I do not believe Vinay actually reads these comments. I have never seen an "author like" on any of them.
But the facts on Vitamin D need to be properly reported. A recent Australian study showed no positive effect on all cause mortality across many years of study, and in fact, potentially negative effects of Vitamin D in 60,000 adults…
I do not believe Vinay actually reads these comments. I have never seen an "author like" on any of them.
But the facts on Vitamin D need to be properly reported. A recent Australian study showed no positive effect on all cause mortality across many years of study, and in fact, potentially negative effects of Vitamin D in 60,000 adults over 60 randomly selected across the population. The negatives were an increase in cancer in the supplemented group. Although small, the authors conclude that since there is no impact of supplementation on all cause mortality, the precautionary principle militates against supplementing based on this. https://pubmed.ncbi.nlm.nih.gov/35026158/
A recent Finnish study of around 2500 people over 60 showed no impact of vitamin D on major cardiovascular events or cancer. https://doi.org/10.1093/ajcn/nqab419
There seems to be solid (but not RCT) information that those who do NOT have normal levels of vitamin D are more likely to get COVID (and who knows what else). The studies above indicate that most people in the study populations appear to have adequate vitamin D or else the supplemented groups would have looked better on all cause measures. Or perhaps the vitamin D effects are specific to Covid but not the entire range of infectious agents.
We should make sure that the elderly (who are those at substantial risk) have adequate vitamin D stores -- it is the least we can do. But as we look to advocate for interventions that work, it is wise to sell them appropriately...and not to oversell them.
https://pubmed.ncbi.nlm.nih.gov/35026158/ "In 4441 blood samples collected from randomly sampled participants (N=3943) during follow-up, mean serum 25-hydroxy-vitamin D concentrations were 77 (SD 25) in the placebo group and 115 (SD 30) nmol/L in the vitamin D group." 77 nmol/L = 30 ng/mL and 115 nmol/L = 46 ng/mL. They note supplementation was 60 000 IU vitamin D3 or placebo once a month.
The recommended level of D for seniors is 50-100 ng/mL. We are encouraged to dose daily with smaller doses. That study that noted little effect is likely right for a monthly dose except that's not what most people do.
Despite no RCT for how most of us use supplements, I understand the death rates were lower. And we are told some 40% of people are deficient in D. In the US the standard for that assessment is way lower than the > 50 ng/mL. And darker skins for obvious reasons really do need supplementation.
The government should have sent a bottle of 2000 units to every person on Medicare and told them one per day.
No question it was an odd dosing schedule. I am still surprised that there was NO impact on ACM. Pondering what (if anything that means).
I expect that the shut in elderly population, especially warehoused in nursing homes, are likely D-deficient. As you and others point out often, some decent RCTs in this area would be of great value.
But it is important that everyone speaking to these issues has an eye on all the data. RCTs always have useful data to impart -- even if that useful data is often buried in the actual data tables and obfuscated in the conclusions. So trying to keep everyone up to date...these are all from the last couple months.
I don't know why it happened that we were told an excess of D is a very bad thing. My look says it's nearly impossible to arrive at an excess. My osteo specialist was concerned when my level went to 110, said that was bad but didn't explain why given quite normal calcium levels. I did back off and am at a steady 70 or so given my osteoporosis (finally decided on Prolia).
Perhaps D levels ought to be a routine test in nearly all yearly wellness tests, except for some reason insurers seem reluctant to pay. "Since no trials". The risks of osteoporosis in seniors via fall consequences are at least like those risks of colon cancer for which we do screen at much greater cost. The long term costs of being in a wheelchair are quite large.
I do not believe Vinay actually reads these comments. I have never seen an "author like" on any of them.
But the facts on Vitamin D need to be properly reported. A recent Australian study showed no positive effect on all cause mortality across many years of study, and in fact, potentially negative effects of Vitamin D in 60,000 adults over 60 randomly selected across the population. The negatives were an increase in cancer in the supplemented group. Although small, the authors conclude that since there is no impact of supplementation on all cause mortality, the precautionary principle militates against supplementing based on this. https://pubmed.ncbi.nlm.nih.gov/35026158/
A recent Finnish study of around 2500 people over 60 showed no impact of vitamin D on major cardiovascular events or cancer. https://doi.org/10.1093/ajcn/nqab419
Yet another recent study of 25,000 Americans showed a 22% reduction in autoimmune disease in the supplemented group. https://www.bmj.com/content/376/bmj-2021-066452
There seems to be solid (but not RCT) information that those who do NOT have normal levels of vitamin D are more likely to get COVID (and who knows what else). The studies above indicate that most people in the study populations appear to have adequate vitamin D or else the supplemented groups would have looked better on all cause measures. Or perhaps the vitamin D effects are specific to Covid but not the entire range of infectious agents.
We should make sure that the elderly (who are those at substantial risk) have adequate vitamin D stores -- it is the least we can do. But as we look to advocate for interventions that work, it is wise to sell them appropriately...and not to oversell them.
https://pubmed.ncbi.nlm.nih.gov/35026158/ "In 4441 blood samples collected from randomly sampled participants (N=3943) during follow-up, mean serum 25-hydroxy-vitamin D concentrations were 77 (SD 25) in the placebo group and 115 (SD 30) nmol/L in the vitamin D group." 77 nmol/L = 30 ng/mL and 115 nmol/L = 46 ng/mL. They note supplementation was 60 000 IU vitamin D3 or placebo once a month.
The recommended level of D for seniors is 50-100 ng/mL. We are encouraged to dose daily with smaller doses. That study that noted little effect is likely right for a monthly dose except that's not what most people do.
Despite no RCT for how most of us use supplements, I understand the death rates were lower. And we are told some 40% of people are deficient in D. In the US the standard for that assessment is way lower than the > 50 ng/mL. And darker skins for obvious reasons really do need supplementation.
The government should have sent a bottle of 2000 units to every person on Medicare and told them one per day.
No question it was an odd dosing schedule. I am still surprised that there was NO impact on ACM. Pondering what (if anything that means).
I expect that the shut in elderly population, especially warehoused in nursing homes, are likely D-deficient. As you and others point out often, some decent RCTs in this area would be of great value.
But it is important that everyone speaking to these issues has an eye on all the data. RCTs always have useful data to impart -- even if that useful data is often buried in the actual data tables and obfuscated in the conclusions. So trying to keep everyone up to date...these are all from the last couple months.
I don't know why it happened that we were told an excess of D is a very bad thing. My look says it's nearly impossible to arrive at an excess. My osteo specialist was concerned when my level went to 110, said that was bad but didn't explain why given quite normal calcium levels. I did back off and am at a steady 70 or so given my osteoporosis (finally decided on Prolia).
Perhaps D levels ought to be a routine test in nearly all yearly wellness tests, except for some reason insurers seem reluctant to pay. "Since no trials". The risks of osteoporosis in seniors via fall consequences are at least like those risks of colon cancer for which we do screen at much greater cost. The long term costs of being in a wheelchair are quite large.