Screening

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][112][113]​ 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]

Clinical guidance on screening in high-risk groups varies.[4][81][115]​ 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][81] See Primary prevention.

Some US guidelines recommend routine screening for older adults (aged >50 years).[84]​ 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]

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][15][26][74]​​​​[76][90][91][113]

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.

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