846 Vitamin D Debate

I look forward to this programme.

There is so much conflicting information (as usual!) about Vitamin D from it being a panacea to latter research that in some cases indicates it is not so powerful after all.

Some clarity on all this would be welcome!

People who live in warmer climates also have access to cheap fresh fruit.

my father 93 years old, at the end of a recent hospital stay in a cardiac unit was given a prescription of 50,000 units of Vit. D a day for 2 weeks. upon receiving the orders the 3 doctors when questioned by me about this dose said that the recommendation would help reverse the symptoms of dementia and depression, which had been increasing in the last year.

The results, if the Vitamin D was the cause, were phenominal and quick. He stopped repeating himself verbally; ended general confusion; gradually helped alleviate denial in his behavior and was able to continue caring for himself.

Aubrey - my concern is more about the doctor you're going to than the safety of your feet. Even our vet checks our animals for their Vitamin D levels.
The literature is replete with studies showing the undeniable need for adequate Vit D, and how our evolving world is causing it to be less available, and linked to more physical disease. Perhaps your doctor can read some of these. Just google the guests on today's show and you'll find a wealth of solid information.

This was an excellent show. So informative, AND an opportunity to join Dr. Manson's study! And two experts sharing information and views together! Many thanks for bringing this to us, and kudos to your producer.

I am part of the study that was apparently discussed during this program. Unfortunately, I tuned in at the end of the program, but I look forward to listening to it online as soon as it is available. I was randomly selected and volunteered for the study because I believe there is too little known about the effect of vitamin D on health.

The comment about listening to a single doctor is exactly the reason that we need a controlled study for useful and tested information. As well informed as we like to believe our doctors are, they are human and things change so rapidly that I don't expect my doc to have the most up to date information. There have been a few times during my annual check up that I was able to bring something to his attention that he checked on line and found was contrary to or different than he had believed, including on one occasion, a little known side effect of statins that I learned about on the People's Pharmacy. Everyone likes to think they or their physicians are the most informed, but we have to be realistic and understand how complex the practice of medicine is.

I am a practicing attorney who has defended the judgment of many types of professionals, including the occasional physician. I can tell you without a doubt that assumptions about what is best when it comes to the effects of the things we ingest is far from absolute, especially when you take into consideration the fact that the body chemistry of each of us is, in many ways, unique. Looking for a single hard and fast answer is a fool's errand - but getting as much information as possible is the best way for all of us to stay as healthy as possible.

That is why I think this is one of the best programs around. It doesn't purport to offer answers as much as stimulate discussion and consider all solutions.

Terry, Joe and your great staff - keep up the great work.

I very much enjoyed this show, and I tend to believe that Vitamin D is a lot more important than we've realized. I was struck by the news that so many of our cells have Vitamin D receptor sites.

I first became intrigued with this subject several years ago, when I saw a map depicting the prevalence (density) of various illnesses around the world. There is a clear correlation between illnesses like Multiple Sclerosis and Latitude. One of the highest rates in the world is in Scotland -- in Brazil, it's almost zero.

I agree that it's hard to separate out "red-herring" factors that make unrelated results seem to be causative. But the example given on your show of the 1915 Navy study was compelling: those officers who worked above deck were much healthier than those who worked below. (Even here, someone could argue that the happiness derived from seeing the water kept the "above-deck" Navy officers healthier. But at some point, one has to take notice of the preponderance of these kinds of indicators.

I do have one question, however, hearing this show: Your guest cited mushrooms as one of the foods that contain Vitamin D, but he qualified it by saying "mushrooms that have been exposed to solar radiation." I thought most, if not all, mushrooms for human consumption are grown in the dark! I've seen the long windowless warehouses in Pennsylvania where mushrooms are grown for the East Coast. And when I was a child, my mother used to coax my sister and me out of the basement and away from the TV by warning us that we would "turn into mushrooms" if we spent too much time in the basement!

How would we know if we are holding a package of mushrooms in the supermarket whether they had ever been exposed to the sun? I am certainly not brave enough to eat the ones that grow in my yard after a big rain! Thank you very much if you can clarify for your listeners on this point! best regards, and thank you for a wonderful program! julie

I heard Dr. Holick on your program with Dr. Dowd just about three years ago and I want to tell you it transformed my life--definitely for the better! Vitamin D has not been the answer to many of my problems, but it has enabled me to one by one eliminate those little "yada, yadas". It also turned me into a devoted listener. I look forward to today's show. Thank you.

I too, heard the initial program a few years ago and was struck by the story of a man who had a skin injury that would not heal, then after taking vitamin D (his levels were almost 0), the injury healed. I have a (thus far mild) case of NLD (Necrobiosis Lipoidica Diabeticorum) {I am not diabetic, but it's often associated with diabetes}

After self-medicating with D3 for about 4 months, I had my blood checked for Vit D. It was in the normal range. At that point I had been taking 6000 IU for 4 months. After about a week to two weeks I noticed a significant improvement in my NDL 'rash/bruise/yellowing/thickening'

NLD is considered to be an 'auto-immune disease', but is rare enough that it's not profitable to study it. I recently read there seems to be a link between Vit D levels and various auto-immune disease, but I would love to see one specifically on NLD and vit D.

Thank you for talking about a subject that many women aren't aware of, when we take to much Vit. D to bring up the Parathyroid number's can really hurt us. Many doctor's tell us our level are normal and sometime they are not.

Can you talk more about this in another show. Women like myself don't understand why doctor's don't know about the seriousness of thyroid and parathyroid issue and Vit.D?

Excellent show, liked how both doctor's gave an open honest view about Vit. D. What does one do if the calicum level in the urine is very high, and Vit. D is very low? I think we need to address younger women like 50 and up, many women like myself weren't told about the Vit. D issue until 9 years later.

Hope to hear about the study and will purchase the recording young women need to understand this very important health problem for women.

Annette, it's hardly just women with these concerns. A close relative of mine, male, developed parathyroid disease and had one of the parathyroid glands removed. Almost immediately, he felt tremendously better. However, he had developed osteoporosis as a result of the parathyroid problem. He was told that this is the ONLY kind of osteoporosis that is REVERSIBLE and through a rigorous regimen of calcium, Vitamin D3, Vitamin K and exercise, he has reversed it, but the damage that WAS done will remain, of course.

The interrelationship of Vitamin D, calcium, and the parathyroid is an amazingly powerful one, with such grave effects on the entire body when gone awry. I, too, wish there would be a People's Pharmacy program devoted to this subject, as not many people - and not even many doctors - know a lot about this. My friend and the surgeon who eventually did the surgery had to do a lot of educating with doctors who were supposedly top in their fields, including endocrinologists. It's a stunningly troubling area of medicine when one is suddenly made to realize the deficiencies in doctors' knowledge in this area. And SO many people refer only to the thyroid, which is totally different from the parathyroid! It gets very frustrating.

Please, do yourself a big favor and get a new doctor. Also start doing your own literature review. I'll bet your doctor has never had his/her vitamin D level checked.

Hi, I did listen to the show on Saturday, 2/11/12. Since about the 1970's, Vitamin D 50,000 IU's has been given once a week for 8 weeks to raise the blood levels to normal, whatever that is. The half-life varies and I saw one value at 2-3 weeks. It takes 5 half lives, or about 10 to 15 weeks to get the blood levels back down to 3 & 1/8%, very low.

There should be data around to determine what levels the people had from the 8 week course to use as a ball park number for a normal range, if there is one. Also, if you divide 50,000 IU's by 7 you get a little over 7000 IU's a day. This will give a lower blood level of Vit D than 50,00 IU once a week due to DME.

The 7000 IU/day may also be a limit number for Vit D dosing.? I guess the question really is: "do you need a 50 to 70ng/ml blood level or is 30 to 60 ng/ml blood level ok for a Vit D level and what is the correct mean dose to support that level? What do the numbers say? Paul C. G., RPh

I heard you today on the PBS station out of Portales New Mexico. I have been taking Vit A&D capsules 2caps tid for the past 17 years, started taking them for arthritis. When I moved here to Roswell 12 years ago I stopped for awhile and tried glucosamine/chondroitin. That did nothing for me. The total of vitamin D is 2400 ud per day. It has really helped me with the arthritis.

Since moving here I've had basal and squamous cell CA on my face removed several times. Am now having radiation for an area 6cm x 2cm on my right lower jaw. Do you think it possible that an increase of Vit. D would help? I am having 15 mor Tx. and if it does not clear this up will have to take medication. The amount of vit.D has never bothered me I am 82 years young.

My doctor put me on Vitamin D twice a day. My legs swell and are red and scaly. Can you tell me what the problem is?

An obvious question I would ask is if the drug companies are at the core of the push for Vitamin D they aren't very good business people as the cost for high dosage of the vitamin is pennies. Please check out the vitamin D council website. I have had many confident doctors who were sure of their information give me info that was contradicted by another confident doctor who was also sure of his different information. I for one do not chose to place a doctor on an unassailable pedestal, he or she is just a person who makes mistakes just like the rest of us.

Thank you.

Re my earlier post, the programme certainly brought clarity to this topic for me. I was also impressed that although the good doctors did not agree on everything, they conducted themselves in the "collegial" atmosphere Joe mentioned.

A good listen. Well done!

Aubrey: I would suggest you find a new doctor. Obviously he/she has not followed the research literature published over the past ten years. You might find it informative to do a GOOGLE search for vitamin D research restricting the response to “scholar” papers. Look for a doctor who personally has had a vitamin D test. That is a pretty good indication that they have read the materials.

Points to Ponder:
1. If my information is correct the half life of D2 is around 19 to 21 HOURS. The half life of D3 is between 19 and 21 DAYS. If that is correct it seems strange to be talking about a weekly dose of 50,000 IU without making a distinction between the effectiveness D2 and D3.
2. One comment mentioned taking vitamin A and vitamin D together for 17 years. Some literature suggests that certain forms of vitamin A block the uptake of vitamin D.
3. The IOM report appears to make no distinction in the incidence of vitamin D deficiency among the people living in Canada and those living in Florida. (On second thought a large percentage of the Canadian population spends the winter in Florida so maybe on average Canadians are no more deficient.)
4. Based on risk and reward I will gladly spend ten cents per day for my 6,000 IU/day in the winter and 4,000 IU/day in the summer in order to maintain 45 to 50 ng/mL. I know this is what it takes because I test every October and March.
5. I think I will skip the VITAL study. Every year the general acceptance of recommending the benefits of raising 25(OH)D to the optimum level is delayed the flow of billions of dollars running to the pharmaceutical companies keeps on running. See: "The Relationship of Vitamin D Deficiency to Health Care Costs in Veterans", Peiris, etal, Military Medicine, Dec. 2008. Forty percent of the veterans in the study group were vitamin D deficient and those in that deficient group required thirty-nine percent more health care in dollars annually than those above 20 ngr/mL. Good job IOM.

After many years of being complimented on how great my diet was and how high my hematocrit is boy was I surprised when my doctor ran some tests and found out my vit. D levels were very low! I am fairly active and spend a lot of time outside gardening, boating and camping. I also walk fairly regularly and take a good multivitamin. I think that I am proof that diet and exercise is very important but may not be enough especially as we get a little older. Nobody cares more about your health than you. Thanks for the information. It was great as usual! I love to be able to make educated, informed decisions.

Thank you, Robert--for articulating so well the reasons why I think The People's Pharmacy is such a valuable program.

The sun makes it crystal clear there is a limit to how much Vit. D one should be getting - sunburn. (Yes the sun delivers thousands of units, but ingestion is not the same as skin absorption. If we were supposed to ingest thousands of units, there would be foods that contained thousands of units.)

Our bodies also let us know. Compare the feeling of being out in the sun after a long winter, with the feeling at the end of the summer. In the spring you almost ache for sunshine. And what about "cabin fever"? It probably should be called Vit D fever.

Water is vital for our systems - yet you can kill yourself with too much at once. There is a sweet spot for everything.

I also have a pet hypothesis that exercise is important to properly absorbing Vit D. Love to see a study on that one.

I thought this was a good and well balanced presentation, but I was really surprised that the recent report in the Journal of Cardiology, (reported in this link in the New York Times Science section) wasn't discussed. They found negative changes above 21 ng/mL blood level of in a marker for cardiovascular inflammation; below what was suggested during the program.

http://www.nytimes.com/2012/01/17/health/research/risks-when-too-much-vitamin-d-is-too-much.html?_r=1&pagewanted=print

As a woman over 65, I wouldn't risk my life or health giving up Vit. D or Omega-3's; I have been deprived and misled for too long. But, not by Joe, Terry or Dr. Holick.

My personal experience with osteoporosis differs greatly from the IOM report. I began taking Fosamax and 600 iu of D. After a year my blood level of D was 23 and I was not gaining bone mass. I increased my D to more than 2,000 iu of D to get above my recommended blood level of 30 yet I was still not gaining bone mass. I then increased my D intake to get above 40 and began gaining bone mass.

I wonder about the 5 year study that is planned. I doubt it will have any value as you will not know the D blood level and will draw conclusions based on something you don't know. I now think the toxic D myth is to get funding for the 5 year flawed study. If anyone is serious about finding out how blood level D affects osteoporosis treatment they could use the VA database to follow the blood level D and bone density scans for osteoporosis patients. Then that wouldn't require an expensive study not using actual data.

In my opinion the IOM is in the business of generating grants for studies to investigate conjured perils. They ignore actual data to do a lucrative study where you won't know the blood level of any of the participants. I declined to participate in this study.

Richard, I am in the study and I have already submitted a blood sample through my doc's lab at no cost to me. I am only assuming that this sample is intended to measure the level of Vitamin D. We should at least try to get our facts straight before maligning institutions and doctors.

Program sounds very interesting. I too would like to know more. Thank you.