Strength of Recommendation Taxonomy (SORT) Table
| Clinical Recommendation | Evidence Rating | Comments |
|---|---|---|
| Patients with COVID-19 infection demonstrate reduced morbidity, but not mortality, when supplemented with vitamin D. | B | Meta-analyses showing decreased severity of illness from COVID-19 infection with vitamin D supplementation.38–40 |
| Avoid vitamin D doses of 100 mcg (4000 IU) per day or higher as well as intermittent high dose regimens due to increased risk of falls in the elderly. | B | Several randomized controlled trials demonstrate that high dose regimens can increase the risk of falls.44–46 Based on a single RCT there is suggestion that the optimal dose may be 1600 to 3200IU daily.46 |
| In patients with vitamin D deficiency and fibromyalgia, supplement with vitamin D3 doses of 50000 international units weekly to improve pain. | B | Findings are generally consistent however, the included studies are lower quality clinical trials.63,64 |
| In patients with dementia, correct known hypovitaminosis D. | C | Based on expert consensus despite a lack of clear evidence of benefit.51,52 |
| For patients with symptomatic depression, supplement with vitamin D3 37.5 mcg daily to reduce depressive symptoms. | B | Two RCTs testing different doses of vitamin D in patients with clinically significant depressive symptoms showed consistent findings of improved symptoms.57,58 |
| For patients with prediabetes, supplement with vitamin D3 1000 IU per day or greater to reduce progression to T2DM | B | Meta-analysis results showing benefit in higher dose (>1000 IU) subgroup.70 Conflicting RCT results from recent study may be due to novel vitamin D formulation.71 |
| For pediatric and adult patients with persistent atopic dermatitis, consider supplementing with vitamin D3 25 to 50 mcg daily to reduce AD symptoms in addition to standard emollient care. | B | Based on meta-analyses, limited by small sample sizes, showing reductions in AD severity scoring measures with vitamin D supplementation of 25 to 50 mcg daily.75,76,81,82 |
| For pregnant patients with known hypovitaminosis D, supplement with vitamin D3 25 to 50mcg per day. Consider supplementing all pregnant patients with vitamin D3 25 to 50mcg per day. | B | Based on a meta-analysis demonstrating decreased fetal mortality and expert consensus despite lack of clear evidence of benefit for other pregnancy conditions.98,100 |
| For human milk-fed infants in the first year of life, supplement 10 mcg of vitamin D3 daily to prevent vitamin D deficiency and rickets | C | Based on consensus opinion, not substantiated by most recent Cochrane review.106,107 |
Abbreviation: RCT, randomized controlled trials; IU, International Units.