Letters

Vitamin D deficiency

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7193.1284a (Published 08 May 1999) Cite this as: BMJ 1999;318:1284

Time for a tablet containing high doses of vitamin D alone

  1. C H Cheetham (lesley.martyn@wyclib.demon.co.uk), Consultant paediatrician
  1. Wycombe General Hospital, High Wycombe, Buckinghamshire HP11 2TT
  2. Metabolism Laboratory, St Vincents Hospital, Dublin 4, Republic of Ireland
  3. Kent and Canterbury Hospital, Canterbury CT1 3NG
  4. Department of Medicine, Addenbrooke's Hospital, Cambridge CB2 2QQ

    EDITOR—I was heartened to read Compston's editorial calling for action on vitamin D deficiency.1 Another point should be made to encourage a more active role by the health service.

    The British National Formulary does not include a tablet containing vitamin D alone in reasonable dose. Prescribers can give a calcium and vitamin D mixture, which may be unpalatable and therefore impair compliance. Alternatively, a vitamin capsule can be prescribed containing many other vitamins. If a dose greater than minimal daily requirements is needed higher doses of unnecessary vitamins must also be given. Surely it should be easy to prescribe 500-1000 units of vitamin D daily without any other addition?

    References

    Groups at risk need supplementation, and milk could be fortified

    1. Rosemarie Freaney, Principal biochemist,
    2. Malachi J McKenna, Consultant endocrinologist
    1. Wycombe General Hospital, High Wycombe, Buckinghamshire HP11 2TT
    2. Metabolism Laboratory, St Vincents Hospital, Dublin 4, Republic of Ireland
    3. Kent and Canterbury Hospital, Canterbury CT1 3NG
    4. Department of Medicine, Addenbrooke's Hospital, Cambridge CB2 2QQ

      EDITOR—We agree with Compston that the time has come for reappraisal of measures aimed at preventing vitamin D deficiency with consequent bone loss predisposing to osteoporotic fracture.1 The high prevalence of vitamin D deficiency and secondary hyperparathyroidism with high bone turnover emphasises this urgent need.

      The adequacy of current vitamin D intake recommendations is being questioned. The most sensitive yardstick for ascertaining the degree of hypovitaminosis D that predisposes to bone disease is secondary hyperparathyroidism. Vitamin D deficiency is known to occur even at a serum 25-hydroxyvitamin D concentration previously considered adequate—namely, 37.5 nmol/l. Over the past two years the threshold has …

      View Full Text

      Sign in

      Log in through your institution

      Free trial

      Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
      Sign up for a free trial

      Subscribe