As vitamin D deficiency and insufficiency is prevalent in children and adults, routine screening of the general population is not recommended.[2]Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30.
https://academic.oup.com/jcem/article/96/7/1911/2833671
http://www.ncbi.nlm.nih.gov/pubmed/21646368?tool=bestpractice.com
[79]Munns CF, Shaw N, Kiely M, et al. Global consensus recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab. 2016 Feb;101(2):394-415.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880117
http://www.ncbi.nlm.nih.gov/pubmed/26745253?tool=bestpractice.com
[80]American Society for Clinical Pathology. Thirty five things physicians and patients should question. Choosing Wisely, an initiative of the ABIM Foundation. 2021 [internet publication].
https://web.archive.org/web/20230316185857/https://www.choosingwisely.org/societies/american-society-for-clinical-pathology
[81]American Academy of Pediatrics – Section on Endocrinology. Five things physicians and patients should question. Choosing Wisely, an initiative of the ABIM Foundation. 2022 [internet publication].
https://web.archive.org/web/20230326144421/https://www.choosingwisely.org/societies/american-academy-of-pediatrics-section-on-endocrinology
The US Preventive Services Task Force state that there is insufficient evidence to support screening in asymptomatic adults.[91]US Preventive Services Task Force, Krist AH, Davidson KW, et al. Screening for vitamin D deficiency in adults: US Preventive Services Task Force recommendation statement. JAMA. 2021 Apr 13;325(14):1436-42.
https://jamanetwork.com/journals/jama/fullarticle/2778487
http://www.ncbi.nlm.nih.gov/pubmed/33847711?tool=bestpractice.com
However, individuals at high-risk of vitamin D deficiency should be evaluated for vitamin D deficiency by measuring their level of serum 25-hydroxyvitamin D.[2]Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30.
https://academic.oup.com/jcem/article/96/7/1911/2833671
http://www.ncbi.nlm.nih.gov/pubmed/21646368?tool=bestpractice.com
Those at high-risk include: people with an inadequate dietary intake of vitamin D; infants receiving breast milk as their sole source of nutrition without vitamin D supplementation; those who are obese; people who have increased skin pigmentation, are institutionalized, are exposed to minimal sunlight, or always wear sun protection or protective clothing outdoors; people ages >50 years; those who have a malabsorption syndrome (celiac disease, cystic fibrosis, Crohn disease, Whipple disease, short bowel syndrome, or a history of gastric bypass surgery); those who take medications such as glucocorticoids, antiepileptic medications, highly active antiretroviral therapy, rifampin, or St John's wort; and those who have liver or kidney disease.