Vitamin D in Health and Disease in Adolescents: When to Screen, Whom to Treat, and How to Treat.

Vitamin D in Health and Disease in Adolescents: When to Screen, Whom to Treat, and How to Treat. Adolesc Med State Art Rev. 2016;27(1):125-39 Authors: Golden NH, Carey DE Abstract The existing guidelines on screening and treatment are confusing because different guidelines target different populations. The IOM and AAP guidelines target generally healthy populations, whereas the Endocrine Society and other subspecialty guidelines target individuals with specific medical conditions associated with increased bone fragility. These distinctions have not always been well articulated. For healthy adolescents, the AAP does not recommend universal screening or screening of obese or dark-skinned individuals. Increased dietary intake of vitamin D is recommended, and vitamin D supplementation can be considered if the RDA cannot be met. For adolescents with chronic medical illnesses associated with increased fracture risk, screening for vitamin D deficiency should be performed by obtaining a serum 25-OHD level. Those found to be deficient (25-OHD level < 20 ng/mL) should be treated with doses of vitamin D2 or vitamin D3 higher than the daily requirement (as discussed in the section on vitamin D and chronic disease), followed by a maintenance dose. A repeat 25-OHD level should be obtained after the therapeutic course is completed. Some experts advocate for achievement of 25-OHD levels greater than 30 ng/mL in conditions associated with increase...
Source: Adolescent Medicine: State of the Art Reviews - Category: Pediatrics Tags: Adolesc Med State Art Rev Source Type: research