Calgary vitamin D test numbers soar

Amid concerns of skyrocketing costs, several Calgary medical professionals are urging restraint on the part of their colleagues when it comes to vitamin D testing.

Alberta reviewing Ontario guideline changes

The growth in vitamin D lab testing in the Calgary area. ((Calgary Laboratory Services))

Amid concerns of skyrocketing costs, several Calgary medical professionals are urging restraint on the part of their colleagues when it comes to vitamin D testing.

The number of blood tests for vitamin D ordered by family doctors in the Calgary area has gone from fewer than 20,000 in 2007 to more than 160,000 in 2010.

Last year, roughly $2 million was spent on local vitamin D testing.

"I think there are too many vitamin measurements being done," said Dr. David Hanley, a leading expert on vitamin D and a professor in the Faculty of Medicine at the University of Calgary.

"A lot of the physicians are responding to demands from their patients to measure vitamin D, and it's hard to say 'no' to a lot of people."

The Ontario government recently restricted coverage for vitamin D testing, paying only when it pertains to someone with a specific medical problem that needs to be checked out. Other provinces, like Manitoba and Nova Scotia, have made similar moves.

In March 2010, a McGill University Health Centre study was released indicating an "epidemic" of vitamin D deficiency. In the same month, a Statistics Canada report suggested more than a million Canadians are facing potentially serious health problems because their vitamin D levels are too low.

It became a hot topic, even as a subsequent study suggested most North Americans are indeed receiving enough vitamin D.

Advocates of vitamin D believe it is important to human health, especially in more northerly climates such as Canada, where sunshine is often limited in winter.

Dr. Cathryn Kuzyk, a Calgary family physician, finds herself doing a lot of chatting with patients about vitamin D these days.

"A lot more patients nowadays are asking me about getting tested than ever before," said Kuzyk.

Leading vitamin D expert Dr. David Hanley said most people just need to be put on supplements, rather than having their vitamin levels monitored through blood tests. ((CBC))
She said she only sends a select few. But it seems many other family doctors aren't quite so discerning.

"I think it's extremely important when we see something like this happening, with the expenditure of one particular item in lab medicine going up, that we take a long hard look at it and find out is spending the money … giving us big bang for the buck?" she said.

"And it's quite clear in vitamin D testing, that the research is showing us that screening large percentages of the population is really not worth it. That really does not lead to better patient outcomes."

Kuzyk said some doctors might not be aware of the testing guidelines, which Hanley said are clear: only people who are vulnerable to vitamin D deficiency should be tested. This category includes some people with osteoporosis and people on medications that interfere with vitamin D absorption.

"My main concern is ... are these unnecessary tests? And I think a large number of them are," said Hanley.

Everyone else should simply be put on a vitamin D supplement, Hanley said.

A spokesperson for Alberta Health said the ministry is reviewing Ontario's guidelines, but that no decision had yet been made to follow in that province's footsteps.