Vitamin D and Bone Health 2022: Is the Evidence Pendulum Switching Backward on Its Benefits?

Abstract

Abstract Objectives:  This concise article aims to (a) review the role of vitamin D in bone health, (b) discuss the consequences of vitamin D deficiency, (c) analyze the use of vitamin D to prevent and treat osteoporosis and (d) explore if the evidence pendulum is switching back on the beneficial effects of vitamin D. Materials and Methods:  A narrative nonsystematic review of the literature was done thematically to answer the questions stated in the objectives above. Results:  A literature review suggests that vitamin D deficiency can be a real clinical condition that warrants recognition and management, particularly in high-risk groups. The optimal vitamin D level is likely more than or equal to 50 nmol/L (20 ng/mL). The established consequences of vitamin D deficiency in adults include osteomalacia and osteoporosis. Moreover, whether vitamin D supplementation reduces falls and fractures in subjects with baseline vitamin D more than 50 nmol/L (20 ng/mL) is not confirmed. However, vitamin D supplementation is still needed for patients with osteoporosis and those at increased risk of vitamin D deficiency. Finally, there is no justification for measuring 25-hydroxyvitamin D in the general population. Conclusions:  For patients at increased risk for osteoporosis, those with vitamin D deficiency, or both, it remains reasonable to consider vitamin D supplementation (800–1,000 IU/d or more), consistent with recommendations of multiple societies.