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Volume 353:1974-1975 November 3, 2005 Number 18
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Postmenopausal Osteoporosis

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by Rosen, C. J.
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To the Editor: In discussing vitamin D deficiency, Rosen (Aug. 11 issue)1 refers to a serum level of 25-hydroxyvitamin D below 15 ng per milliliter (37.4 nmol per liter). I believe that this level is too low. Studies have shown increases in serum parathyroid hormone levels2 and decreases in bone mineral density3 at approximately 20 ng per milliliter (50 nmol per liter) and below. In addition, levels below 20 ng per milliliter have been associated with decreases in intestinal calcium absorption and lower-extremity function. Therefore, vitamin D deficiency should be considered if the serum 25-hydroxyvitamin D level is below 20 . . . [Full Text of this Article]



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