Vitamin D

What is Vitamin D?

Vitamin D promotes calcium absorption and maintains calcium levels in the blood. Calcium is essential for normal mineralization of bones. Vitamin D has other roles in the body, including control of cell growth, control of nerves and muscles, and reduction of inflammation.

Where Does Vitamin D Come From?

Vitamin D is naturally present in very few foods. It can be produced when UV (ultraviolet) light from sunlight strikes the skin. Apart from taking supplements, this UV exposure is therefore necessary to derive the levels of vitamin D needed for strong bones.

Vitamin D Deficiency

People at risk of inadequate vitamin D include

  • dark-skinned individuals, as less UV radiation reached the deeper layers of the skin
  • people who cover their skin for religious reasons
  • people with little or no sun exposure - such as the elderly (especially the homebound or those in residential care); people with chronic illness; night-shift workers
  • people with osteoporosis, who often require vitamin D supplements

In Queensland, adequate vitamin D levels are usually obtained through incidental sun exposure. Only a few minutes a day are required. The use of sunscreen does not prevent adequate vitamin D synthesis.

Vitamin D Testing

As of November 1st 2014, Medicare requires specific patient criteria in order for certain pathology tests to be bulk billed. Vitamin D testing will be available to be bulk billed when the patient:

  • Has signs or symptoms of osteoporosis or osteomalacia
  • Has increased alkaline phosphatase and otherwise normal live function tests
  • Has hyperparathyroidism, hypo – or hypercalcaemia, or hypophosphataemia
  • Is suffering from malabsorption (for example the patient has cystic fibrosis, short bowel syndrome, inflammatory bowel disease or untreated coeliac disease or has had bariatric surgery)
  • Has deeply pigmented skin or chronic and severe lack of sun exposure for cultural, medical, occupational or residential reasons; or
  • Is taking medication known to decrease 25-OHD levels (for example anticonvulsants)
  • Has chronic renal failure or is a renal transplant recipient
  • Is less than 16 years of age and has signs or symptoms of rickets
  • Is an infant whose mother has established vitamin D deficiency
  • Is an exclusively breastfeed baby and has at least one other risk factor listed in this criteria
  • Has a sibling who is less than 16 years of age and has vitamin D deficiency. 1,25 Dihydroxyvitamin D will be available to be bulk billed:
  • If the request for the test is made by, or on the advice of, the specialist or consultant physician managing the treatment of the patient
  • The patient has hypercalcaemia and the request for the test is made by a general practitioner managing the treatment of the patient

Please be aware that if you don’t fulfil the guidelines above, a fee  may be charged by the pathology company.