UK Osteoporosis Society (inadequate) guidelines for vitamin D and bone health

National Osteoporosis Society Practical Clinical Guideline on Vitamin D and Bone Health

Maturitas: November 27, 2014, DOI: http://dx.doi.org/10.1016/j.maturitas.2014.11.018

R.M. Francisemail, T.J. Aspray, C.E. Bowring, W.D. Fraser, N.J. Gittoes, M.K. Javaid, H.M. Macdonald, S. Patel, P.L. Selby, N. Tanna

📄 Download the PDF from VitaminDWiki.

There is growing interest in the importance of vitamin D in the maintenance of bone health and the prevention of falls and fractures. Although there is no universal consensus on the criteria for vitamin D deficiency, this is common in the UK, particularly in frail older people ^[1]. This has resulted in a marked increase in requests for serum 25 hydroxyvitamin D (25OHD) estimation, but there has been confusion about the indications for these measurements, interpretation of the results and the management of vitamin D deficiency.

Quotes from PDF with comments by VitaminDWiki

• For average adult
  • They do not mention dark skin, obese, pregnant, child, or senior

• “Serum 25OHD measurements are not recommended in asymptomatic healthy individuals with no evidence of bone disease.”

• 20 ng is sufficient for almost the whole population

• “Patients with a serum 25OHD above 50 nmol/L should be reassured and given advice on maintaining adequate vitamin D levels through safe sunlight exposure and diet. “

  • No suggestion about supplementing: just sunlight and diet
  • No comment about the cofactors REQUIRED for bone health
• “Vitamin D2 may be preferred by vegetarians and patients who wish to avoid vitamin D of animal origin because of religious or cultural beliefs”
  • They appear to be unaware of the availability of vitamin D3 made from plants
• “ Oral administration of vitamin D is recommended, because of unpredictable bioavailability and slower correction of vitamin D deficiency with intramuscular preparations (7,8).”
  • Appear to be unaware of topical, vaginal, sublingual, etc
• “Loading doses should provide a total of approximately 300,000 IU (7,500 µg) vitamin D, given either as weekly or daily doses.
  • Overview Loading of vitamin D has many other opinions on loading doses around the world
• “Maintenance treatment should be considered one month after loading, with doses equivalent to 800 to 2,000 IU”
  • half of seniors got ZERO improvement from 1600 IU
• The only references in the PDF after 2010 were to Vitamin D2 studies

See also VitaminDWiki

• Overview Osteoporosis and vitamin D

• Vitamin D and Bone Health – UK National Osteoporosis Society – April 2013

• National Osteoporosis Society of UK declares that 12 ng of vitamin D is enough – June 2013 same group!

• European Osteo group recommends 20-50 ng of vitamin D – Jan 2013

• Is 50 ng of vitamin D too high, just right, or not enough

• Korea proposes vitamin D of 20 ng, but notes 20ng increases osteo by 50 percent – Oct 2012

• Vitamin D, K2, Magnesium, etc increase bone density when taking together– Jan 2012

• 30 to 50 ng of vitamin D is optimal – Central Europe consensus Sept 2013

• Dark Skinned adults need more than 45 minutes of UK summer sun daily – June 2013

• 8X higher Osteoporosis risk if high level of vitamin A, vitamin D important too – Feb 2013

• Overview - Bone Fractures

• Overview: Vitamin D and falling

• Hypothesis: increased bone mineral density needs protein, Ca, Mg, Vitamin D and K