Vitamin D Supplementation and Physical Decline

[f1jim]

Yet another study showing various levels of vitamin D supplementation had no positive effect on physical function and actually INCREASED the rate of falls for those taking the vitamin D supplementation. Hasn't Dr. McDougall been saying this for a very long time? People supplementing were actually INCREASING their risks.

http://plus.mcmaster.ca/EvidenceUpdates ... leID=67647

f1jim

[veg tom]

I just orders a vitamin d lamp. It is to arrive today. Cant wait to see the results. Its feb 1st in Michigan and we have been without useable sun for a long time even if this winter has not been that bad. I don't want to supplement, I believe what Dr. MC said about supplements. Hard to justify $425 but you have to what you got to do to stay healthy.

[TerriNC]

Jim,

I can't get the link to come up, and would love to read the article.

Terri

[f1jim]

The link seems to have died. It's from the British Medical journal. I'll look for another link.
f1jim

[pundit999]

Is it this one, Jim?

http://plus.mcmaster.ca/EvidenceUpdates/QuickSearch.aspx?Page=1&ArticleID=65808#Data

BACKGROUND: Whether screening and treatment of vitamin D deficiency improves clinical outcomes in medical inpatients remains unclear. We performed a systematic search and summarized the evidence from observational and randomized, controlled studies (RCTs) on the influence of vitamin D deficiency and its treatment on patient outcomes.

METHODS: The MEDLINE and EMBASE databases were searched in January 2015 using the terms "vitamin D deficiency," "vitamin D," "mortality," "inpatient," "length of stay," "hospitalization," "accidental falls," "quality of life," "activities of daily living," and "intensive care units."

RESULTS: Of 239 potential studies, 29 observational studies and 5 RCTs were included. Observational studies revealed an association between vitamin D deficiency and adverse patient outcomes, such as mortality, higher incidence and severity of infections, and increased duration of hospital stay, in the inpatient and geriatric patient population. The RCT data, however, are inconclusive regarding beneficial effects of vitamin D supplementation for reduction of mortality and length of hospital stay, as well as fall prevention.

CONCLUSIONS: Despite evidence of associations in observational studies, high-quality evidence from interventional trials on the benefits of vitamin D supplementation in inpatients is currently lacking. On the basis of the available evidence, general vitamin D screening and supplementation for the medical inpatient population in an acute care setting cannot be recommended.

[f1jim]

Here is a working link:

http://www.ncbi.nlm.nih.gov/pubmed/26747333

f1jim

[BlueHeron]

I have had a cold for six weeks. I finally saw my doctor, and she said it was probably hanging on because I'm low in Vitamin D and that supplementation is essential for people who live in Michigan. She said that she had a patient whose job keeps him outside all day long, and he was still low in Vitamin D. I did some research and discovered that Vitamin D is essential for proper functioning of the immune system.

Here's a study showing that Vitamin D supplementation reduces respiratory tract infections:
http://www.ncbi.nlm.nih.gov/pubmed/26319134

Just because Vitamin D supplementation doesn't decrease falls doesn't mean it's not useful for some people. Let's not throw the baby out with the bathwater.

[f1jim]

"Just because Vitamin D supplementation doesn't decrease falls doesn't mean it's not useful for some people. Let's not throw the baby out with the bathwater."

The study I quoted, as are most studies, limited to their rather narrow topic. That's as it should be. But with Vitamin supplementation we have seen MANY studies that show negative effects. So if you take vitamin D as a prophylactic for upper respiratory infections you risk all the other side effects noted in the many other studies. What happens when we give supplements to people that have cancer? It shortens their lives. Vitamin D for upper respiratory infections? They get more dangerous falls.
Everything has tradeoffs. Sometimes tragic ones. It can be difficult to distinguish the baby from the bath water when deciding to supplement. As always, these supplements should be used when prescribed by a trained medical professional.
f1jim

[dynodan62]

Just because Vitamin D supplementation doesn't decrease falls doesn't mean it's not useful for some people. Let's not throw the baby out with the bathwater.

I suspect many wrong-headed parents have drowned their babies over the years in the effort to keep them fastidiously clean!

Much as with the mythical dietary values that just won't die ('good' protein, 'low' fat, etc.) people WILL believe whatever feels comfortable, and find/cherry-pick studies that support their conclusions. If the next study proves that those who take D supplements actually are shortening their lives, I bet many will STILL opt for fewer URIs.

[GeoffreyLevens]

About 12 or 15 years ago, can't remember, I tested quite low in D. After a lifetime of upper respiratory infections, at least one or two a year and flu every year or two, as soon as I supplemented to blood level in mid-"normal" range, all that stopped. The only time I have had one since (once) was when a poorly done test showed me as suddenly very high so I stopped taking it to let level normalize. At about 6 weeks no supp, about time it would take for blood level to fully adjust, I got a cold. Restarted the D and after 3 days cold was gone.

N=1 anecdote, yes. Coincidence? I doubt it.

[Jumpstart]

Most people outside our community don't need to supplement with vitamin D. It's added to milk and milk products like cheese. Many manufactured cereals have it added. And many types of fish and organ meat also contain vitamin D. We on the other hand are potentially short on vitamin D, especially in the northern climes. Of course many of the plant milks we buy and consume have vitamin D added in addition to calcium. So, even if you aren't taking a vitamin D supplement, you're probably consuming supplemented products.

[GeoffreyLevens]

Most people outside our community don't need to supplement with vitamin D.

All depends on who you believe. If you got by the blood test, many omni's are also deficient, even some who get a lot of sun!

http://www.ncbi.nlm.nih.gov/pubmed/17426097

AbstractSend to:
J Clin Endocrinol Metab. 2007 Jun;92(6):2130-5. Epub 2007 Apr 10.
Low vitamin D status despite abundant sun exposure.
Binkley N1, Novotny R, Krueger D, Kawahara T, Daida YG, Lensmeyer G, Hollis BW, Drezner MK.
Author information
Abstract
CONTEXT:
Lack of sun exposure is widely accepted as the primary cause of epidemic low vitamin D status worldwide. However, some individuals with seemingly adequate UV exposure have been reported to have low serum 25-hydroxyvitamin D [25(OH)D] concentration, results that might have been confounded by imprecision of the assays used.

OBJECTIVE:
The aim was to document the 25(OH)D status of healthy individuals with habitually high sun exposure.

SETTING:
This study was conducted in a convenience sample of adults in Honolulu, Hawaii (latitude 21 degrees ).

PARTICIPANTS:
The study population consisted of 93 adults (30 women and 63 men) with a mean (sem) age and body mass index of 24.0 yr (0.7) and 23.6 kg/m(2) (0.4), respectively. Their self-reported sun exposure was 28.9 (1.5) h/wk, yielding a calculated sun exposure index of 11.1 (0.7).

MAIN OUTCOME MEASURES:
Serum 25(OH)D concentration was measured using a precise HPLC assay. Low vitamin D status was defined as a circulating 25(OH)D concentration less than 30 ng/ml.

RESULTS:
Mean serum 25(OH)D concentration was 31.6 ng/ml. Using a cutpoint of 30 ng/ml, 51% of this population had low vitamin D status. The highest 25(OH)D concentration was 62 ng/ml.

CONCLUSIONS:
These data suggest that variable responsiveness to UVB radiation is evident among individuals, causing some to have low vitamin D status despite abundant sun exposure. In addition, because the maximal 25(OH)D concentration produced by natural UV exposure appears to be approximately 60 ng/ml, it seems prudent to use this value as an upper limit when prescribing vitamin D supplementation.

PMID: 17426097 [PubMed - indexed for MEDLINE]

[veg tom]

your liver and kidneys need to be function properly in order to process vitamin d properly. Something I just learned.

[Crider]

Here's a study showing that Vitamin D supplementation reduces respiratory tract infections:
http://www.ncbi.nlm.nih.gov/pubmed/26319134

Here's a paper on influenza and vitamin D:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870528/

From that article, "Recently, vitamin D has been found to modulate macrophages' response, preventing them from releasing too many inflammatory cytokines and chemokines. Vitamin D deficiency also impairs the ability of macrophages to mature, to produce macrophage-specific surface antigens, to produce the lysosomal enzyme acid phosphatase, and to secrete H2O2, a function integral to their antimicrobial function. The same authors found that the addition of 1,25(OH)2D increased expression of macrophage-specific surface antigens and the lysosomal enzyme acid phosphatase while stimulating their ‘oxidative burst’ function.

"Perhaps most importantly, three independent research groups have recently shown that 1,25(OH)2D dramatically stimulates genetic expression of antimicrobial peptides (AMP) in human monocytes, neutrophils, and other human cell lines."

Vitamin D affects so much more than bone health.

[f1jim]

I don't think anyone underestimates the importance of vitamin D to human health. Or really any of the macro or micro nutrients we need. There is an excellent argument, though, about the best way to get those nutrients. That might be the biggest story of all.
f1jim