Estonia’s new vitamin D guidelines challenge routine testing and supplements

New guidance on vitamin D use has sparked discussions among health professionals in Estonia. While supplements remain common, experts now advise against routine testing for most adults. The updated recommendations also clarify who should take extra vitamin D—and who does not need it.

Endocrinologist Vallo Volke recently outlined that adults under 75 generally do not require regular vitamin D supplements or blood tests. The exception applies only if someone shows clear signs of deficiency or gets little sunlight and dietary vitamin D. For children, adolescents up to 18, pregnant women, and those at high risk of prediabetes, supplements are still recommended.

Testing for vitamin D levels has become more widespread, but the Health Insurance Fund discourages including it in standard blood work. Doctors may order the test only when medically justified, leaving the final decision to their judgement. Confusion persists over what counts as a sufficient level, with newer guidelines setting the threshold at 50 nmol/L, while some labs still use the older 75 nmol/L standard. For people aged 75 and older, taking additional vitamin D is advised, though routine blood checks remain unnecessary. However, the ideal dose and exact blood concentration for preventing disease have not been scientifically confirmed. The overall benefits and risks of extra vitamin D intake also stay unclear.

The latest advice aims to reduce unnecessary testing while targeting supplements to those most in need. Doctors will assess individual cases to decide whether a vitamin D test is required. For now, the focus remains on specific groups rather than blanket recommendations for the general population.