By Dr. Kenny Lin

First Posted at Common Sense Family Doctor on 5/18/2013

Kenny Lin, MD, The Common Sense Family Doctor
Kenny Lin, MD, The Common Sense Family Doctor

The U.S. Preventive Services Task Force recently announced its intent to review the evidence and issue recommendations about screening for vitamin D deficiency, after finding insufficient evidence to recommend routine supplementation for the prevention of fractures in adults. According to a 2009 review published in American Family Physician, up to half of U.S. adults 65 years and older have inadequate vitamin D levels, which places them at increased risk of falls and fractures. Two editorials in the April 15th issue of AFP debate the pros and cons of screening for vitamin D deficiency in asymptomatic persons.

Dr. Leigh Eck makes the case for targeted screening for vitamin D deficiency in at-risk populations, which include, but are not limited to, persons with malabsorption syndromes, persons with chronic kidney disease, pregnant and lactating women, and older persons with a history of falls. “Most of these factors put patients at risk of osteoporosis,” Dr. Eck argues. “Given the role of vitamin D in bone mineralization, patients who are at risk of or who have osteoporosis should be considered as candidates for vitamin D screening.”

On the other hand, Dr. Colin Kopes-Kerr identifies several problems with measurement of serum vitamin D levels in asymptomatic persons, regardless of risk level: lack of test standardization; disagreement about what constitutes a “normal” vitamin D level; unclear treatment implications; and uncertain cost-effectiveness. Finally, he points out, “No study has demonstrated that measurement of serum 25-hydroxyvitamin D levels offers outcome benefits over clinical assessment alone.”

The Endocrine Society recommends against population-based screening for vitamin D deficiency, and the American Society for Clinical Pathology included this screening test in its list of “Five Things Physicians and Patients Should Question” for the Choosing Wisely campaign.

Kenny Lin, MD, MPH
Host, Common Sense Family Doctor. Dr. Kenny Lin is a board-certified Family Physician and Public Health professional practicing in the Washington, DC area. He also Associate Deputy Editor of the journal American Family Physician and teach family and preventive medicine at the Georgetown University School of Medicine, Uniformed Services University of the Health Sciences, and the Johns Hopkins University Bloomberg School of Public Health.


  1. Hi Editors of,

    When browsing the internet I came across your article on “Vitamin D screening: few pros and cons” by Dr. Kenny Lin which was a very interesting and informative read. My friend has a vitamin D deficiency and was advised by her doctors to take some sort of vitamin D supplement. I’m actually thinking about starting it too, but thought it might be best to consult my doctor first. But I think I’ll read a bit more about it.

    Also I wanted to know if you are accepting guest posts on your site? I’d be very much interested to contribute a great piece I’m working on to your site. It’s about vitamins and supplements. I’d greatly appreciate if you would get in contact with me to discuss this further.

    Warm regards


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