A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review, identified and prioritized 14 clinically relevant questions related to the use of vitamin D and 25(OH)D testing to lower the risk of disease. The panel prioritized randomized placebo-controlled trials on the effects of empiric vitamin D administration throughout the lifespan, as well as in select conditions (pregnancy and prediabetes). The GRADE methodology was used to assess the certainty of evidence and guide recommendations.
Based on this evidence, the panel suggested empiric vitamin D supplementation for children and adolescents (ages 1–18 years), adults older than 75 years, individuals who are pregnant, and those with high-risk prediabetes. The panel suggested against routine 25(OH)D testing in the absence of specific clinical indications.
These recommendations are intended to complement existing Dietary Reference Intakes for vitamin D, and they do not apply to individuals with established indications for treatment or testing. They reflect a shift toward practical, population-based strategies grounded in trial evidence.
