Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It

https://www.nytimes.com/2018/08/18/business/vitamin-d-michael-holick.html

150 65 8 years ago

taeric• 8 years ago

The amount of faith in vitamin d is rather high. I'm not sure this reads nefariously yet, but it is hard not to think something is getting oversold when my doctor just assumes I need more of it. Didn't even test, just recommended.

So, color me shocked that we are finding that it is no panacea. Shocked.

jeffdavis2• 8 years ago

I think doctors recommend it because most people get less sun than our ancestors, and supplementing is cheap and low-risk.

Kind of like saying "eat more vegetables" without bothering to ask you about your diet first.

geomark2• 8 years ago

Or the doctor says you need to lose weight because your BMI is above healthy range, without even looking at you to see that you are extraordinarily fit with all muscle mass and little body fat.

amarsharma• 8 years ago

Vitamin D supplements cant be takes as “vegetables” as high dosage is toxic.

nosefrog2• 8 years ago

Supplementing vitamin D has had a large impact on my life. A couple years ago, I frequently felt lethargic and was always getting sick. I randomly got a blood test, and it said that everything was fine except my vitamin D levels, which were at 7 ng/ml (!!), when the recommendation is 20-30+ ng/ml. Within the first two weeks of supplementing vitamin D, my health went back to normal.

The same thing happened to one of my friends earlier this year. He started getting all sorts of weird diseases when he used to never get sick. After getting a blood test and learning his vitamin D levels were low, he started taking it and he hasn't gotten sick since.

So even if there is big money behind it, I think it's worth getting tested if you spend a lot of time indoors.

TACIXAT• 8 years ago

Yea, similar thing happened to me. Went in for a physical and was at a 10.5 for D. I didn't really realize I was in such a rut until it changed. I joke now that the way to know I'm depressed is when I drive slow and would be willing to buy a Prius. Vitamin D supplement totally flipped my mood, it was pretty amazing.

inertiatic2• 8 years ago

My experience after testing very deficient and megadosing D3 for a few months was that I noticed absolutely no change.

I will thus cut down on supplementation to avoid vascular calcification.

speakeron2• 8 years ago

I will thus cut down on supplementation to avoid vascular calcification.

Current good practice is to also supplement with vitamin K when taking D. This is to promote carboxylation of osteocalcin, so calcium is directed into bones rather than soft tissues[1].

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613455/

rapsey2• 8 years ago

You can get vitamin d light therapy lamps. Those are very effective

jehlakj2• 8 years ago

Don’t mean to sound like your mom but just walk outside for 10 minutes a day.

Numberwang• 8 years ago

Just take a normal dose..

baccheion2• 8 years ago

Calcification can usually be avoided by also taking magnesium and vitamin K. 5,000 IU D3 : 1,000 mcg+ MK-4 or 5,000 IU D3 : 200 mcg+ MK-7.

LinaLauneBaer2• 8 years ago

I always thought it takes months until Vitamin D supplements show their effect...

https://www.quora.com/How-long-does-it-take-for-a-vitamin-D-...

Broken_Hippo2• 8 years ago

Definitely not true.

Last winter, I wound up sick due to low vitamin D. We are talking "had to sit while making a simple dinner" sort of sick, headaches and backaches and so on. Now, stronger vitamin D pills are prescription here, lower-dose aren't. I got prescription pills to take for 90 days. I had a blood test after 1.5 to 2 months (earlier than initially thought, but the doctor was curious.

Not only were my vitamin D levels good, but I felt much better. Better than I had in months. I still take the lower dose pills to prevent such a thing. I have the choice to get sun during the summer - at least 15 minutes a day with sun on more than just my face. Alas, I find the temperatures too cold to do that all the time (I live in Norway, summers are chilly). On the other hand, my levels are still good (had them tested last month per doctor's orders).

Now, it might take a bit longer to actually repair damage done by low vitamin D, but as far as how I felt - it was much quicker.

hannob• 8 years ago

Not if you're talking about a placebo effect.

TheArcane2• 8 years ago

Wherever do you and your friend live?

nosefrog2• 8 years ago

California

tmaly• 8 years ago

My sister and I had the same issues. Doctor prescribed a large does of D3. I would say there is a certain percentage of the population that may have a true deficiency.

The original article seems to imply that the whole industry is just some sort of hype. I cannot say for certain how much of it is true given the author’s experience is not in the medical field

jeffdavis2• 8 years ago

The article makes the money sound evil, but I'm just not seeing the evil here. $1000/mo to a doctor? So what?

The treatment is probably a little ahead of the science, but the answer to that is better science.

It makes sense to me that people get less sun than before, and therefore have lower and less consistent vitamin D levels. It doesn't feel unnatural to me... I think of it more like a replacement of what we lose by staying indoors more.

nickserv• 8 years ago

There's the principle of neutrality and objectivity which is extremely important in science, especially when lives are at stake.

1000 a month may indeed not be a huge sum for a doctor, but it is not nothing, and one has to wonder what exactly is being bought here.

DanielGee• 8 years ago

Especially considering medicine has a long history of being co-opted by money.

There was a time when doctors were paid to push cigarettes by cigarette companies.

https://www.adweek.com/brand-marketing/throwback-thursday-wh...

And of course in recent times, pharma was able to convince doctors to push addictive painkillers to patients.

A healthy skepticism is a good thing in science.

lukestevens• 8 years ago

That’s just one of the sources of money:

”Yet Dr. Holick also has extensive financial ties to the pharmaceutical industry. He received nearly $163,000 from 2013 to 2017 from pharmaceutical companies for consulting and other services, according to Medicare’s Open Payments database, which tracks payments from drug and device manufacturers. The companies paying him included Sanofi-Aventis, which markets vitamin D supplements; Shire, which makes drugs for hormonal disorders that are given with vitamin D; Amgen, which makes an osteoporosis treatment; and Roche Diagnostics and Quidel Corporation, which both make vitamin D tests.”

and

”Dr. Holick’s ties to the tanning industry also have drawn scrutiny. Although Dr. Holick said he doesn’t advocate tanning, he has described tanning beds as a “recommended source” of vitamin D “when used in moderation.” Dr. Holick has acknowledged accepting research money from the UV Foundation — a nonprofit arm of the now-defunct Indoor Tanning Association — which gave $150,000 to Boston University from 2004 to 2006, earmarked for Dr. Holick’s research. The International Agency for Research on Cancer classified tanning beds as carcinogenic in 2009.”

bookofjoe2• 8 years ago

$1000/mo to a doctor? So what?

From OP:"In an interview, he said that working for Quest for four decades — he is currently paid $1,000 a month — hasn’t affected his medical advice."

Also from OP:"...Dr. Holick acknowledged he has worked as a consultant to Quest Diagnostics, which performs vitamin D tests, since 1979. Dr. Holick also has extensive financial ties to the pharmaceutical industry. He received nearly $163,000 from 2013 to 2017 from pharmaceutical companies for consulting and other services, according to Medicare’s Open Payments database, which tracks payments from drug and device manufacturers. The companies paying him included Sanofi-Aventis, which markets vitamin D supplements; Shire, which makes drugs for hormonal disorders that are given with vitamin D; Amgen, which makes an osteoporosis treatment; and Roche Diagnostics and Quidel Corporation, which both make vitamin D tests. The database includes only payments made since 2013, but Dr. Holick’s record of being compensated by drug companies started before that."

tchaffee2• 8 years ago

Just because something makes sense to you doesn't mean there is anything to it at all. Lots of things sounds like common sense and then end up having no basis in reality. We need studies and advice from doctors who have nothing to gain from whatever the answer might be.

com2kid• 8 years ago

Living in the Pacific Northwest, working an office job, it is quite possible to go 6 or 7 months and not have the sun touch your skin.

Taking a mid-winter break to someplace sunny gives a distinct feeling if physical wellness and energy.

Denying that vitamin D is important seems silly when people who are indoors so often feel remarkably better after spending even just a few hours outside in the sun.

anothergoogler• 8 years ago

I'm not convinced. Living in an oppressively sunny place, you'll notice the same salutary effect of a run of overcast weather.

trukterious• 8 years ago

I'm at 52 deg N and an enthusiastic convert to D3 supplementation.

Yet there are other factors which make going out into the sunshine pleasant. UV light causes nitric oxide to be released from the skin, relaxing the blood vessels. Also I think just seeing brightly lit outside objects and moving about feel good. It's a different world and 'a change is as good as a rest'.

https://www.youtube.com/watch?v=jURTHzLakoo

jaclaz• 8 years ago

Denying that vitamin D is important seems silly when people who are indoors so often feel remarkably better after spending even just a few hours outside in the sun.

The two things are not exactly the same, however.

If you feel better after a mid-winter break in a sunny place, maybe it is because the mid-winter break in a sunny place or a few hours outside do good, and you should do that.

Staying in a non-sunny environment indoors and taking vitamin D might (or might not) provide the same wellness.

I guess it is the same thing with meal substitutes, maybe (though I doubt it) we have arrived to a point where we could take a single pill or gulp a dose of some (possibly terribly tasting) high-tech mush containing all that is needed, but maybe sitting at a table, making a pause for half an hour, eating some good tasting food, sniffing its aroma, etc. are the things that actually do the good.

dictum• 8 years ago

I've had first-hand experience of something that's been discussed elsewhere: a lack of omega 3 fatty acids and vitamin D3 itself may be associated with heavy sunburns and sun allergy (itchy skin, runny nose etc right as you're out in the sun, and not caused by fragrances or cold air).

I'm not able to look up studies for this right now so I'm just going by my own experience and other anecdotal reports, but it's a kind of circular dependency that intrigues me.

actuator• 8 years ago

Another anecdotal account. I started practicing MMA and somehow in the first two month itself had minor fractures three times and not from doing something very dangerous. I was worried about my bone health, so I went to consult a doctor and he found my Vitamin D levels to be 9 IU. After supplementing for a few months the number shot up and I felt better overall(though this might have been just placebo effect).

peter_retief• 8 years ago

The treatment of Tuberculosis involves long courses of antibiotics and drug resistant TB is becoming common. Often what helps is time in the sun. (This doesn't always happen)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684962/

bookofjoe2• 8 years ago

I'm a board-certified physician (anesthesiology). I read the OP and all the comments here. I've followed the subject of vitamin D supplementation and whether it's generally effective or overused for over 40 years, and I'm still uncertain.

tchaffee2• 8 years ago

Thank you for saying something that far too many doctors, scientists, and my fellow programmers seem to have trouble with: I don't know. Your honesty is refreshing and we need to use those words far more often.

300bps• 8 years ago

I think with uncertainty some people may err on the side of “supplements can’t hurt” and start or continue to take them.

For another perspective, I get a yearly physical and about 15 years ago I was having elevated ALT/AST liver enzyme results in my blood test. This lasted two years in a row while my primary care physician ran a dozen tests including for hepatitis trying to figure out what was causing it. Everything came back negative. She asked me if I took a multi-vitamin and I said I did, a daily Centrum.

She told me to stop taking it. I have never had elevated liver enzymes in the 15 years since. She told me overdosing on some vitamins was causing live damage as my liver struggled to process them.

milesvp• 8 years ago

Piece of anecdata for you. I take 2000iu of d3 daily, and live in Seattle. I've found when I stop taking d3 it's highly correlated to feelings of depression. Once I realize what's going on, if I start taking it again usually the depression starts to lift within days.

Now that said, it's not clear to me that it's causitive, since usually when I stop taking my dose, it's because I've run out, and it's very possible my not having time or interest to get more means I may have already started down the depressed path, and I may already be recovering when I finally start taking care of myself.

In any event I don't seem to get the really dark depressions I got before taking d3 and I don't dare stop taking it intentionally. Even if it's largely placebo the cost and risk seem very small conpared to my perceived benefits.

bennyelv• 8 years ago

Alas, such anecdotes are not helpful to the question at hand. There's nothing wrong with taking placebo or the approach that you have as an individual, but you have to be aware that there's no way that you could ever know if there was a causative relationship without a double blind placebo controlled study... which is not something you can realistically do on yourself!

open-source-ux• 8 years ago

Official health guidelines in the UK recommended an average daily intake of 10 micrograms of vitamin D to protect bone and muscle health.

These recommendations are based on a scientific review of the available evidence on Vitamin D and health published in 2016:

Vitamin D and Health: Scientific Advisory Committee on Nutrition [PDF]: https://assets.publishing.service.gov.uk/government/uploads/...

The press release that accompanied the publication of the report states:

PHE (Public Health England) advises that in spring and summer, the majority of the population get enough vitamin D through sunlight on the skin and a healthy, balanced diet. During autumn and winter, everyone will need to rely on dietary sources of vitamin D. Since it is difficult for people to meet the 10 microgram recommendation from consuming foods naturally containing or fortified with vitamin D, people should consider taking a daily supplement containing 10 micrograms of vitamin D in autumn and winter.
People whose skin has little or no exposure to the sun, like those in institutions such as care homes, or who always cover their skin when outside, risk vitamin D deficiency and need to take a supplement throughout the year. Ethnic minority groups with dark skin, from African, Afro-Caribbean and South Asian backgrounds, may not get enough vitamin D from sunlight in the summer and therefore should consider taking a supplement all year round.

From: https://www.gov.uk/government/news/phe-publishes-new-advice-...

sunstone• 8 years ago

Anecdotally, vitamin D has worked to eliminate or strongly moderate gout amongst a group of aquaintances. Definitely worth a try if you suffer from this.

jehlakj2• 8 years ago

Why bother when there’s an easy alternative? I absolutely hate doctors when they see that you’re low on X, they advise you to take X supplement.

fma2• 8 years ago

I was tested for vitamins D two years ago and was found to be low. I was told to take an OTC supplement. That test was covered by Blue Cross Blue Shield insurance. I've taken some here and there.

This year, my wife and I got tested again...new insurance (Aetna) and it wasn't covered. We have different doctors, so to the point of the article, doctors are asking for the tests more now. My range is nornal. I don't feel a huge difference, but admittedly I did at first, but could be placebo effect.

So three gripes.

1)Not knowing a test isn't covered before a test is executed

2)Doctors performing test that may not be necessary (per the article)?

3) There is no medical consensus on what is 'nornal'...and the range ised by Quest borders what can be doable?!

Also, my dad who is on medicare got tested too, for the first time last year. He was low. He lives in South Florida and gets plenty of sun from being outdoors.

Sigh.

bproven2• 8 years ago

If you really want to get the test, you can do it yourself online (usingonline lab test sites) - at least in most states in the US - cost of the D3 blood test is only about $40 if you pay out of pocket. You basically buy the test and arrange a blood draw at a local Quest Diagnostics / LabCorp. The lab then sends you the results directly via email.

If you want you can then bring that to your doctor for guidance

fma2• 8 years ago

That's rather interesting. From Google, I guess you're referring to a site like directlabs.com or www.healthlabs.com?

The 'contract rated' for my test ($30?) was less than the pricing those sites are offering, but at least good to know for future if I want to do it outside the doctors visit.

zzzeek• 8 years ago

interesting this article doesn't mention any of the history of how virtually all milk bought in stores (in the US at least...) has vitamin D added to it as well.

joveian• 8 years ago

One thing I discovered recently is that the most common vitamin D test significantly undercounts D2, although there is another test that is more accurate in that case (I'm guessing it is also more expensive). Since D2 is added to a number of processed foods these days, many people who test low with the common test may not actually be low.

kateg5• 8 years ago

I had been experiencing joint pain for months and had a vitamin D test done which showed my levels at 11. After taking an 8 week treatment of superdoses, my joint pain was gone and D levels were in normal (25) range. Vitamin D is very important for people who work in offices all day and don’t get enough sunlight.

baccheion2• 8 years ago

Vitamin D is mainly problematic when low or insufficient, as is the case with many other nutrients. 40-60 ng/mL 25(OH)D is a commonly preferred range. It can have positive effects at higher serum levels (>70 ng/mL, with >90 ng/mL being even better) when trying to heal.

Anand_S• 8 years ago

My experience is that whenever I have tried to increase Vit D level above 30+ng/ml I have got severe iron deficiency anemia. High dose vit D depletes Vit A, bio available copper, iron and potassium. Some info on the dark side of Vit D. https://mindbodynetwork.com/article/the-darker-side-of-suppl...

Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It

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