Which patient populations should be prioritized for vitamin D screening and supplementation?

Patients who should be prioritized for vitamin D screening and supplementation include:

• People with risk factors for vitamin D deficiency, such as those with very low sun exposure, including individuals who cover their skin for cultural reasons, are housebound, or confined indoors for long periods ¹.
• People with dark skin, such as those of African, African-Caribbean, or South Asian origin, due to reduced skin synthesis of vitamin D ¹.
• Pregnant and breastfeeding women, especially teenagers and young women, to ensure adequate vitamin D levels for maternal and fetal health ³.
• Children under 4 years of age, including infants who are breastfed and may need vitamin D drops from 1 month of age if the mother has not taken supplements ²,³.
• Individuals with conditions that predispose to hypercalcaemia, such as granulomatous disease, metastatic bone disease, some lymphomas, or primary hyperparathyroidism, where specialist advice is recommended before treatment ¹.
• People with gastrointestinal or malabsorption disorders resulting in inability to maintain adequate vitamin D status, who may require intensive high-dose treatment under specialist supervision ¹.
• Older adults over 65 years, particularly those with limited sun exposure or dietary intake ³.

Note: Routine testing is not recommended unless symptoms of deficiency or high risk are present ¹,²,³.