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
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