Stop testing vitamin D in well adults

The edition in brief

The edition closes on an American Family Physician review of vitamin D in community-dwelling adults. Randomised trials, including in people with low baseline levels, show no reduction in mortality or cardiovascular disease, and no consistent benefit for falls, fractures, cancer, dementia, infections, depression, fatigue or pain. Daily intake of 600 IU up to age 70 and 800 IU above it prevents deficiency in nearly everyone; the one possible exception is prediabetes, where several years of higher-dose supplementation may slow progression. A BJGP diagnostic study in 601 men with lower urinary tract symptoms across 67 practices found a model built from symptom scores, a bladder diary, PSA, flow rate and post-void residual predicted bladder outlet obstruction well (c-index 0.82 in validation), but detrusor underactivity and overactivity less well. A BJGP analysis in Alberta associated high clinic continuity with lower acute care costs in people with chronic disease, largest in the most complex patients. A Chinese trial in 1404 adults found inactivated COVID-19, 23-valent pneumococcal and influenza vaccines could be given together with mostly non-inferior antibody responses and only mild extra local reactions. The pearl covers red flags in low back pain.