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Vitamin D Replacement — SCE Rheumatology MCQ

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ModerateMetabolic Bone DiseaseVitamin D ReplacementSCE Rheumatology

A 55-year-old woman with suspected vitamin D deficiency has a serum 25-hydroxyvitamin D of 18 nmol/L. According to current UK guidance what replacement regimen is recommended for deficiency?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — A divided loading course followed by maintenance vitamin D

Vitamin D deficiency (<25 nmol/L) requires a loading regimen before maintenance therapy. UK guidance recommends approximately 300000 IU total given as divided doses over 6-12 weeks (e.g. 50000 IU weekly for 6 weeks or 20000 IU twice weekly for 7 weeks). This is followed by lifelong maintenance of 800-2000 IU daily. Calcium supplementation should be added if dietary intake is inadequate. Checking 25-hydroxyvitamin D after loading confirms repletion. Patients on bisphosphonates must have vitamin D corrected before or alongside starting treatment to avoid hypocalcaemia.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions