There is consensus that routine screening for vitamin D deficiency in the general population (i.e., in the absence of risk factors or symptoms) is not recommended.[4]Demay MB, Pittas AG, Bikle DD, et al. Vitamin D for the prevention of disease: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2024 Jul 12;109(8):1907-47.
https://academic.oup.com/jcem/article/109/8/1907/7685305?login=false
http://www.ncbi.nlm.nih.gov/pubmed/38828931?tool=bestpractice.com
[112]McChesney C, Singer A, Duquette D, et al. Do not routinely test for vitamin D. BMJ. 2022 Jul 18;378:e070270.
http://www.ncbi.nlm.nih.gov/pubmed/35850784?tool=bestpractice.com
[113]Harvey NC, Ward KA, Agnusdei D, et al. Optimisation of vitamin D status in global populations. Osteoporos Int. 2024 Aug;35(8):1313-22.
http://www.ncbi.nlm.nih.gov/pubmed/38836946?tool=bestpractice.com
This is reflected within the US Preventive Services Task Force (USPSTF) statement, which concludes that there is insufficient evidence to assess the benefits and harms of screening in asymptomatic adults.[114]US Preventive Services Task Force, Krist AH, Davidson KW, et al. Screening for vitamin D deficiency in adults: US Preventive Services Task Force recommendation statement. JAMA. 2021 Apr 13;325(14):1436-42.
https://jamanetwork.com/journals/jama/fullarticle/2778487
http://www.ncbi.nlm.nih.gov/pubmed/33847711?tool=bestpractice.com
Clinical guidance on screening in high-risk groups varies.[4]Demay MB, Pittas AG, Bikle DD, et al. Vitamin D for the prevention of disease: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2024 Jul 12;109(8):1907-47.
https://academic.oup.com/jcem/article/109/8/1907/7685305?login=false
http://www.ncbi.nlm.nih.gov/pubmed/38828931?tool=bestpractice.com
[81]National Institute for Health and Care Excellence. Vitamin D: supplement use in specific population groups. Aug 2017 [internet publication].
https://www.nice.org.uk/guidance/ph56
[115]American College of Obstetricians and Gynecologists. Committee opinion no. 495: vitamin D: screening and supplementation during pregnancy. Jul 2011 [internet publication].
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2011/07/vitamin-d-screening-and-supplementation-during-pregnancy
Recent US (2024 Endocrine Society) and UK (NICE) guidance suggest that routine screening for vitamin D deficiency (serum 25-hydroxyvitamin D measurement) is not necessary for the majority of healthy people with common risk factors for deficiency. Instead, this guidance recommends that prevention strategies, such as regular and effective safe sun exposure and empirical vitamin D supplementation in some groups, remain important for maintaining adequate vitamin D levels.[4]Demay MB, Pittas AG, Bikle DD, et al. Vitamin D for the prevention of disease: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2024 Jul 12;109(8):1907-47.
https://academic.oup.com/jcem/article/109/8/1907/7685305?login=false
http://www.ncbi.nlm.nih.gov/pubmed/38828931?tool=bestpractice.com
[81]National Institute for Health and Care Excellence. Vitamin D: supplement use in specific population groups. Aug 2017 [internet publication].
https://www.nice.org.uk/guidance/ph56
See Primary prevention.
Some US guidelines recommend routine screening for older adults (aged >50 years).[84]LeBoff MS, Greenspan SL, Insogna KL, et al. The clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2022 Oct;33(10):2049-102.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9546973
http://www.ncbi.nlm.nih.gov/pubmed/35478046?tool=bestpractice.com
The American College of Obstetricians and Gynecologists (ACOG) states that routine screening for vitamin D deficiency in pregnancy is not recommended, but may be considered for women at high risk, such as vegetarians, those with dark skin, those living in northern latitudes, or women who wear clothing that limits sun exposure.[115]American College of Obstetricians and Gynecologists. Committee opinion no. 495: vitamin D: screening and supplementation during pregnancy. Jul 2011 [internet publication].
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2011/07/vitamin-d-screening-and-supplementation-during-pregnancy
Furthermore, although not a guideline-based recommendation, some experts recommend routine serum 25-hydroxyvitamin D screening for healthy individuals within additional high-risk groups for vitamin D deficiency, such as people with darker skin, those with malabsorption syndromes, those who are institutionalised or exposed to minimal sunlight, those with obesity and those who take certain prescription or non-prescription drugs including glucocorticoids, anticonvulsants anti-epileptic medication, highly active antiretroviral therapy (ART), rifampicin, or St. John's wort.[3]Hossein-Nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc. 2013 Jul;88(7):720-55.
http://www.mayoclinicproceedings.org/article/S0025-6196(13)00404-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/23790560?tool=bestpractice.com
[15]Wacker M, Holick MF. Sunlight and vitamin D: a global perspective for health. Dermatoendocrinol. 2013 Jan 1;5(1):51-108.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897598
http://www.ncbi.nlm.nih.gov/pubmed/24494042?tool=bestpractice.com
[26]Charoenngam N, Holick MF. Immunologic effects of vitamin D on human health and disease. Nutrients. 2020 Jul 15;12(7):2097.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400911
http://www.ncbi.nlm.nih.gov/pubmed/32679784?tool=bestpractice.com
[74]Wortsman J, Matsuoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000 Sep;72(3):690-3. [Erratum in: Am J Clin Nutr. 2003 May;77(5):1342.]
http://ajcn.nutrition.org/content/72/3/690.full
http://www.ncbi.nlm.nih.gov/pubmed/10966885?tool=bestpractice.com
[76]Gröber U, Kisters K. Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinol. 2012 Apr 1;4(2):158-66.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427195
http://www.ncbi.nlm.nih.gov/pubmed/22928072?tool=bestpractice.com
[90]Gallagher JC, Peacock M, Yalamanchili V, et al. Effects of vitamin D supplementation in older African American women. J Clin Endocrinol Metab. 2013 Mar;98(3):1137-46.
http://www.ncbi.nlm.nih.gov/pubmed/23386641?tool=bestpractice.com
[91]Yetley EA. Assessing the vitamin D status of the US population. Am J Clin Nutr. 2008 Aug;88(2):558S-64S.
https://www.sciencedirect.com/science/article/pii/S0002916523241131?via%3Dihub
http://www.ncbi.nlm.nih.gov/pubmed/18689402?tool=bestpractice.com
[113]Harvey NC, Ward KA, Agnusdei D, et al. Optimisation of vitamin D status in global populations. Osteoporos Int. 2024 Aug;35(8):1313-22.
http://www.ncbi.nlm.nih.gov/pubmed/38836946?tool=bestpractice.com
One rationale for screening high-risk groups is to offer individualised treatment, such as providing the appropriate vitamin D supplementation to reach target levels, with subsequent remeasurement if necessary.