• Robert P Baughman and Ilias Papanikolaou.
• aDepartment of Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio, ISA bDepartment of Pulmonary Medicine, Corfu General Hospital, Corfu c2nd Pulmonary Department, ATTIKON University Hospital, Athens, Greece.
• Curr Opin Pulm Med. 2017 Sep 1; 23 (5): 476-481.

Purpose Of ReviewVitamin D supplementation is widespread used in the general population. In sarcoidosis, up to 50% of patients, especially postmenopausal women and those taking corticosteroids, show evidence of increased bone fragility. The purpose of this review is to provide an evidence-based rationale on how to treat sarcoidosis patients with bone health issues.Recent FindingsEvidence from observational studies show that decreased 25-hydroxy vitamin D is common in sarcoidosis. However, the great majority of sarcoidosis patents have normal or often elevated levels of 1,25-dihydroxy vitamin D (calcitriol), a marker associated with disease activity. High calcitriol levels may often be associated with hypercalcemia and hypercalcuria. The few interventional randomized controlled studies in the field, suggest that vitamin D supplementation may not be well tolerated because of hypercalcemia, moreover without substantial benefit on bone health and risk for fractures in these patients.SummaryVitamin D supplementation may be withheld in sarcoidosis patients with bone fragility, unless calcitriol levels are below normal limits. A treating scheme is proposed.

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