Should vitamin D (Vitamin D) supplementation be stopped before surgery?

From the Guidelines

Vitamin D supplementation generally does not need to be stopped before surgery. Most patients can safely continue their regular vitamin D supplements right up until the day of surgery. Standard vitamin D doses (typically 600-2000 IU daily for adults) do not interfere with anesthesia, wound healing, or increase bleeding risk [ 1 ]. In fact, maintaining adequate vitamin D levels may be beneficial for immune function and tissue healing during the recovery period.

Key Considerations

• The general recommendation to continue vitamin D is based on its important role in calcium metabolism, immune function, and the lack of evidence showing any harmful effects during the perioperative period [ 1 ].
• If you're taking extremely high doses of vitamin D (above 10,000 IU daily) or have specific medical conditions like hypercalcemia, kidney stones, or certain parathyroid disorders, you should discuss this with your surgeon or anesthesiologist before surgery [ 1, 1 ].
• They may recommend temporarily adjusting your dosage.
• Always inform your surgical team about all supplements you're taking during your pre-operative assessment, as individual circumstances may vary.

Monitoring and Adjustment

• Serum 25-hydroxyvitamin D levels should be checked at regular intervals post-surgery, with levels of 75 nmol/L or greater considered sufficient [ 1 ].
• Consider the following frequency of monitoring of vitamin D levels: 3,6 and 12 months in the first year and at least annually thereafter [ 1 ].
• If vitamin D supplementation is adjusted, serum calcium and 25OHD levels should be rechecked [ 1 ].

From the Research

Stopping Vitamin D Before Surgery

There is no direct evidence to suggest that vitamin D supplementation should be stopped before surgery. However, the following points should be considered:

• The decision to stop vitamin D supplementation before surgery should be made on a case-by-case basis, taking into account the individual's overall health and the specific surgical procedure 2.
• Vitamin D deficiency has been associated with inferior surgical outcomes, particularly in orthopedic surgery 2.
• High-dose vitamin D supplementation can correct hypovitaminosis D prior to total knee arthroplasty, and a loading dose regimen of 50,000 IU weekly for 4 weeks followed by a maintenance dose of 2000 IU/d may be effective in correcting vitamin D deficiency 2.
• The safety of vitamin D supplementation has been established, with no significant adverse effects reported at doses up to 10,000 IU/d 3.
• The benefits of vitamin D supplementation, including the prevention of osteoporosis, secondary hyperparathyroidism, and some cancers, should be weighed against the potential risks of stopping supplementation before surgery 4, 5, 3.

Key Considerations

• The individual's vitamin D status should be assessed before surgery, and supplementation should be adjusted accordingly 2.
• The surgical team should be informed of the individual's vitamin D supplementation regimen to ensure safe perioperative management 2.
• Further research is needed to determine the optimal vitamin D supplementation regimen for surgical patients 4, 5, 2, 3.

Potential Risks of Stopping Vitamin D Supplementation

• Stopping vitamin D supplementation before surgery may lead to a decline in vitamin D levels, potentially increasing the risk of inferior surgical outcomes 2.
• Vitamin D deficiency has been associated with an increased risk of falls, fractures, and other musculoskeletal disorders, which may be particularly relevant in the perioperative period 4, 5.
• The potential risks of stopping vitamin D supplementation should be carefully considered and weighed against the potential benefits of continuing supplementation 4, 5, 2, 3.