Treatment Plan
Treatment Plan
- Prevention: Sufficient sunlight
Supplementation 400 IU o Adults with Risk factors & if >65 regardless of risk factors – take daily o Adults with no risk factors – take in the autumn & winter months o 0-4 yrs old: aim for 400iu/day o <18 yrs old: aim for 400iu/day
- If only mildly low: sunlight exposure + diet
- Insufficiency: Advise maintenance drug treatment
- Deficiency: Needs Loading dose before Maintenance: 800-2000 IU daily
- Assess calcium supplementation: if <700mg/day, advise an increase in dietary intake.
If not successful, consider supplementation.
- Children:
400 IU daily until adulthood
Refer to paediatrics if rickets/osteomalacia is suspected.
- Contraindications to Vitamin D treatment:
Hypercalcaemia
Chronic liver disease
Severe renal disease
Malabsorption
Nephrocalcinosis
Metastatic calcification
- Medication timing:
Take bisphosphonates 2 hours before calcium supplements.
Take levothyroxine 4 hours before calcium supplements.