25(OH)D concentration of <20 ng/mL (<50 nmol/L) is considered as vitamin D deficiency A 25(OH)D concentration of ≥20 ng/mL (≥50 nmol/L) and <30 ng/mL (<75 nmol/L) is considered as vitamin D insufficiency A 25(OH)D concentration of 30–50 ng/mL (75–125 nmol/L) is considered as vitamin D sufficiency A 25(OH)D concentration of >50–60 ng/mL (125–150 nmol/L) is considered as safe but not as a target level A 25(OH)D concentration of >60–100 ng/mL (150–250 nmol/L) is considered as area of uncertainty with potential benefits or risks. A 25(OH)D concentration of >100 ng/mL (250 nmol/L) is considered as oversupply/vitamin D toxicity	9 (strongly agree)	50%
	8	20%
	7 (agree)	30%
	6	0%
	5 (neutral)	0%
	4	0%
	3 (disagree)	0%
	2	0%
	1 (strongly disagree)	0%
Overall agreement 100%, consensus endorsed