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Q. Just like there are different levels of eye doctors -- optometrist, ophthalmologist, eye surgeon, etc. -- what are the different kinds of allergy doctors, and which one would be considered the most knowledgeable?

A. Members of the specialty of Allergy/Immunology are physicians who are specifically trained to diagnose and treat patients who have asthma, allergic and immunologic diseases. Within the profession, there are certainly physicians with interest and expertise in specific areas of the field. If your allergist is certified by the American Board of Allergy and Immunology, you can be certain that he or she has completed a three-year residency program in internal medicine or pediatrics and an additional two or three years of study specifically in the field of allergy and immunology.

Q. Who should have vitamin D blood tests?

A. Presently, it is not recommended that all individuals have annual vitamin blood tests. However, it is appropriate for certain subsets of the population to have routine assessment of vitamin D levels. It is appropriate to determine vitamin D levels in the following individuals:Q: How often should vitamin D levels be checked? A: An annual baseline vitamin D level is considered to be appropriate for the above individuals. If the vitamin D level is low, then a vitamin D supplement should be started and the vitamin D level should be re-checked in 6 to 8 weeks. If the vitamin D blood level has risen to normal, then the vitamin D supplementation should be continued with annual or semi-annual assessment of vitamin D levels.Q: What is considered to be an optimal vitamin D level?A: The current parameters defining normal vitamin D levels are based on maintaining normal calcium-bone-phosphate homeostasis. There is no universal agreement on what vitamin D levels are ideal in all individuals in all age brackets. The most commonly accepted vitamin D level parameters used by most reference laboratories in the United States are those developed by the Endocrine Society. Whether these cut points represent vitamin D levels for optimal immunomodulatory, antimicrobial, and paracrine function is unknown at this time and is an area being intensively researched. The Endocrine Society has defined the following serum vitamin D-25-hydroxy parameters:References: