Can we depend on the values of vitamin d determination foe our clinical decision ?
Dear Dr Atoum,
I would say it can support our clinical decisions, especially when estimating the dose of vitamin d supplements. This might play a role if someone is at risk of developing osteoporosis. In this case, it makes sense to consider vitamin d supplements. Because it is important to avoid doses that are too high, it makes sense to measure vitamin d values in the course of the treatment. If they are either too low or too high, these values can be taken for dose adjustments. In this regard, I think vitamin d values / along with PTH values, can assist for our clinical decisions.
Take care,
Rainer Spiegel
We do take values in consideration. There are many studies that have shown beneficial effects of supplementation of VD. I have patients that believe VD changed their lives and other who don't seem to feel such difference. We do check PTH but we do it independently of VD. The dose varies based on the level and patient. All patients are treated on a individual basis with special emphasis given to pregnant and bariatric surgical patients and advanced renal pts . If there are other issues we investigate with other markers ( 125 etc).
Yes, particularly to adjust dose, since all will not be equilibrated with the recommended 800U/day.
Probably you mean the determination of 25hydroxy vitamin D3 (or the sum of 25OH D2 and 25 OH D3) .
It has been published that 25OH D3 is best correlated with the clinical outcome. Besides that, 25OH D3 was for many years the only vit D component that could be measured.
A discussion about what to be measured is given in a review of Hermann et al in Clin Chem Lab Med 2017; 55(1): 3–26
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