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GPs go forth

NICE calls for national campaign to promote daily vitamin D supplements

NICE has called for a nationwide public health campaign to make sure people at risk of vitamin D deficiency take a daily supplement, as recommended by the Department of Health.

In draft public health guidance launched today, NICE backed the DH advice by calling for GPs to recommend a daily vitamin D supplement to at-risk groups ‘at every available opportunity’.

However, GP leaders warned that while it was important to raise awareness about the risks of vitamin D deficiency, there should be more emphasis on getting people to take in enough vitamin D through their diet or from sun exposure rather than relying on daily supplements.

NICE said the new guidance is aimed at improving implementation of current recommendations on vitamin D to prevent deficiency, which advise supplements for infants and children aged under five, pregnant and breastfeeding women, older people, those with darker skin and those have limited sun exposure.

However, the NICE advisors said the DH needed to make sure vitamin D supplements are more widely available in the right strengths, and from pharmacies as well as on prescription.

And they called for greater consistency between the DH’s recommendations and those from NICE and the Scientific Advisory Committee on Nutrition, before the awareness campaign is started.

The guidance states: ‘Public Health England should lead development of a national campaign to raise awareness of the importance of vitamin D, as soon as existing recommendations on vitamin D have been clarified and made consistent.

‘The campaign should: emphasise the importance of vitamin D for good health, emphasise the importance of a daily supplement for identified at-risk groups [and] let people know where they can get vitamin D supplements.’

NICE said GPs should avoid vitamin D testing in people who do not have symptoms of deficiency – in line with National Osteoporosis Society guidance - and simply offer supplements to those from at-risk groups.

It said: ‘Health and social care professionals should recommend a daily vitamin D supplement to people from at-risk groups at every available opportunity.’

The guidance comes despite doubts being raised about the value of vitamin D supplementation even in some at-risk groups and concerns from some commissioners that widespread prescribing of vitamin D supplements is costly and unnecessary.

Dr John Grenville, chair of Derbyshire LMC, told Pulse he would prefer more emphasis on people getting vitamin D naturally, but would welcome the awareness campaign provided people were able to access the supplements easily.

Dr Grenville said: ‘I think we should be recommending sources of vitamin D as part of a healthy diet – as we should be for everybody. And I think as a society we should possibly be thinking about supplementing foods with vitamin D as we do with vitamin B, rather than treating it as a medical problem.’

He added: ‘I would welcome it provided we have the means to deal with it – people need to know where they can get the vitamins and we need to make that as effective and cost-effective as possible.

‘We certainly don’t want to make it only available on prescription, except in the cases with a definite vitamin D deficiency and related illness, because we have enough problems with access to prescribers anyway – be those doctors, nurses or other prescribers.’

NICE Public Health Draft Guidance - Vitamin D: implementation of existing guidance to prevent deficiency

Readers' comments (7)

  • It is not possible to get sufficient vitamin D3 through diet alone, and sunlight can only boost it for a period in the Summer. To optimise vitamin D3 levels, it is necessary to take a supplement. There are plenty available, and one helpful version is a spray under the tongue in a range of doses.

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  • Let common sense prevail

    Anonymous 8.23am
    Can you back up those statements with evidence?

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  • Vitamin D is not a drug its a food. Perhaps NICE should give guidance on the need to breathe.

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  • Sounds like a huge cost pressure for not much gain to me...Pts have managed for years without supplements and we don't want to create a culture of pts expecting vitamins etc on Rx....

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  • What needs to be clarified is what the expectation is in terms of prescribing vit D supplements. GP's are being told to recommend supplements and in my mind recommending is quite different to prescribing. There is much confusion and disparity as some GPs are prescribing £1000's worth of supplements while others ask them to buy OTC. So which is it please?!

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  • Tell them to buy it over the counter, it is cheaper than a prescription if using a DLux spray, with varying doses. Once level happy, recommend the 1000iu dose per day as maintenance.

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  • David, a great summary and overview of the subject is 'The Vitamin D revolution' by Dr Soram Khalsa.
    To achieve 2,000iu per day of D3 would require over 500g of salmon or mackerel every day..easier would be nearly 2 tablespoons of cod liver oil!

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