Joint guidance on vitamin D in the era of COVID-19

Joint guidance on vitamin D in the era of COVID-19 from the American Society for Bone and Mineral Research (ASBMR), Endocrine Society, American Association of Clinical Endocrinologists (AACE), European Calcified Tissue Society (ECTS), the National Osteoporosis Foundation (NOF), and the International Osteoporosis Foundation (IOF)

In response to the current COVID-19 global pandemic, and the attendant impact on outdoor physical activity and leisure time, the ASBMR, Endocrine Society, AACE, ECTS, NOF, and IOF remind individuals of the importance of obtaining the daily recommended dosage of vitamin D. The scientific evidence clearly supports the benefits that vitamin D, in combination with calcium intake, plays in building strong skeletons and preventing bone loss.

One of the best sources of vitamin D is through 15-30 minutes of direct sunlight exposure on your skin daily (taking care to avoid sunburn). As a result of the current global pandemic and particularly stay-at-home orders, individuals may be spending less time outdoors, resulting in fewer opportunities to obtain this important nutrient.

Vitamin D Guidance

• For those unable to spend at least 15-30 minutes with direct sun exposure each day, the easiest way to acquire vitamin D is through food supplemented with vitamin D and/or vitamin D nutritional supplements. Although some foods in the U.S. and elsewhere are fortified with vitamin D, the levels are often fairly low.
• Most adults 19 years and older should obtain between 400-1000 International Units (IUs) of vitamin D daily from food and/or with supplements (ideal intake depends on age and sex).
• To date, no clinical trials studying a potential effect of vitamin D supplementation on preventing COVID-19 disease have been completed. Although recent epidemiologic (observational) studies have suggested associations between low 25(OH)-vitamin D concentrations and higher rates of COVID-19 infection, these are likely related to ethnicity, age, and general health rather than a causal relationship.
• The current data do not provide any evidence that vitamin D supplementation will help prevent or treat COVID-19 infection; however, our guidance does not preclude further study of the potential effects of vitamin D on COVID-19. Research to date suggests that vitamin D may play a role in enhancing the immune response, and given prior work demonstrating a role for the activated form of vitamin D [1,25(OH)2D] in immune responses, further research into vitamin D supplementation in COVID-19 disease is warranted.
• Vitamin D is very safe when taken at reasonable dosages and is important for musculoskeletal health. Levels are likely to decline as individuals reduce outside activity (and so sun exposure) during the pandemic. Most older and younger adults can safely take 400-1000 IU daily to keep vitamin D levels within the optimal range as recommended by Institute of Medicine guidelines (1).

1. Institute of Medicine. 2011. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press. https://doi.org/10.17226/13050.

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