Medical Panel: Don't Go Overboard On Vitamin D

[LaurenG]

November 30, 2010
The Institute of Medicine is throwing cold water on the latest dietary supplement fad: big doses of vitamin D.

Humans make vitamin D when they are exposed to the sun. But many worry that clothing, indoor living and sunscreen are depriving most people from enough of the sunshine vitamin. It's also hard to get enough vitamin D from the diet, proponents say, despite fortification of milk and orange juice.

But the Institute's Food and Nutrition Board, which makes official recommendations on dietary intake, says advocates of high-dose vitamin D are going overboard.

After two years of study and debate, the panel says children and most adults need 600 international units of vitamin D a day. People over 70 need 800.

http://www.npr.org/2010/11/29/131668100/medical-panel-don-t-go-overboard-on-vitamin-d?sc=fb&cc=fp

[w8liftinglady]

1. Which is why vit d should be a routine blood test

I'm one of the lucky ones who's had to max out on it(level of only 14)
it blows...but I'm lucky,because i have a good doc and good insurance.

[LaurenG]

3. This is very interesting to me because I fall on the side of

a higher dose being better. I personally don't get enough even at their lower reccomendations though.

[w8liftinglady]

16. I have to take like 40,000 ut..X 8 weeks..will get it remeasured tomorrow

[MannyGoldstein]

2. These are the same folks who said we needed 400 IU a few years ago

Why do we believe they're right this time?

[LaurenG]

4. I don't know what to think. The MD's I work with will be interested in this though.

I think a wait and see attitude might be good.

[midnight]

5. Precisely.

[trotsky]

7. They're all fucking stupid!

What could people who have studied this kind of stuff for years possibly know?

:sarcasm:

Honestly, the anti-intellectual, anti-science hostility shown all across the political spectrum is just killing the human species right now.

[LaurenG]

13. No but no one agrees on dosage. The people I work for are having

better results with the higher dosage.
No one is stupid they just can't get consistant results so it's difficult to come to consensus.

[trotsky]

14. Sorry, you must have missed this:

:sarcasm:

[bemildred]

6. Another link from the same place:

---

Now, these were very big doses of the sunshine vitamin — 500,000 IU spread across ten days, once a year for four years. That's more than 600 times the daily dose of 700 to 800 that's been shown in earlier studies to decrease fracture risk by up to 25 percent.

Why, you might ask, would doctors even think about giving patients such huge vitamin doses?

As Dr. Bess Dawson-Hughes, a long-time bone researcher at Tufts University who wrote an editorial about the work in the same issue of JAMA, b]says it's quite common for doctors to kickstart their patients who are low on vitamin D with 50,000 IU twice a week for six to eight weeks.

http://www.npr.org/blogs/health/2010/05/12/126773143/huge-vitamin-d-doses-appear-to-hurt-more-than-help

[hedgehog]

8. I suspect that as this area receives more study , we'll be making

some surprising findings. For example, my daughter who is somewhere on the lupus-rheumatoid arthritis spectrum, was taking 4000 IOU a day. When her Vitamin D level was tested, she was only at 40 ng/ml. The recommended level is about 60 to 80, depending on the study. Given the connections between the immune system and Vitamin D, I couldn't begin to guess which came first, her lupus or low blood level. I have to believe there is some connection. This is only an anecdote, but suggests scientists have only scratched the surface here.

[bemildred]

9. From the OP:

"The new report says people's blood levels of vitamin D don't need to be higher than 20 nanograms per milliliter of blood. Leading proponents aim for a blood level of 30 or even 40."

Apparently there is no agreement on that either. Different premises, you get different results. I also see confusion between therapeutic use and prophylactic use, where presumably the criteria for utility ought to be different. Most of the "take lots of Vit D" folks are speaking prophylactically, hoping to prevent things, whereas the therapeutic people are speaking of treating diagnosed conditions.

[Celebration]

10. Definitely no consensus yet

But the people who spend their entire lives studying vitamin D have reached more of a consensus among themselves than the rest of the scientific community. Because they don't yet have the prospective controlled studies on disease prevention, the PTB are being dragged along slowly, kicking and screaming.

However, even lacking consensus on appropriate blood levels, one would think that both sides would want levels checked in patients. More information is always good. And there do appear to be a lot of differences among patients, with some needing a lot more vitamin D to maintain a particular blood level.

[bemildred]

11. I agree.

I am not a doctor, so I am not going to offer any advice to anyone, but I take Vit D in the 5-10K IU range a couple times a week. It's cheap and way below toxic levels and clear enough that it's good to have plenty.

One can argue that it is appropriate for TPTP to be somewhat cautious, they are raked over the coals when they recommend therapies that later turn out to have serious flaws.

[xynthee]

12. I was hoping someone would post this so I could get DUers' opinions.

I never know when to trust the so-called experts. IOM seems to be a pretty upstanding organization, though.

I've been taking about 4000 IUs a day for about six months, and haven't really noticed a difference, but I wonder if I'd notice a difference if I suddenly stopped taking it. I've read so many glowing anecdotes and so much research about vitamin D that I felt confident it was indeed a good idea to up my intake. Maybe I'll try 2000 IUs/day and see if I notice a difference.

The good news is that it's virtually impossible to harm oneself by taking too much Vitamin D (unless it is an absurd amount prescribed by a doctor in massive doses). Based on everything I've read, it appears that anything under 10,000 IUs/day is pretty safe. If anyone knows otherwise, please let us know.

article about harmfulness of megadoses for elderly women:

http://www.npr.org/blogs/health/2010/05/12/126773143/huge-vitamin-d-doses-appear-to-hurt-more-than-help

[RagAss]

15. I've been taking 7,500 IUs a day for almost a year...never felt better in my life !

[SheilaT]

17. Okay put me down in the

I don't take supplements or any medications and I'm the healthiest person I know category.

However, this article, and many others I've read about vitamin D never seems to give me what I consider basic information:

If you take a supplement (and it increases the level in your blood as well it should), how long does a given dose last? Heck, how quickly does it hit the bloodstream?

At what rate does a fair-skinned person (I'm in that category) actually produce Vitamin D in the presence of sunshine? How about a somewhat darker skinned person? And how about a very, very dark-skinned person?

What exactly is the connection between vitamin D and osteoporosis? What else might be going on here?

Anyway, far be it from me to tell someone that their experience in taking supplements and improved health is all in their imagination. Because I also think that there are often vast differences between people in all sorts of things, including whether or not any kind of supplement does good or harm. And THAT'S the variable we may never be able to pin down.

[laconicsax]

18. You're not supposed to ask questions. Someone might accuse you of being a pharma shill.

[SheilaT]

24. Gee, that's real insightful.

Not to mention helpful.

I don't see that just because I ask a few questions I'm a shill for big Pharma. Indeed, if it's true that most people don't need supplements, then isn't big pharma going to make less money?

[laconicsax]

26. You must not hang out here much.

Questioning the efficacy of supplements, suggesting they be regulated, or even suggesting that not everyone take them is rarely taken well.

I agree with your comment first comment BTW.

[Orrex]

19. What the hell am I supposed to do with this 80-pound sack of powdered Vitamin D?

I wasn't expecting that one to last me through December. Now what?!?

[laconicsax]

20. Sprinkle a half-teaspoon into your local water system.

Bingo! Super powerful homeopathic vit D treatment.

(1/2 tsp is just a recommendation based on how much will likely be lost before it makes it into the water system. If you can work out a lossless system, 1/4 tsp will be more than enough (maybe even too much) to do the job.)

[bemildred]

21. Compost it. nt

[snagglepuss]

22. Response from Vit D expert Dr William Grant

"The committee was constrained in the studies they could use in their evaluation. They could not use case-control studies in which serum vitamin D was measured at time of diagnosis and they could not consider ecological studies that used solar ultraviolet-B doses as the index of vitamin D production.

Many randomized controlled trials used too little vitamin D (400 IU/day) to find an effect. The health benefits of vitamin D extend to at least 100 types of disease, with the strongest evidence for many types of cancer (breast, colon, ovarian, pancreatic, prostate, and rectal), cardiovascular disease, diabetes types 1 and 2, respiratory infections such as type A influenza and pneumonia, other infections such as sepsis, autoimmune diseases such as multiple sclerosis. The level of 25-hydroxyvitamin D <25(OH)D> in the blood, which is measured in vitamin D tests, should be at least 40 ng/ml to 60 ng/ml for optimal health.

White Americans on average have 26 ng/ml, while African-Americans have 16 ng/ml due to their darker skin that reduces production of vitamin D from solar UVB. Raising serum vitamin 25(OH)D levels to 40 ng/ml could reduce mortality rates by 15% in the United States <3>, corresponding to a 2-year increase in life expectancy.

Amazingly, a government-sponsored panel could not bring itself to recommend the 1000 to 2000 IU/day or more of vitamin D required by most people to raise thjeir serum 25(OH)D levels to nearly optimal values in spite of all the past decades’ research that reported beneficial effects of >1,000 IU/day vitamin D.

Meanwhile, the FDA approves pharmaceutical drugs based on only one good randomized controlled trial without understanding the adverse effects as in the case of Vioxx. Those interested in vitamin D can search the web for more information on the health benefits of vitamin D as well as read information posted at www.vitamindcouncil.org.


http://www.vitamindcouncil.org/vitamin-d-announcements.shtml

[flamingdem]

23. The downside of too much D?

The article yesterday in the New York Times said that too much D could in fact lead to more easily fractured bones. Anyone know more about this?

[snagglepuss]

25. I have read extensively about osteoporosis and vit d. I am not a scientist

however I have never seen medical literature about Vit D3 (the preferred type of Vita D) weakening bones.(Too much Fosamax and other bisphosphanates weaken bones and there were articles about that recently in the news.) Vitamin D enables the body to absorb calcium which is why it so important. Much of the concern with high amounts of Vit D regards hypercalciumia which is too much calcium in the body and the issue with that is hardening the arteries. However according to Reinhold Vieth and other researchers this is rare.

Dr Reinhold Vieth,a professor at U of Toronto and a world recognized expert in Vit D and osteoporosis did a much quoted study about high doses of Vit D. He himself takes 10,000 IUs daily, the amount of Vitamin D a human would absorb if standing in sun all day, which is how humans evolved. The reason Caucasians are white is that as early humans moved north out of Africa skin pigmentation decreased to allow Vit D production in northern latitudes where there wasn't constant sunlight. His papers are online as well as videos of his lectures.

A couple of months ago I posted a Globe and Mail article about Vit D researchers at universities, all of whom are taking a minimum of 4000 IUs daily. A good site to get information is the Vitamin D council. Grassroots.org is also excellent, this organization is comprised of Vitamin D experts from universities and medical centres across North America, who have taken it apon themselves to educate the medical profession and the public about the importance of Vitamin D. They are alos making testing available so people can determine their levels which is critical.

[flamingdem]

28. Thanks for this interesting info

I want to know about all the experts, such a difference of opinion!

[tiptoe]

27. FNB comm SUPPRESSED reprts of 14 vit D experts. (Corp media consortium SUPPRESSED '08 exit polls)

...the FNB committee consulted with 14 vitamin D experts and — after reading these 14 different reports — the FNB decided to suppress their reports. Many of these 14 consultants are either famous vitamin D researchers, like Professor Robert Heaney at Creighton or, as in the case of Professor Walter Willett at Harvard, the single best-known nutritionist in the world. So, the FNB will not tell us what Professors Heaney and Willett thought of their new report? Why not?

Today, the Vitamin D Council directed our attorney to file a federal Freedom of Information (FOI) request to the IOM's FNB for the release of these 14 reports.
...

Full statement of Dr. John Jacob Cannell: 'Today, the Institute of Medicine's (IOM) Food and Nutrition Board (FNB) has failed millions...'