TAM (Treatments and Medicines) NHS Highland
Vitamin D deficiency is highly prevalent in the Highlands
Those who show NO clinical signs of deficiency DO NOT need vitamin D testing, and should simply be advised on appropriate vitamin D supplementation as per NHS Inform advice.
- This advice includes people at higher risk of developing vitamin D deficiency e.g. pregnant, dark skin, limited sun exposure and explains which groups are eligible for free supplements and how to access these.
For those NOT at higher risk of deficiency:
- Vitamin D supplements can be purchased from community pharmacies, supermarkets or on-line.
For care home residents:
- Additional guidance is available from NHS Scotland and the Care Inspectorate: Vitamin D in care homes | Care Inspectorate Hub
Testing
- For those with clinical signs of deficiency, vitamin D status is currently best assessed by measurement of serum 25(OH)D.
- All requests for vitamin D are vetted by the NHS Highland Duty Biochemist team.
- NHS Highland blood sciences laboratory sends samples to NHS GG&C for this specialist analysis.
- NHS GG&C restricts vitamin D measurement to once every 340 days unless a specific clinical justification is given.
- Any vitamin D requests that do not follow this guideline should be discussed with the NHS Highland Duty Biochemist team in advance:
- via Clinical Dialogue, nhsh.dutybiochemisthighland@nhs.scot
- or 01463 705931
Testing is additionally allowed for the following patient groups:
- muscular dystrophy
- post hematopoietic cell transplantation and cellular therapy
- inflammatory bowel disease
- receiving total parental nutrition
- chronic pancreatitis
- cystic fibrosis
- post bariatric surgery (see: Bariatric surgery (Guidelines)
- other malabsorption syndrome (please state exact indication on request form)
For chronic kidney disease stages 4 and 5:
- Vitamin D measurement is not routinely recommended, but could be considered if eGFR <20, and clinically appropriate.