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Vitamin D screening?

  • 1.  Vitamin D screening?

    Posted 09-23-2020 11:36
    Hello everyone,

    Do you routinely screen all HIV patients for vitamin D deficiency or only those with specific risk factors? 

    Thank you all for your input! :)

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    Gina Tomkus
    San Diego CA
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  • 2.  RE: Vitamin D screening?

    Posted 09-23-2020 15:27
    Hi Gina,

    I don't routinely screen for vitamin d levels, because I haven't seen convincing evidence linking repletion with any beneficial outcomes. I do check it in patients with osteoporosis or osteopenia. I would love to hear what others are doing!

    Best,
    Lealah

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    Lealah Pollock
    University of California, San Francisco
    San Francisco CA
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  • 3.  RE: Vitamin D screening?

    Posted 09-23-2020 18:59

    I only screen patients with osteopenia.  We screen all of our patients at age 50 for bone density and if this is abnormal then get a vitamin D level.  If not normal; and it almost never is we supplement to correct this deficiency along with optimizing ART to minimize impact on bone density.  We also address any other risks for decreased bone density such as smoking and excess ETOH, poor calcium diet etc.  This in the majority of our patients improves bone density or at least stabilizes it.






  • 4.  RE: Vitamin D screening?

    Posted 03-28-2021 18:56
    I screen all of my patients annually for vitamin D deficiency, and/or if something funky is going on. It appears as though the entire world is deficient!

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    Amber Siegel
    Crew Health
    Carthage NY
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  • 5.  RE: Vitamin D screening?

    Posted 03-29-2021 21:18
    Yep! Same here, annually. Several recent studies have shown differences in cognitive and other conditions that appear to show high normal is the better end to keep it at.

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    Michael Roggelin MSN, APRN-FPA, AGNP-C, AAHIVS
    Chicago, IL
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  • 6.  RE: Vitamin D screening?

    Posted 03-29-2021 10:57
    Edited by Sean Leonard 03-29-2021 10:57
    I practice in Erie, PA.  We are significantly deficient in sunny days.

    As a result, a large percentage of my patients are deficient in Vitamin D.

    I check levels routinely on my patients. If less than 20, I provide Vitamin D3, 1000 units daily.

    If less than 10, I provide 8 weeks of Vitamin D2, 50,000 units 1 tab weekly, then follow with vitamin D3 1000 units daily afterwards.

    Some of my patients who had vitamin D-OH levels less than 10, did feel an improvement in fatigue when they were replenished.

    --Sean

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    Sean Leonard
    Meadville PA
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  • 7.  RE: Vitamin D screening?

    Posted 03-30-2021 15:10
    I screen all my patients, not just HIV patients, for vitamin D and prescribe supplements as needed. In Ohio, almost everyone is deficient unless they are taking multivitamins routinely. Although sun is a natural source of vitamin D, it is not surprising that some people are deficient in both winter and summer months. Most people work or stay indoors during the summer months.
    Vitamin D has many benefits hence it is important to have adequate levels.

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    Faith Richard
    Cleveland OH
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  • 8.  RE: Vitamin D screening?

    Posted 04-07-2021 13:10
    I also screen all of my patients. I would refer folks back to presentations given by Dr Brown at the Ryan White Clinical Conference (free on-line). He recommends initial replacement doses up to 400-800K units over several months if severely deficient followed by maintenance doses of 1-2000 depending on what's needed to maintain levels between 30-50. Remember however that higher levels can sometimes predisposed to nephrolithiasis, so you definitely need to follow-up.

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    Ann Khalsa
    Maricopa Integrated Health System
    Phoenix AZ
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