I have long been skeptical of the current push by physicians to prescribe megadoses of vitamin D to their patients. Nearly everyone I see who has been to another physician has been told that they have vitamin D deficiency. It’s not uncommon to see people who are taking 5,000 to 10,000 IU of vitamin D daily and I’ve seen individuals who are taking prescription doses up to 100,000 IU twice a week in an attempt to achieve a "normal” level of vitamin D in their blood.
I’ve been encouraging people to take nutritional supplements for over two decades. I’ve been labeled a "quack” by the medical establishment for doing so. Perhaps that’s one of the reasons I’m shocked by its blind acceptance of the idea that prescribing absurdly high amounts of vitamin D to achieve blood levels that were arbitrarily set by a committee is sound medical practice. I believe it’s a hoax, an act intended to trick people into believing something that is false or even preposterous.
Two articles caught my eye this week. The first was Vitamin D-binding protein and vitamin D status of black Americans and white Americans N Engl J Med. 2013;369:1991-2000, 2047-2048. The article addressed what appears to be a paradox. Based on the current guidelines, which suggest a minimum vitamin D blood level of 20 or 30 ng/ml, up to 96% of black people are considered vitamin D–deficient. In spite of this, blacks tend to have a higher bone density, higher calcium levels, and slightly higher parathyroid hormone levels (all indicators of normal vitamin D activity) than whites.
The authors found that the form of vitamin D being reported in standard blood tests did not correlate with bioavailable vitamin D – the form actually available to perform the functions of vitamin D in the body. They concluded that more research is needed to fully appreciate what bioavailable versus total vitamin D status means for bone health but also for other aspects of vitamin D in health and disease.
The second was "The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis” Lancet Diabetes Endocrinol 2014. Published online January 24, 2014. This was an analysis of the current research regarding the benefits of vitamin D supplementation. The authors found that taking vitamin D does not lower the incidence of heart attack, stroke, cancer, or hip fracture. The only benefit from vitamin D was in reducing hip-fracture risk in elderly women living in residential care facilities. The effective dose was 800 IU/day. The lead author, Dr. Mark Bolland, concluded, "Until more information is available, it would be prudent to choose a cautious approach to vitamin D supplementation and to put more emphasis on the development of evidence-based cutoff points for vitamin D inadequacy."
If universal vitamin D deficiency is a hoax, who is perpetrating it and why? The pharmaceutical industry that stands to gain financially from the sale of prescriptive doses of vitamin D and the nutritional industry that stands to gain substantially from increased sales of over-the-counter vitamin D products.
What then, is the average person to do? Recognize that the body requires approximately 100 different vitamins and minerals to properly maintain itself on a daily basis. Yes, there are reports that low levels of vitamin D are associated with nearly every disease known to man, but that doesn’t mean that supplementing vitamin D will solve the problem. I am certain that low vitamin D levels are simply an indicator of deficiencies of all needed vitamins and minerals. I encourage vitamin D supplementation, but only at amounts up to 1,000 IU daily and only as part of a comprehensive formulation that provides all of the nutrients required to restore and maintain health. |