Vitamin D2026-05

Best Practice Recommendations for the Assessment, Prevention and Treatment of Vitamin D Deficiency in Türkiye: A 2026 Update in a Setting with Limited Mandatory Food Fortification.

Gogas Yavuz Dilek, Topaloğlu Ömercan, Güneş Mutlu, Gürlek Alper et al. — Nutrients

Summary

A group of medical experts in Türkiye developed updated guidelines for managing vitamin D deficiency, a common health issue in the country. These recommendations aim to standardize how vitamin D levels are assessed, who should be tested, and how deficiency should be prevented and treated. The guidelines provide clear thresholds for deficiency and suggest targeted approaches rather than widespread screening.

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Key points

Medical experts in Türkiye created new guidelines for managing vitamin D deficiency.
They defined specific vitamin D levels for deficiency and severe deficiency.
Routine population-wide screening for vitamin D is not recommended; instead, targeted testing for high-risk adults is advised.
Supplementation with cholecalciferol is recommended for certain high-risk groups, with individualized doses for some conditions.

What the study looked at

What question the study asked: This expert panel aimed to create up-to-date, country-specific guidelines for assessing, preventing, and treating vitamin D deficiency in adults in Türkiye, where food fortification is limited. The goal was to standardize clinical practices and ensure appropriate care. How it was studied: A national group of endocrinologists from across Türkiye developed these consensus recommendations. They used a structured "Delphi methodology," which involved systematically reviewing existing literature, gathering expert opinions through online surveys, and holding multiple rounds of discussions and a face-to-face meeting to reach a unified agreement on the best practices. What it found: The experts defined vitamin D deficiency as a blood level below 20 ng/mL and severe deficiency below 12 ng/mL, with a target range of 20-50 ng/mL. They recommended against routine population-wide screening, instead suggesting targeted testing for adults at high risk. For prevention and treatment, they advised supplementation with cholecalciferol for specific high-risk groups, with doses adjusted for individuals with conditions like obesity or malabsorption.

Dietary takeaway

While these guidelines are specific to Türkiye, they highlight the importance of maintaining adequate vitamin D levels, especially for individuals at higher risk. For general readers, this means considering dietary sources like fatty fish, fortified foods, and safe sun exposure, but also recognizing that some people may need targeted testing and supplementation. Remember, this is one set of expert recommendations, and personalized advice from a healthcare provider is always best.

Abstract

BACKGROUND: Vitamin D deficiency is a common global health problem and remains highly prevalent in Türkiye, where limited food fortification and heterogeneous clinical practices contribute to variability in testing and supplementation strategies. AIMS: To provide Türkiye-specific best practice recommendations for defining clinically relevant serum 25-hydroxyvitamin D [25(OH)D] thresholds, identifying adult risk groups for targeted testing, and recommending evidence-based prevention, treatment, and monitoring approaches while minimizing under-treatment and inappropriate high-dose use. METHODS: This national expert consensus document was developed by endocrinologists from across Türkiye using a structured, modified Delphi methodology. Draft statements informed by systematic literature reviews were rated via online surveys using a 9-point Likert scale, followed by two Delphi rounds and a face-to-face consensus meeting in İstanbul in October 2025. RESULTS: Recommendations addressed sun exposure, laboratory assessment, screening, supplementation, treatment, and follow-up. Serum 25(OH)D <20 ng/mL was defined as deficiency and <12 ng/mL as severe deficiency, with a target range of 20-50 ng/mL. Routine population-wide screening was not recommended; instead, targeted testing in high-risk adults and symptom-driven biochemical evaluation were endorsed. Empiric supplementation was recommended for selected high-risk groups, with cholecalciferol as the preferred agent. Higher individualized doses were suggested in obesity or malabsorption, while loading regimens were reserved for specific clinical indications, such as severe deficiency or certain medical conditions that impair vitamin D metabolism. Reassessment of 25(OH)D at 8-12 weeks was recommended. CONCLUSION: These consensus-based recommendations provide a practical, context-specific framework for assessing, preventing, treating, and monitoring vitamin D deficiency in adults in Türkiye.

View on PubMed →DOI: 10.3390/nu18111665