Here in Chesham it seems spring has finally arrived; the flowers are erupting, the birds are chirruping, and the weather is good enough to get outside (for me, that means a bike ride). Why is this important? It is a chance to top up on vitamin D of course.

Vitamin D is the most common nutritional deficiency in the world. Most vitamin D is obtained through exposure to sunlight. In the UK, there is not enough sunlight during the autumn and winter months to synthesise sufficient quantities, and it is difficult to get enough vitamin D through diet alone—Public Health England recommends that nearly everyone should consider taking a daily supplement during the winter months.

In this month’s top tips article Dr Toni Hazell distils the recommendations from a range of guidelines, and highlights the causes of and risk factors for vitamin D deficiency. Read this article to learn about how to distinguish deficiency from insufficiency, the role of over-the-counter supplements, and lifestyle advice for patients who are at risk of deficiency.

Vitamin D is not the only deficiency discussed in this month’s issue. Professor Geoff Hackett and Professor Mike Kirby discuss the updated BSSM guideline on testosterone deficiency, including the signs and symptoms, diagnosing the condition, and treatment thresholds for testosterone therapy. Use the multiple-choice questions (MCQs) in this issue to test your knowledge after reading the article.


Testosterone deficiency: treat men who have bothersome symptoms

Professor Geoff Hackett and Professor Mike Kirby

Also in the April issue:

Sarah Thomas, Fiona Chiu, and Cathy Kitney answer questions about the pharmacist-led #KnowYourDrops campaign designed to support patients with using eye drops. Read about how the initiative led to improved patient outcomes, better treatment compliance, and fewer hospital appointments.

Photo of contributors Cathy Kitney, Sarah Thomas, Fiona Chiu

Supporting patients with using eye drops

Sarah Thomas, Fiona Chiu, and Cathy Kitney

Chronic cough is the subject of our latest symptoms-focused article. Dr Jessica Garner explains a range of differential diagnoses of chronic cough using hypothetical case studies, and highlights features that can help distinguish one cause from another. Test your knowledge with the MCQs after reading the article.

Finally, in our View from the ground article, Dr Rachel Hooke speculates about charging for GP appointments—would it help patients to recognise the value of a professional opinion?

On the subject of spring and ‘new beginnings’, this is my first issue as Editor of Guidelines in Practice and I am delighted to be taking on the role. Having worked on Guidelines in Practice for 3 years already, I am excited to be getting more involved and helping to shape the content to best meet your needs. I have learnt a lot from Julia over the last few years—she will be a hard act to follow—and I look forward to continuing to work with her on developing new content. I am also very keen to hear your views about the journal and topics that you would like to see covered, so please do get in touch with any ideas or suggestions by emailing me at: