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Another Vitamin D consensus for 40-60 ng – India March 2025

Prevention and Treatment of Vitamin D Deficiency in India: An Expert Group Consensus

Indian J Endocr Metab 2025;29:13-26.
Sanjay Kalra1,2, Abdul H. Zargar3, Ashok K. Das4, Arjun Baidya5, Arundhati Dasgupta6, Chitra Selvan7, Ganapathi Bantwal8, Nitin Kapoor9, Om J. Lakhani10, Pankaj K. Agarwal11, Sarita Bajaj12, Vijaya Sarathi13, Vitamin D Consensus Steering Committee14
'Department of Endocrinology, Bharti Hospital, Karnal, Haryana, "University Centre for Research and Development, Chandigarh University, Mohali, Punjab, "Centre for Diabetes and Endocrine Care, National Highway Gulshan Nagar, Srinagar, 'Department of Endocrinology, Mahatma Gandhi Medical College and Research Institute -SBV, Puducherry, "Department of Endocrinology, NRS Medical College, Kolkata, "Department of Endocrinology, Rudraksh Super Specialty Care, Siliguri, West Bengal, "Department of Endocrinology, MS Ramaiah Medical College, "Department of Endocrinology, St John's Medical College Hospital, Bengaluru, Karnataka, "Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, 10Zydus Hospitals, Ahmedabad, Gujarat, ''Consultant Endocrinologist, Hormone Care and Research Centre, Ghaziabad, Uttar Pradesh, Founder, Medical Concepts in Hindi (MCH), '"Consultant Endocrinologist, Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh, '"Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, '4Jubbin Jacob, Christian Medical College, Ludhiana, India; Saurabh Arora, Fortis Hospital, Ludhiana, India; Ashok Kumar, CEDAR Clinic, Panipat, Haryana, India; Rajneesh Mittal, Mittal Maternity and Super Specialty Hospital, Yamunanagar, India; Dr. Shivani, AIIMS, Bathinda, India; Prasun Deb, KIMS Hospital, Secunderabad, India; Shivaprasad KS NARAYANA HEALTH, BANGALORE, India; Samantha Sathyakumar, Apollo Hospitals, Hyderabad; Arun Mukka, Yashoda Hospitals, Somajiguda, India; Rajwanth Pratap Mathur, Hyderabad Multi Speciality and Diabetes Centre, Banjara Hills, Hyderabad, India, Sunetra Mondal, NRS Medical College, Kolkata, WB, India; Sambit Das, Kalinga Institute of Medical Sciences, KIIT , Bhubaneswar, India; Jayashree Swain, IMS and SUM Hospital, Bhubaneswar, Odisha, India; Manash Pratim Baruah, Apollo Excel Care Hospital, Guwahati, Assam, India; Jaya Bhanu Kanwar, IMS SUM Hospital, Bhubaneswar, Odisha, India; Salam Ranabir, Regional Institute of Medical Sciences, Imphal, India; Nilakshi Deka, Apollo Hospital, Guwahati, Assam, India; Paramita Chowdhury, Institute of Neurosciences, Kolkata, WB, India; Atul Dhingra, Ganganagar Superspecialty Clinics and Gangaram Bansal Hospital, Sri Ganganagar Rajasthan, India; Shehla Shaikh, HN Reliance Hospital, Mumbai, Maharashtra, India; Ameya Joshi, Bhaktivedanta Hospital, Mumbai, Maharashtra, India; Varsha Jagtap, Jagtap Clinic and Research Centre, Pune, Maharashtra, India; Piyush Lodha, Ruby Hall Clinic, Pune, KEM Hospital, Pune, India; Jaideep Khare, Professor, Department of Endocrinology, People's College of Medical Sciences and RC, Bhopal, MP India; Sharvil Gadve, Excel Endocrine Centre, Kolhapur, Maharashtra, India; Vaishali Deshmukh, Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India; Milind Patwardhan, Diabetes and Endocrinology Research Centre, Miraj Hospitals, Miraj, Maharashtra, India; Dr. Kripa Cherian, Christian Medical College, Vellore, Tamil Nadu, India

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Vitamin D deficiency is highly prevalent in India, yet no standardized guidelines exist for classifying vitamin D status or its prevention and treatment. Even more, there is no consensus specific to vitamin D supplementation for the Indian population, and there are inconsistencies in the cut-off values for deficiency, severe deficiency, and insufficiency across various guidelines, which this evidence-based consensus seeks to resolve, thus guiding healthcare professionals in identifying, preventing, and managing vitamin D deficiency. An expert group of 41 endocrinologists from across India developed the consensus using the DELPHI method, achieving over 90% agreement on all recommendations. The consensus defines vitamin D deficiency, severe deficiency, and insufficiency, recommending supplementation strategies to maintain physiological 25(OH) D levels of 40-60 ng/mL (100-150 nmol/L). Tailored treatment regimens for neonates, infants, children, adolescents, adults, the elderly, pregnant and lactating women, and individuals with co-morbid conditions are provided to ensure optimal health for all age groups in India.
 Download the PDF from VitaminDWiki

29 Recommendations

  • 1 Recommendation 1: Vitamin D deficiency, severe deficiency, and insufficiency can be defined as
    • 1a Deficiency <20 ng/mL (50 nmol/L) of serum 25-hydroxyvitamin D
    • 1b Severe deficiency <10 ng/mL (25 nmol/L) of serum 25-hydroxyvitamin D
    • 1c Insufficiency: 20-30 ng/mL (50-75 nmol/L) of serum 25(OH) D levels.
  • Recommendation 2: Prevention of vitamin D deficiency in the general population is recommended irrespective of age, physical activity, and lifestyle.
  • Recommendation 3: The aim of vitamin D3 therapy should be to achieve a physiological 25(OH) D level (40-60 ng/mL or 100-150 nmol/L).
  • Recommendation 4: If disease-specific practice guidelines are unavailable, strategies for preventing vitamin D deficiency in high-risk groups should be similar to those for the general population.
  • Recommendation 5: The vitamin D supplement/replacement regimen in adults should be
    • 5a Vitamin D sufficiency - cholecalciferol 60,000IU, once a month
    • 5b Vitamin D insufficiency - cholecalciferol 60,000IU, once a week for 8 weeks (once sufficiency is achieved, transition to cholecalciferol 60,000 IU, once a month)
    • 5c Vitamin D deficiency: Cholecalciferol 60,000 IU, once a week for 12 weeks (once sufficiency is achieved, transition to cholecalciferol 60,000 IU, once a month).
  • Recommendation 6: Adjusting the dosing regimen to the patient’s preference and supplementing weekly or monthly may positively impact adherence.
  • Recommendation 7: In the risk groups (Box 1), the evaluation of vitamin D status, based on a serum 25(OH) D assay, is strongly recommended.
    • Image Box 1
  • Recommendation 8: A 25(OH) D value of <20 ng/mL (<50 nmol/L) reflects a strong need to initiate vitamin D replacement.
  • Recommendation 9: A single-loading therapy using a cholecalciferol dose of 1,00,000 IU or higher is not recommended in India*.
    • A loading dose of vitamin D should be used only under expert monitoring.
  • Recommendation 10: Cholecalciferol dosing for therapy of vitamin D deficiency should be based on serum 25(OH) D concentrations (if affordable and feasible) and previous prophylactic schemes.
  • Recommendation 11: A daily and cumulative (weekly, biweekly, monthly) dosing regimen of therapy with the use of cholecalciferol to attain and maintain optimal 25(OH) D concentrations is complementary, effective, and safe.
  • Recommendation 12: For children aged 0-6 months, 400 IU/day (10 ug/day) of cholecalciferol should be taken from the first days of life, regardless of the feeding method.
  • Recommendation 13: For children aged 6-12 months, take 400-600 IU/day (10-15 ug/day) of cholecalciferol, depending on the daily amount of vitamin D consumed with meals.
  • Recommendation 14: In healthy children aged 1-3, 600 IU (15 ug)/day of cholecalciferol should be supplemented.
    Due to age-related restrictions on sunlight exposure, supplementation is recommended throughout the year.
  • Recommendation 15: In healthy children aged 4-10, cholecalciferol supplementation in doses 600-1,000 IU (15-25 ug)/day
    is recommended throughout the year, based on body weight and dietary vitamin D intake.
  • Recommendation 16: In children aged 3 years and above with confirmed vitamin D deficiency, 60,000 IU should be given once a week for 6 weeks.
  • Recommendation 17: In healthy adolescents, sunbathing with uncovered forearms and legs for 30-45 minutes between 10 am and 3 pm without sunscreen throughout the year is recommended. Routine vitamin D supplementation is not necessary, although it is safe and effective.
  • Recommendation 18: In adolescents aged 11-18 years with confirmed vitamin D deficiency, 60,000 IU should be given once a week for 6 weeks.
  • Recommendation 19: Due to the decreased efficacy of the skin synthesis, supplementation based on cholecalciferol in a dose of
    1,00,000 (=100,000) IU every 90 days or 4,000 IU/day may be given empirically (Specific patients may require high doses.)
  • Recommendation 20: Women planning pregnancy should receive adequate cholecalciferol supplementation, the same as in the general adult population, if possible, under the control of serum 25(OH) D concentration.
  • Recommendation 21: When pregnancy is confirmed until the end of breastfeeding, cholecalciferol supplementation should be carried out under the control of 25(OH) D concentration to achieve and maintain optimal concentrations within the ranges of >30-50 ng/mL (>75-125 nmol/L).
    • ''Note: Many groups recommend higher, not lower levels during pregnancy''
  • Recommendation 22: If the assessment of serum 25(OH) D concentration is not accessible, it is recommended to use cholecalciferol at a dose of 2,000 IU/day (50 ug/day) throughout pregnancy and lactation.
  • Recommendation 23 (a): Obese patients with malabsorption syndromes and those on medications affecting vitamin D metabolism, including anticonvulsant medications, glucocorticoids, and antifungals such as ketoconazole, and those taking medications for acquired immunodeficiency syndrome (AIDS) should be given at least 2-3 times more vitamin D for their age group to achieve an optimal concentration of >30-50 ng/mL (>75-125 nmol/L).
    • Recommendation 23 (b): These patients should receive a higher dose of 6,000-10,000 IU/day.
  • Recommendation 24: If the assessment of serum 25(OH) D3 concentration is not possible in the risk groups, cholecalciferol dosing should be carried out according to the guidelines for the general population at the maximal doses for a given age group.
  • Recommendation 25: In patients with extrarenal production of 1,25(OH) 2D, regular monitoring of 25(OH) D levels and serum calcium is recommended during treatment with vitamin D to prevent hypercalcemia.
  • Recommendation 26: For patients with primary hyperparathyroidism and vitamin D deficiency, we recommend treatment with vitamin D as needed. Serum calcium levels should also be monitored.
  • Recommendation 27: In immunocompromised patients, empirical supplementation of vitamin D 60,000 IU every 30 days (monthly) should be considered.
  • Recommendation 28: In patients with cardiometabolic disease, diabetes mellitus, cancer, and infectious diseases, it is recommended to monitor vitamin D supplementation to ensure a physiological range between 40 and 60 ng/mL (100-150 nmol/L).
  • Recommendation 29: In patients with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, a physiological level of 25(OH) D3 > 40 ng/mL (>100 nmol/L) should be maintained, and they should be regularly monitored.
Not mentioned: other forms (gut-friendly, vegan, topical) co-factors, genes restrict celluar D, seniors, fatty meal needed, poor responders, poor kidney or liver etc.

9+ VitaminDWiki pages have 40-60 in the title

The list is automatically updated

Items found: 9


See also Osteoporosis in France can be fought with 50,000 IU of Vitamin D, weekly then bi-weekly (30-60ng) - Feb 2025

VitaminDWiki – Consensus Vitamin D category contains:

  • Target level: >40 ng
  • Dose:- 4,000+ IU average daily
      dose varies a lot with weight, age, type of health problems, etc
  • How often to take: daily or as infrequently as 50,000 IU once every 2 weeks
  • Type: Vitamin D3 (Note - Vegan and gut-friendly forms of D3 are available)
    • Note: Some doctors still mistakenly prescribe D2, which has been found to not be nearly as good as D3
  • Form: any (capsule, gelcap, sublingual, spray, topical, etc.)
  • When to take: during or after a fatty meal - unless use water-dispersable vitamin D
  • Cofactors adjustment to aid vitamin D and prevent imbalance - essential if >40 ng for more than a year
       Increase Magnesium, Vitamin K2, Omega-3, and reduce Calcium
  • Increase Vitamin D to cells ~30% of those with health problems have poor Vitamin D Receptors
    • Increasing Magnesium, Omega-3, Resveratrol, Zinc, etc, increases Receptor activation
  • It is important to restore levels even if Vitamin D has not been proven to treat a specific disease
  • Loading dose: (400,000 IU over 8 days) provides very quick restoration is sometimes required
  • Whom to treat?: Virtually everyone
    • <1% of people have conditions or use drugs that are not compatible with Vitamin D
  • How long to treat?: Generally, supplement with vitamin D forever.
    • Note: Many doctors prescribe 50,000 IU of vitamin D weekly for only 8 weeks
    • This 8-week supplementation wears off in about 8-12 weeks

74 Vitamin D consensus publications

VitaminDWiki – Optimum category contains

The RDA (600 IU) is barely enough for infant bones.
   Need an optimal level for the body to thrive

99 items in Optimum Vitamin D category

Example pages

See also in VitaminDWiki

50,000 IU of Vitamin D - many studies
50,000 IU of Vitamin D monthly is safe for 1 year, levels still rising – June 2024
Image
   India's recommended 60,000 IU monthly is probably not enough
One pill every two weeks gives you all the vitamin D most adults need
   one pill = 50,000 IU
Getting Vitamin D into your blood and cells
Is 50 ng of vitamin D too high, just right, or not enough includes

Vitamin D Treats
150 ng Multiple Sclerosis *
80 ng Cluster Headache *
Reduced office visits by 4X *
70 ngSleep *
60 ngBreast Cancer death reduced 60%
Preeclampsia RCT
50 ng COVID-19
T1 Diabetes
Fertility
Psoriasis
Infections Review
Infection after surgery
40 ng Breast Cancer 65% lower risk
Depression
ACL recovery
Hypertension
Asthma?
30 ng Rickets

* Evolution of experiments with patients, often also need co-factors

References for India delphi consensus
  1. Aparna P, Muthathal S, Nongkynrih B, Gupta SK. Vitamin D deficiency in India. J Fam Med Prim Care 2018;7:324-30.
  2. Siddiqee MH, Bhattacharjee B, Siddiqi UR, Meshbahur Rahman M. High prevalence of vitamin D deficiency among the South Asian adults: A systematic review and meta-analysis. BMC Public Health 2021;21:1823.
  3. Kalra S, Zargar AH, Unnikrishnan AG, Dasgupta A, Sahay R, Shaikh SS, et al. Vitamin D in clinical practice: Current perspectives. Indian J Clin Pract 2023;33:13-25.
  4. Khadilkar A, Kajale N, Oza C, Oke R, Gondhalekar K, Patwardhan V, et al. Vitamin D status and determinants in Indian children and adolescents: A multicentre study. Sci Rep 2022;12:16790.
  5. Chawang SK, Imchen N, Christudoss P To assess and compare vitamin D levels between genders, age groups and geographical locations in a secondary care hospital of Dimapur, Nagaland, India. Indian J Public Health Res Dev 2024;15. doi: 10.37506/g7k2zb89.
  6. Kimball SM, Holick MF. Official recommendations for vitamin D through the life stages in developed countries. Eur J Clin Nutr 2020;74:1514-8.
  7. Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. In: Ross AC, Taylor CL, Yaktine AL, et al., editors. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US); 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56070/. doi: 10.17226/13050. [Last accessed on 2024 Mar 04].
  8. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011;96:1911-30.
  9. Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, et al. IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 2012;97:1146-52.
  10. Heaney RP, Dowell MS, Hale CA, Bendich A. Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 2003;22:142-6.
  11. Fink-Hafner D, Dagen T, Dousak M, Novak M, Hafner-Fink M. Delphi method: Strengths and weaknesses. Adv Methodol Statistics 2019;2:1- 19. doi: 10.51936/fcfm6982.
  12. Gupta N, Agarwal A, Jindal R, Sr S. Estimating Vitamin D threshold for the Indian population: Delving into the actual disease burden. Med J Armed Forces India 2023;79(Suppl 1):S224-9.
  13. Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, et al. Vitamin D status in healthy Indians aged 50 years and above. JAPI 2011;59:706-9.
  14. Farnik H, Bojunga J, Berger A, Allwinn R, Waidmann O, Kronenberger B, et al. Low vitamin D serum concentration is associated with high levels of hepatitis B virus replication in chronically infected patients. Hepatology 2013;58:1270-6.
  15. Walentowicz-Sadlecka M, Grabiec M, Sadlecki P, Gotowska M, Walentowicz P, Krintus M, et al. 25(OH) D3 in patients with ovarian cancer and its correlation with survival. Clin Biochem 2012;45:1568-72.
  16. Mudur G. Indian endocrinologists set guidance to combat vitamin D deficiency. BMJ 2015;351:h5997. doi: 10.1136/bmj.h5997.
  17. Holick MF. Vitamin D status: Measurement, interpretation, and clinical application. Ann Epidemiol 2009;19:73-8.
  18. Trilok Kumar G, Chugh R, Eggersdorfer M. Poor vitamin D Status in healthy populations in India: A review of current evidence. Int J VitamNutr Res 2015;85:185-201.
  19. Maeda SS, Borba VZ, Camargo MB, Silva DM, Borges JL, Bandeira F, et al. Recommendations of the Brazilian Society of Endocrinology and Metabology (SBEM) for the diagnosis and treatment of hypovitaminosis D. Arq Bras Endocrinol Metabol 2014;58:411-33.
  20. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab 2016;101:394-415.
  21. Alves C. Diagnosis and treatment of hypovitaminosis D: Recommendations from India and Brazil. Indian J Endocrinol Metab 2017;21:367.
  22. Pludowski P, Takacs I, Boyanov M, Belaya Z, Diaconu CC, Mokhort T, et al. Clinical Practice in the prevention, diagnosis and treatment of vitamin D deficiency: A Central and Eastern European Expert Consensus Statement. Nutrients 2022;14:1483.
  23. Kearns MD, Alvarez JA, Tangpricha V. Large, single-dose, oral vitamin D supplementation in adult populations: A systematic review. Endocr Pract 2014;20:341-51. doi: 10.4158/EP13265.RA.
  24. Kuznia S, Czock D, Kopp-Schneider A, Caspari R, Fischer H, Laetsch DC, et al. Efficacy and safety of a personalized vitamin D3 loading dose followed by daily 2000 IU in colorectal cancer patients with vitamin D insufficiency: Interim analysis of a randomized controlled trial. Nutrients 2022;14. doi: 10.3390/nu14214546.
  25. Abrams SA. Vitamin D in preterm and full-term infants. Ann Nutr Metab 2020;76(Suppl 2):6-14.
  26. Abrams SA, Hawthorne KM, Rogers SP, Hicks PD, Carpenter TO. Effects of ethnicity and vitamin D supplementation on vitamin D status and changes in bone mineral content in infants. BMC Pediatr 2012;12:6.
  27. Jullien S. Vitamin D prophylaxis in infancy. BMC Pediatr 2021;21(Suppl 1):319. doi: 10.1186/s12887-021-02776-z.
  28. Fort P, Salas AA, Nicola T, Craig CM, Carlo WA, Ambalavanan N. A comparison of three vitamin D dosing regimens in extremely preterm infants: A randomized controlled trial. J Pediatr 2016;174:132-8.e1.
  29. Ogbo FA, Dhami MV, Awosemo AO, Olusanya BO, Olusanya J, Osuagwu UL, et al. Regional prevalence and determinants of exclusive breastfeeding in India. Int Breastfeed J 2019;14:20. doi: 10.1186/ s13006-019-0214-0.
  30. Ozkan B, Doneray H, Karacan M, Vançelik S, Yildirim ZK, Ozkan A, et al. Prevalence of vitamin D deficiency rickets in the eastern part of Turkey. Eur J Pediatr 2009;168:95-100.
  31. Mutlu GY, Kusdal Y, Ozsu E, Cizmecioglu FM, Hatun S. Prevention of vitamin D deficiency in infancy: Daily 400 IU vitamin D is sufficient. Int J Pediatr Endocrinol 2011;2011:4. doi: 10.1186/1687-9856-2011-4.
  32. Gallo S, Comeau K, Vanstone C, Agellon S, Sharma A, Jones G, et al. Effect of different dosages of oral vitamin D supplementation on vitamin D status in healthy, breastfed infants: A randomized trial. JAMA 2013;309:1785-92.
  33. Gallo S, Hazell T, Vanstone CA, Agellon S, Jones G, L’Abbé M, et al. Vitamin D supplementation in breastfed infants from Montréal, Canada: 25-hydroxyvitamin D and bone health effects from a follow-up study at 3 years of age. Osteoporos Int 2016;27:2459-66.
  34. Holmlund-Suila E, Viljakainen H, Hytinantti T, Lamberg-Allardt C, Andersson S, Makitie O. High-dose vitamin D intervention in infants- -effects on vitamin D status, calcium homeostasis, and bone strength. J Clin Endocrinol Metab 2012;97:4139-47.
  35. Gupta P, Dabas A, Seth A, Bhatia VL, Khadgawat R, Kumar P, et al. Indian Academy of Pediatrics Revised (2021) Guidelines on prevention and treatment of vitamin D deficiency and rickets. Indian Pediatr 2022;59:142-58.
  36. Huey SL, Acharya N, Silver A, Sheni R, Yu EA, Peña-Rosas JP, et al. Effects of oral vitamin D supplementation on linear growth and other health outcomes among children under five years of age. Cochrane Database Syst Rev 2020;12:CD012875. doi: 10.1002/14651858. CD012875.pub2.
  37. MoHFW. Comprehensive National Nutrition Survey 2016-18. MoHFW; 2019. Available from: https://healthnutritionindia.in/reports/documents/25/CNNS-v1.0-Data-Note-for-MoHFW.pdf. [Last accessed on 2024 Mar 06].
  38. Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol 2013;5:51-108.
  39. Bilezikian JP, Formenti AM, Adler RA, Binkley N, Bouillon R, Lazaretti-Castro M, et al. Vitamin D: Dosing, levels, form, and route of administration: Does one approach fit all? Rev Endocr Metab Disord 2021;22:1201-18.
  40. Giustina A, Bouillon R, Dawson-Hughes B, Ebeling PR, Lazaretti-Castro M, Lips P, et al. Vitamin D in the older population: A consensus statement. Endocrine 2023;79:31-44.
  41. Pilz S, Zittermann A, Trummer C, Theiler-Schwetz V, Lerchbaum E, Keppel MH, et al. Vitamin D testing and treatment: A narrative review of current evidence. Endocr Connect 2019;8:R27-43.
  42. Scragg R. The Vitamin D Assessment (ViDA) study-Design and main findings. J Steroid Biochem Mol Biol 2020;198:105562. doi: 10.1016/j. jsbmb.2019.105562.
  43. Alavi NM, Khademalhoseini S, Vakili Z, Assarian F. Effect of vitamin D supplementation on depression in elderly patients: A randomized clinical trial. Clin Nutr 2019;38:2065-70. doi: 10.1016/j.clnu. 2018.09.011.
  44. Cai Y, Wanigatunga AA, Mitchell CM, Urbanek JK, Miller ER 3rd, Juraschek SP, et al. The effects of vitamin D supplementation on frailty in older adults at risk for falls. BMC Geriatr 2022;22:312. doi: 10.1186/ s12877-022-02888-w.
  45. Bruyère O, Cavalier E, Souberbielle JC, Bischoff-Ferrari HA, Beaudart C, Buckinx F, et al. Effects of vitamin D in the elderly population: Current status and perspectives. Arch Public Health 2014;72:32. doi: 10.1186/2049-3258-72-32.
  46. Kupisz-Urbanska M, Pludowski P, Marcinowska-Suchowierska E. Vitamin D deficiency in older patients—problems of sarcopenia, drug interactions, management in deficiency. Nutrients 2021;13:1247. doi: 10.3390/nu13041247.
  47. American Association of Clinical Endocrinologists. Vitamin D Deficiency. 2019. https://pro.aace.com/sites/default/files/2019-02/Vitamin_D_Deficiency_formatted.pdf. [Last accessed on 2024 Mar 05].
  48. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: What clinicians need to know. J Clin Endocrinol Metab 2011;96:53-58. doi: 10.1210/jc. 2010-2704.
  49. Anagnostis P, Livadas S, Goulis DG, Bretz S, Ceausu I, Durmusoglu F, et al. EMAS position statement: Vitamin D and menopausal health. Maturitas 2023;169:2-9. doi: 10.1016/j.maturitas. 2022.12.006.
  50. Boucher BJ. The problems of vitamin D insufficiency in older people. Aging Dis 2012;3:313-29.
  51. Pekkarinen T, Välimäki V-V, Aarum S, Turpeinen U, Hämäläinen E, Löyttyniemi E, et al. IU of vitamin D3(cholecalciferol) on either The same annual dose of 292000 daily or four monthly basis for elderly women: 1-year comparative study of the effects on serum 25(OH) D3 concentrations and renal function. Clin Endocrinol 2010;72:455-61.
  52. Abdelmageed RM, Hussein SMM, Anamangadan SM, Abdullah RWM, Rauf L, AlFehaidi AS, et al. Prospective cohort study of vitamin D deficiency in pregnancy: Prevalence and limited effectiveness of 1000 IU vitamin D supplementation. Womens Health (Lond) 2024;20:17455057231222404. doi: 10.1177/17455057231222404.
  53. Kiely ME, McCarthy EK, Hennessy A. Iron, iodine and vitamin D deficiencies during pregnancy: Epidemiology, risk factors and developmental impacts. Proc Nutr Soc 2021;80:290-302.
  54. Pilz S, Zittermann A, Obeid R, Hahn A, Pludowski P, Trummer C, et al. The role of vitamin D in fertility and during pregnancy and lactation: A review of clinical data. Int J Environ Res Public Health 2018;15:2241. doi: 10.3390/ijerph 15102241.
  55. Bi WG, Nuyt AM, Weiler H, Leduc L, Santamaria C, Wei SQ. Association between vitamin D supplementation during pregnancy and offspring growth, morbidity, and mortality: A systematic review and meta-analysis. JAMA Pediatr 2018;172:635-45.
  56. Roth DE, Morris SK, Zlotkin S, Gernand AD, Ahmed T, Shanta SS, et al. Vitamin D supplementation in pregnancy and lactation to promote infant growth. N Engl J Med 2018;379:535-46.
  57. Wagner CL, Hollis BW. Early-life effects of vitamin D: A focus on pregnancy and lactation.Ann Nutr Metab 2020;76(Suppl 2):16-28.
  58. WHO. Vitamin D supplementation during pregnancy. 2023. Available from: https://www.who.int/tools/elena/interventions/vitamind-supp-pregnancy. [Last accessed on 2024 Mar 02].
  59. ACOG. Vitamin D: Screening and supplementation during pregnancy. 2011. p. 495.
    https://www.acog.org/clinical/clinical-guidance/ committee-opinion/articles/2011/07/vitamin-d-screening-and-supplementation-during-pregnancy. [Last accessed on 2024 Mar 02].
  60. Vitamins, supplements, and nutrition in pregnancy-NHS. 2023. Available from: https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/. [Last accessed on 2024 Mar 02].
  61. FOGSI. Clinical Recommendations: Vitamin D in pregnancy, lactation, PCOS, Infertility, Bone health, and menopause. 2019. https://www.fogsi.org/wp-content/uploads/tog/Sanofi_KPP_Vit_D_Booklet_V05. pdf. [Last accessed on 2024 Mar 04].
  62. Kovacs CS. Vitamin D in pregnancy and lactation: Maternal, fetal, and neonatal outcomes from human and animal studies. Am J Clin Nutr 2008;88:520S-8S. doi: 10.1093/ajcn/88.2.520S.
  63. Wagner CL, Taylor SN, Johnson DD, Hollis BW. The role of vitamin D in pregnancy and lactation: Emerging concepts. Womens Health (Lond) 2012;8:323-40.
  64. Dura-Trave T, Gallinas-Victoriano F. Pregnancy, breastfeeding, and vitamin D. InMol Sci 2023;24 (15):11881. doi: 10.3390/ijms241511881.
  65. Thorne-Lyman A, Fawzi WW. Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: A systematic review and meta-analysis. Paediatr Perinat Epidemiol 2012;26(Suppl 1):75-90.
  66. Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, et al. Vitamin D deficiency 2.0: An update on the current status worldwide. Eur J Clin Nutr 2020;74:1498- 513.
  67. Abdullah Thani NSI, Khairudin R, Ho JJ, Muhamad NA, Ismail H. Vitamin D supplementation for overweight or obese adults. Cochrane Database Syst Rev 2019;2019:CD011629. doi: 10.1002/14651858. CD011629.pub2.
  68. Musazadeh V, Zarezadeh M, Ghalichi F, Kalajahi FH, Ghoreishi Z. Vitamin D supplementation positively affects anthropometric indices: Evidence obtained from an umbrella meta-analysis. Front Nutr 2022;9:980749. doi: 10.3389/fnut.2022.980749.
  69. Tobias DK, Luttmann-Gibson H, Mora S, Danik J, Bubes V, Copeland T, et al. Association of body weight with response to vitamin D supplementation and metabolism. JAMA Netw Open 2023;6:e2250681. doi: 10.1001/jamanetworkopen.2022.50681.
  70. Pereda CA, Nishishinya MB. Optimal dosage of vitamin D supplementation in obese patients with low serum levels of 25-hydroxyvitamin D. A systematic review. Obes Med 2022;29:100381. doi: 10.1016/j.obmed.2021.100381.
  71. Duan L, Han L, Liu Q, Zhao Y, Wang L, Wang Y. Effects of vitamin D supplementation on general and central obesity: Results from 20 randomized controlled trials involving apparently healthy populations. Ann Nutr Metab 2020;76:153-64.
  72. Bhatt SP, Misra A, Pandey RM, Upadhyay AD, Gulati S, Singh N. Vitamin D supplementation in overweight/obese Asian Indian women with prediabetes reduces glycemic measures and truncal subcutaneous fat: A 78 weeks randomized placebo-controlled trial (PREVENT-WIN Trial). Sci Rep 2020;10:220. doi: 10.1038/s41598-019-56904-y.
  73. Rajabi S, Aghamohammadi V, Moradpour G, Amini M, Hosseini SV, Sobhani Z, et al. Vitamin D status in patients with morbid obesity following bariatric surgery in Shiraz, Iran: A retrospective observational study. Bariatr Surg Pract Patient Care 2022;17:121-6.
  74. Chakhtoura MT, Nakhoul NN, Shawwa K, Mantzoros C, El Hajj Fuleihan GA. Hypovitaminosis D in bariatric surgery: A systematic review of observational studies. Metabolism 2016;65:574-85.
  75. Chakhtoura M, Rahme M, El-Hajj Fuleihan G. Vitamin D metabolism in bariatric surgery. Endocrinol Metab Clin North Am 2017;46:947-82.
  76. Alsareii SA, Elbashir AM, Shalayel MHF. Obesity and bariatric surgery: Ultimate need for vitamin D supplementation. Biomed Pharmacol J 2017;10:1187-95.
  77. Chakhtoura MT, Nakhoul N, Akl E, Mantzoros C, El Hajj Fuleihan G. Guidelines on vitamin D replacement in bariatric surgery: Identification and systematic appraisal. Metabolism 2016;65:586-597.
  78. Bleizgys A. Vitamin D dosing: Basic principles and a brief algorithm (2021 Update). Nutrients 2021;13:4415. doi: 10.3390/nu13124415.
  79. Pludowski P Supplementing vitamin D in different patient groups to reduce deficiency. Nutrients 2023;15:3725. doi: 10.3390/nu15173725.
  80. Rusinska A, Pludowski P, Walczak M, Borszewska-Kornacka MK, Bossowski A, Chlebna-Sokól D, et al. Vitamin D Supplementation Guidelines for General Population and Groups at Risk of Vitamin D Deficiency in Poland—Recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel With Participation of National Specialist Consultants and Representatives of Scientific Societies—2018 Update. Front Endocrinol (Lausanne) 2018;9:246. doi: 10.3389/fendo. 2018.00246.
  81. Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord 2017;18:153-65.
  82. American Geriatrics Society Workgroup on Vitamin D Supplementation for Older Adults. Recommendations abstracted from the American Geriatrics Society Consensus Statement on vitamin D for prevention of falls and their consequences. J Am Geriatr Soc 2014;62:147-52.
  83. Charoenngam N, Holick MF. Immunologic effects of vitamin D on human health and disease. Nutrients 2020;12:2097. doi: 10.3390/ nu12072097.
  84. Ferder L, Martín Giménez VM, Inserra F, Tajer C, Antonietti L, Mariani J, et al. Vitamin D supplementation as a rational pharmacological approach in the COVID-19 pandemic. Am J Physiol Lung Cell Mol Physiol 2020;319:L941-8.
  85. Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients 2020;12:988. doi: 10.3390/nu12040988.
  86. Utmani SB, Thyagaraj V. A study of the association between metabolic syndrome and vitamin D deficiency. J Assoc Physicians India 2022;70:11-12.
  87. Nasr MH, Hassan BAR, Othman N, Karuppannan M, Abdulaziz NB, Mohammed AH, et al. Prevalence of vitamin D deficiency between type 2 diabetes mellitus patients and non-diabetics in the Arab Gulf. Diabetes Metab Syndr Obes 2022;15:647-57.
  88. Taheriniya S, Arab A, Hadi A, Fadel A, Askari G. Vitamin D and thyroid disorders: A systematic review and Meta-analysis of observational studies. BMC Endocr Disord 2021;21:171. doi: 10.1186/s12902-021- 00831-5.
  89. Galusca D, Popoviciu MS, Babes EE, Vidican M, Zaha AA, Babes VV, et al. Vitamin D implications and effect of supplementation in endocrine disorders: Autoimmune thyroid disorders (Hashimoto’s disease and Grave’s disease), diabetes mellitus and obesity. Medicina (Kaunas) 2022;58:194. doi: 10.3390/medicina58020194.
  90. Dawson-Hughes B, Staten MA, Knowler WC, Nelson J, Vickery EM, LeBlanc ES, et al. Intratrial exposure to vitamin D and new-onset diabetes among adults with prediabetes: A secondary analysis from the Vitamin D and Type 2 Diabetes (D2d) Study. Diabetes Care 2020;43:2916-22.
  91. Rolighed L, Rejnmark L, Sikjaer T, Heickendorff L, Vestergaard P, Mosekilde L, et al. Vitamin D treatment in primary hyperparathyroidism: A randomized placebo-controlled trial. J Clin Endocrinol Metab 2014;99:1072-80.
  92. De Martinis M, Allegra A, Sirufo MM, Tonacci A, Pioggia G, Raggiunti M, et al. Vitamin D deficiency, osteoporosis and effect on autoimmune diseases and hematopoiesis: A review. Int J Mol Sci 2021;22:8855. doi: 10.3390/ijms22168855.
  93. Raftery T, Martineau AR, Greiller CL, Ghosh S, McNamara D, Bennett K, et al. Effects of vitamin D supplementation on intestinal permeability, cathelicidin and disease markers in Crohn’s disease: Results from a randomised double-blind placebo-controlled study. United Eur Gastroenterol J 2015;3:294-302.
  94. Caravaca F, Caravaca-Fontán F, Azevedo L, Luna E. Changes in renal function after discontinuation of vitamin D analogues in advanced chronic kidney disease. Nefrologia (Engl Ed) 2018;38:179-89.
  95. Oksa A, Spustová V, Krivosíková Z, Gazdíková K, Fedelesová V, Lajdová I, et al. Effects of long-term cholecalciferol supplementation on mineral metabolism and calciotropic hormones in chronic kidney disease. Kidney Blood Press Res 2008;31:322-9.
  96. Jean G, Souberbielle JC, Chazot C. Monthly cholecalciferol administration in haemodialysis patients: A simple and efficient strategy for vitamin D supplementation. Nephrol Dial Transplant 2009;24:3799-805.
  97. Delanaye P, Weekers L, Warling X, Moonen M, Smelten N, Medart L, et al. Cholecalciferol in haemodialysis patients: A randomized, double­blind, proof-of-concept and safety study. Nephrol Dial Transplant 2013;28:1779-86.
  98. Chandler PD, Chen WY, Ajala ON, Hazra A, Cook N, Bubes V, et al. Effect of vitamin D3 supplements on development of advanced cancer: A secondary analysis of the VITAL randomized clinical trial. JAMA Netw Open 2020;3:e2025850. doi: 10.1001/jamanetworkopen. 2020.25850.
  99. Timerman D, McEnery-Stonelake M, Joyce CJ, Nambudiri VE, Hodi FS, Claus EB, et al. Vitamin D deficiency is associated with a worse prognosis in metastatic melanoma. Oncotarget 2016;8:6873-82.
  100. Manson JE, Cook NR, Lee IM, Christen W, Bassuk SS, Mora S, et al. Vitamin D supplements and prevention of cancer and cardiovascular disease. N Engl J Med 2019;380:33-44.
  101. Schall JI, Hediger ML, Zemel BS, Rutstein RM, Stallings VA. Comprehensive safety monitoring of 12-month daily 7000-IU vitamin D3 supplementation in human immunodeficiency virus- infected children and young adults. JPEN J Parenter Enteral Nutr 2016;40:1057-63.
  102. Alvarez N, Aguilar-Jimenez W, Rugeles MT. The potential protective role of vitamin D supplementation on HIV-1 infection. Front Immunol 2019;10:2291. doi: 10.3389/fimmu.2019.02291.
  103. Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ 2017;356:i6583. doi: 10.1136/bmj. i6583.
  104. Harinarayan CV. How to treat Vitamin D deficiency in sun-drenched India-guidelines. J Clin Sci Res 2018;7:131-40.

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