Pathology

 In summary PACEF Guidance is:

1. Vitamin D testing in asymptomatic patients, whether in at risk populations (defined below) or not, is not recommended

2. Vitamin D testing should not be a part of the TATT screening in patients not in the at risk categories, as it is unlikely to unmask true deficiency in patients not in the at risk categories highlighted below:

For information - the following are groups considered at increased risk:

 Anyone with dark skin.

 People who cover their skins for cultural, religious or reasons of personal preference

 People with skin photosensitivity (e.g., azathioprine, chlorpromazine) or history of skin cancer

 Pregnant women or those who have recently had children, particularly multiparous women with short intervals between pregnancies

 Housebound, institutionalised and certain older people.

 Chronic disease (liver, kidney, malabsorption including coeliac disease, short bowel).

 All babies, particularly those who have had prolonged breast feeding without supplementation. Family history of vitamin D deficiency. Vegetarian (or other non-fish eating) diet.

 Anticonvulsant, rifampicin, colestyramine, HAART, corticosteroid use.

 Obese – risk increases with increasing obesity.