In her own practice, Dr. Buckley generally tries to get patients into the 20- to 29-ng/mL range, while in African Americans and patients with known cardiovascular disease she aims for 15 ng/mL or slightly more, she said. She reserves expedited supplementation—50,000 IU weekly for 8 weeks—mainly for vitamin D–deficient elderly patients at high risk for fracture or fall. That's where there is supporting evidence of benefit. There is no evidence to support supplementation in young or middle-aged patients.
Like many others, Dr. Buckley eagerly awaits fresh guidance in the form of updated recommendations on vitamin D from the Institute of Medicine. That IOM report, due this spring, is expected to recommend an increase in the currently recommended supplemental 400 IU/day for 50- to 70-year-olds not getting sufficient vitamin D from the sun (see related article on p. 1). Her hope is the IOM will address the thorny issues of who should receive supplementation, and how fast it should be done.
Dr. Buckley reported having no relevant financial relationships.
The extra calcium absorption promoted by boosting vitamin D may be taken up by atherosclerotic plaque.
Source DR. BUCKLEY