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Updated perspectives on vitamin D deficiency, screening, supplementation and clinical guidance

Dina MA, Hanif A, Arshed A, Karamat A, Basit MS, Bhutta MA, Ehsan MO

Cardiovascular diabetology. Endocrinology reports, 2026

Abstract

Vitamin D functions like a hormone and plays a crucial role in regulating calcium levels and maintaining normal bone metabolism. A deficiency of vitamin D can lead to an increased risk of fractures, osteoporosis and osteomalacia that’s why research has linked vitamin D deficiency to various chronic diseases and certain types of cancer, thereby enhancing interest in its overall health implications. vitamin D deficiency is still prevalent among many populations. It is often found in older adults, individuals with chronic health conditions, those residing in care facilities and women who are either pregnant or nursing. There exists significant variability in clinical practices. Experts have differing opinions on who should undergo screening, what serum levels indicate sufficiency and the appropriate timing for initiating supplementation. This narrative review explores the key reservations that influence the diagnosis and management of vitamin D deficiency and current perspectives on screening, identifies high-risk populations that may benefit from testing and delineates circumstances in which empirical supplementation is a sensible and effective approach. Monitoring is beneficial and discusses how target levels correlate with bone health outcomes. A specific focus is directed towards the frequently cited 25(OH)D threshold of 30 ng/mL which is broadly linked to optimal bone health and underscores the synergistic significance of vitamin D and calcium in the management of…

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