CLICK HERE for Buckinghamshire guidance on vitamin D and calcium supplements (including Calcium Intake Assessment Tool)

Vitamin D can be purchased over the counter and is not usually prescribed.

Women and children from families who are eligible for the Government’s Healthy Start scheme can get free vitamin supplements which include vitamin D, in the form of tablets for women and drops for children - see link at bottom of page.

Why can't I get a prescription for an over-the-counter medicine?

Initial blood test results (for adults with no history of osteoporosis):

• Vitamin D sufficiency >50: Considered to be adequate / sufficient. You can purchase vitamin D as a lifestyle choice if you wish. Suggested maintenance dose of vitamin D 400 IU (10 micrograms) daily.

• Vitamin D insufficiency 25-50: You can purchase vitamin D and use a dose of 800 IU (20 micrograms) daily either alone or with calcium, dependent upon calcium intake (you can check that you calcium intake is sufficient by completing the questionnaire in the Buckinghamshire guidance above). Please contact us after 6 months to arrange a re-test of your vitamin D levels.

• Vitamin D deficiency <25: We will send a prescription for an initial course of high dose vitamin D to your usual pharmacy. After you complete this, you can purchase vitamin D and use a dose of 800 IU (20 micrograms) daily either alone or with calcium, dependent upon calcium intake (you can check that you calcium intake is sufficient by completing the questionnaire in the Buckinghamshire guidance above). Please contact us after 3 months to arrange a re-test of your vitamin D levels.

*If your re-test shows that your vitamin D level is >50 and sufficient, the guidance suggests that you continue lifelong maintenance treatment with 400 IU (10 micrograms daily) and continue to follow dietary and lifestyle advice.

*If your re-test shows that your vitamin D levels remains <50 we will contact you with further guidance about treatment.

For patients diagnosed with osteoporosis the guidance is as follows:

• Dietary calcium intake: 800 to 1200 mg daily (see Buckinghamshire calcium tool at link above). If insufficient intake, add supplemental calcium so that the intake is 800 to 1200 mg daily.

• Sufficient dietary protein intake ideally from dairy products

• Vitamin D: 800 IU (20 micrograms) daily

• Advice on alcohol intake, smoking and weight bearing exercise can be found at The Royal Osteoporosis Society

What is Vitamin D and What Does it Do?

Vitamin D is a fat soluble vitamin and plays an important role in protecting your bones, both by helping your body absorb calcium and by supporting muscles needed to avoid falls. Children need vitamin D to build strong bones, and adults need it to keep their bones strong and healthy.

www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

What is Calcium and What Does it Do?

Every day, we lose calcium through our skin, nails, hair, sweat, urine and faeces. Our body cannot produce its own calcium. That’s why it’s important to get enough calcium from the food we eat. When we don’t get the calcium our body needs, it is taken from our bones. This imbalance causes bones to get weak and easier to break.

www.nhs.uk/conditions/vitamins-and-minerals/calcium/

The following groups of people are at risk of vitamin D deficiency:

• All pregnant and breastfeeding women, especially teenagers and young women.

• Infants and young children under 5 years of age.

• Older people aged 65 years and over.

• People who have low or no exposure to the sun, for example those who cover their skin for cultural reasons, who are housebound or confined indoors for long periods.

• People who have darker skin, for example people of African, African-Caribbean and South Asian origin, because their bodies are not able to make as much vitamin D.

All UK Health Departments recommend:

• All pregnant and breastfeeding women should take a daily supplement containing 10µg of vitamin D, to ensure the mother’s requirements for vitamin D are met and to build adequate fetal stores for early infancy.

• All infants and young children aged 6 months to 5 years should take a daily supplement containing vitamin D in the form of vitamin drops, to help them meet the requirement set for this age group of 7-8.5 micrograms of vitamin D per day. However, those infants who are fed infant formula will not need vitamin drops until they are receiving less than 500ml of infant formula a day, as these products are fortified with vitamin D. Breastfed infants may need to receive drops containing vitamin D from one month of age if their mother has not taken vitamin D supplements throughout pregnancy.

• People aged 65 years and over and people who are not exposed to much sun should also take a daily supplement containing 10 micrograms of vitamin D.

Are free vitamin D supplements available?

Women and children from families who are eligible for the Government’s Healthy Start scheme can get free vitamin supplements which include vitamin D, in the form of tablets for women and drops for children.

www.healthystart.nhs.uk/