Which patient populations should be prioritized for vitamin D screenin

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Patients who should be prioritized for vitamin D screening and supplementation include:

People with risk factors for vitamin D deficiency, such as those with very low sun exposure, including individuals who cover their skin for cultural reasons, are housebound, or confined indoors for long periods .
People with dark skin, such as those of African, African-Caribbean, or South Asian origin, due to reduced skin synthesis of vitamin D .
Pregnant and breastfeeding women, especially teenagers and young women, to ensure adequate vitamin D levels for maternal and fetal health .
Children under 4 years of age, including infants who are breastfed and may need vitamin D drops from 1 month of age if the mother has not taken supplements ,.
Individuals with conditions that predispose to hypercalcaemia, such as granulomatous disease, metastatic bone disease, some lymphomas, or primary hyperparathyroidism, where specialist advice is recommended before treatment .
People with gastrointestinal or malabsorption disorders resulting in inability to maintain adequate vitamin D status, who may require intensive high-dose treatment under specialist supervision .
Older adults over 65 years, particularly those with limited sun exposure or dietary intake .

Note: Routine testing is not recommended unless symptoms of deficiency or high risk are present ,,.

Which patient populations should be prioritized for vitamin D screening and supplementation?