An exponential increase in vitamin D testing and supplement use in recent years has raised justifiable concerns, experts say.
Writing in the MJA endocrinologist Paul Glendenningan from Royal Perth Hospital and Associate Professor Gerald Tse-Jiun Chew from the University of Western Australia note that between 2000 and 2010 Medicare figures showed a 94-fold increase in vitamin D testing.
Repeat testing accounted for nearly half the test numbers, despite only a 0.5-fold increase in bone mineral density testing over the same period, they said.
In the climate of rising costs and limited resources, it behoves clinicians to ensure that their requests for vitamin D measurement and their prescription of vitamin D supplements are evidence-based, they say.
“Current evidence suggests that the main beneficial effects of vitamin D supplementation relate to musculoskeletal, rather than extraskeletal health outcomes, with a subset of frail older patients with the highest likelihood of vitamin D deficiency being those most likely to benefit,” they write.
The results of ongoing trials such as the current Australian D-Health trial (http://dhealth.qimrberghofer.edu.au), will hopefully further clarify the role of vitamin D supplementation in the prevention and management of skeletal and non-skeletal disorders, including its effects on mortality risk, in various patient and individual subgroups, they add.