Adults Aged ≥75 Years
Recommendation 6
➤ In the general population ages 75 years and older, we suggest empiric vitamin
D supplementation because of the potential to lower the risk of mortality.
(2|
⊕⊕⊕
)
Technical remarks:
• Empiric vitamin D may include daily intake of fortified foods, vitamin formulations that
contain vitamin D and/ or daily intake of a vitamin D supplement.
• For empiric supplementation, daily, lower-dose vitamin D is preferred over non-daily,
higher doses.
• In the clinical trials included in the SR that reported on the mortality outcome, vitamin D
dose ranged from 400 to 3333 IU (10 to 83 μg) daily equivalent. The estimated weighted
average was approximately 900 IU (23 μg) daily. Participants in many trials were allowed
to remain on their routine supplements, including up to 800 IU (20 μg) of vitamin D
daily.
Recommendation 7
➤ In the general population ages 75 years and older, we suggest against routine
testing for 25(OH)D levels. (2|
⊕
)
Technical remarks:
• In this population, 25(OH)D thresholds that provide outcome-specific benefits have not
been established in clinical trials.
• The panel suggests against (a) routine screening for a 25(OH)D level to guide decision-
making (i.e., vitamin D vs no vitamin D) and (b) routine follow-up testing for 25(OH)
D level to guide vitamin D dosing.
• This recommendation relates to generally healthy adults who do not otherwise have
established indications for 25(OH)D testing (e.g., hypocalcemia).
Pregnancy
Recommendation 8
➤ We suggest empiric vitamin D supplementation during pregnancy, given its
potential to lower risk of preeclampsia, intra-uterine mortality, preterm birth,
small for gestational age birth, and neonatal mortality. (2|
⊕⊕
)
Technical remarks:
• This recommendation is based on evidence from trials conducted in healthy individuals
during pregnancy.
• Empiric vitamin D may include daily intake of fortified foods, prenatal vitamin
formulations that contain vitamin D, and/ or a vitamin D supplement (pills or drops).
• In the clinical trials included in the SR, the vitamin D doses ranged from 600 to 5000 IU
(15 to 125 μg) daily equivalent, usually provided daily or weekly. The estimated weighted
average was approximately 2500 IU (63 μg) per day.
