Address the Cause(s)
lack of sun
and inactive; diet lacking eggs/oily fish, obesity, malabsorption, renal and liver disease
Dietary Advice
healthy
eating eggs, meat, oily fish: wt loss if obese
fortified
foods margarine, some bfast cereals and soya milk
Supplement with appropriate amounts of
nutrient
Ca +vit D x
1-2/day for osteoporosis (x2/day if poor diet)
Vit. D 1000
iu (25 ug) OTC x 1-4/day for >3months
Severe deficiency or
renal disease parenteral or specialist supplements (see
NHS Direct and BNF)
Avoid cod liver
oil/vitamin A if osteoporosis
Consider need for other nutrients
Calcium if
low intake, young/old or osteoporosis +
extra vit D
Once main deficiency corrected
Re-measure
25OH D after 3-6 months
Target >50 nmol/l but >75 if
osteoporosis
Long-term oral vit D 1000
iu/day is safe and suitable for many