There is a rapidly expanding but not always consistent literature on the role of Vitamin D in health and disease. Clearly Vitamin D deficiency can cause Rickets in children and Osteomalacia in adults. The extraskeletal effects of Vitamin D are not as well understood, but there is an emerging body of experimental and clinical data that adequate Vitamin D stores in the body can help prevent cancer, and help people with cancer get better. Many different types of cells in the body have enzymes that convert Vitamin D precursors to the active agent, 1.25 di-hydroxy Vitamin D. Against this background the United States Preventive Services Task Force has recently recommended against screening for Vitamin D deficiency in healthy adults, this despite the fact that a huge percentage of adults have low D levels and with the widespread use of sunscreens this percentage is likely to increase. The article justifying their position can be read online in the recent Annals of Internal Medicine. Dr. Stark can send the full article; email him on the form on this page to request it. It will be available for a short period to the general public as well. An accompanying editorial is a scathing rebuke of these guidelines. Dr. Stark comments, ” There is an emerging body of literature on the beneficial effects of Vitamin D. Because these studies are not absolutely definitive, the USPSTF has elected to go against current conventional wisdom — to measure Vitamin D levels in adults. I view this as regressive borderline on disastrous. It will give cover to insurance companies to deny reimbursement for commonly performed blood tests that measure D levels. This is the latest in a series of missteps brought to you by the USPSTF.”
Update 2020: despite the above considerations, in 2018 the USPSTF again refused to endorse monitoring vitamin D status saying the data were insufficient to support this approach. Dr. Stark’s comments are unchanged.