I think this might fit in here. Claims about vitamin D3 seem to have reached faddish proportions. Several of my friends (remember I live in La-La Land) who are not skeptical and who don’t investigate such things, are now swearing by it. I can’t find anything on the Internet that explains the difference between Vitamin D3 and any other kind of vitamin D supplement. I’m hoping that McGyver might weigh in.
What is Vitamin D3? How does it differ from other kinds of Vitamin D? Is it superior in any way? Nobody seems to be explaining it.
These friends also claim that their doctors (not sure what kind of doctors) have checked the D levels in their blood and found them “very low” so they keep raising the dose. But I have heard that these blood tests are unreliable. Among people who live in Southern California who go outside during the day, I doubt that anyone here suffers from any kind of Vitamin D deficiency. I also understand that there is a new book by a “nutritionist” touting the magical qualities of Vitamin D3.
What’s the story?
This is a real pet peeve of mine. You are correct. Vit D has become the Vit B12 of the 21st century and its no just in La La Land. in the last century doctors often gave fatigued patients Vit B12 as the cure all for fatigue and many other ailments. We are a little more sophisticated today and no we know that B12 does nothing for a patient unless they have a documented B12 deficiency. Apparently we are not as sophisticated as I thought though. We have simply substituted one unscientific practice for another
First a little background:
Vitamin D is not truly a vitamin since humans are capable of producing it on their own. Vit D3 is the active molecule of Vit D and it is formed in the skin when exposed to UV rays. Vit D is a fat soluble vitamin which means the body is unable to get rid of extra Vit D if a someone takes too much. In large amounts it can be toxic to the liver. When measuring Vit D levels in the blood the recommended form to measure is 25 OH Vit D but because Vit D is fat soluble the amount found in solution in the water based serum is not always in equilibrium with the Vit D stored in the tissues. When this fad began and everyone came in asking for Vit D levels I relented and drew levels on the first 50 patients as a study of my own. It was done between June and August and out of 50 patients only one had “normal” levels. These were all perfectly healthy people. I quickly came to the conclusion that there was something very wrong with the way we were measuring and interpreting these tests.
Fatigue is one of the most common complaints that patients bring up to their doctors. Its also one of the hardest to treat since the vast majority of cases are do to life’s daily stress rather than any real medical issue. Patients don;t want to hear that though. They want to be told their is a real problem that can be cured with a pill.
In the past decade or so a number of population based retrospective studies have been done that showed a correlation between vitamin D intake and lower rates of cardiovascular disease and some cancers. Other studies also showed that a very large proportion of the population have levels of Vit D which are below the “normal” range. What should have happened at this point was that the medical and science communities would begin RCT’s to see which if any of these benefits were actually cause and effect and which were just correlations. Unfortunately we live in a world where the media is always craving the latest medical news and consumerism has entered the medical field so that doctors feel compelled to give patients what they want and also to appear that they are always on the cutting edge. As a result no one waited for the real studies to come out. Vit D quickly became the cure all for almost everything.
What do the real studies show? So far the small number of RCT’s that have been done have shown no benefits from Vit d supplementation for any of the conditions studied. There are absolutely no studies that demonstrate that measuring Vit D levels and supplementing them is either safe or beneficial for anything except a few conditions like rickets.
So where are we now? Across the country many doctors are measuring vitamin D levels and supplementing everyone who’s level is low despite a complete lack of evidence to support this practice. Patients love it though and many swear by it because the placebo effect is very strong especially in people who have vague subjective symptoms and especially if they continually read about the benefits of this treatment and see it on all the news programs and talk shows.
In my personal opinion this is all a fad created by preliminary studies, an overzealous and medically ignorant media, and physicians who feel an increasing need to compete in medical environment where consumerism is unfortunately influencing how physicians practice.
I’m not saying Vit D levels and supplementation is a bad thing. What I am saying is that no one knows. The doctors who are following this practice are practicing bad medicine and the patients who are caught up in this fad may find out 10 or 20 years from now that it was a waste of time and money or worse, they may find out there were harmful effects associated with this practice. Instead of jumping on the latest fad everyone should just take a step back and wait for the RCT’s even if it takes a decade or more.
Regarding Occams comment, The RDA for Vit D is 800-1,000 iu daily so if you are taking a supplement that is in that dosage range I have no evidence to say its harmful to do especially if you do not eat a lot of fish or other items high in Vit D. I would strongly advise against having your Vit D level checked though and certainly would avoid the 50,000iu doses I have seen some doctors giving their patients.