Referral criteria from primary care - adult vitamin D deficiency

• referral to a specialist if
  • a patient with vitamin D deficiency if there is no obvious cause, or,
  • if there is unexplained weight loss or anaemia or any other suggestion of coeliac disease or fat malabsorption, or,
  • if medication (e.g. antiepileptic drugs, rifampicin) might be the cause, or,
  • if the patient has hepatic or renal disease, or,
  • if there is any illness associated with undue sensitivity to vitamin D and so an increased risk of toxicity with treatment (e.g. sarcoidosis, tuberculosis, lymphoma, primary hyperparathyroidism, pregnancy)
  • also, symptomatic patients who have taken supplements as directed for about 2 months with no improvement clinically or in vitamin D status should be referred to a specialist

Reference:

1. Drug and Therapeutics Bulletin 2006; 44(4):26-9.