Technical Note: Unexpectedly Low Prevalence of Vitamin D Deficiency, but High Prevalence of Vitamin D Excess in the Older Adult Population at Our Large Academic Hospital: Should 25 Hydroxy Vitamin D Concentration Be Measured in all Elderly Patients?

OBJECTIVE: Most published reports in medical literature indicate vitamin D deficiency in older adult populations, indicating the need for vitamin D supplementation. However, vitamin D is a fat soluble vitamin and some toxicity may be encountered at a level exceeding 60 ng/mL. Therefore, both vitamin D deficiency and vitamin D excess have clinical consequences.

METHODS: We reviewed vitamin D status from the medical record of 528 patients aged 65 years and older where 25-hydroxy vitamin D test was ordered.

RESULTS: Only 66 patients (12.5%) demonstrated vitamin D deficiency (25-hydroxy vitamin D concentration <20 ng/mL) while 177 patients (33.5%) showed 25-hydroxy vitamin D concentrations above 50 ng/mL, but less than 60 ng/mL. In addition, 285 patients (53.9%) showed 25-hydroxy vitamin D concentrations above the recommended upper limit of 60 ng/mL.

CONCLUSIONS: In our older adult patient population, we unexpectedly observed that most patients showed elevated 25-hydroxy vitamin D concentrations. Therefore, screening is critical to avoid excess concentration of 25-hydroxy vitamin D in elderly patients.