27 of 30
27
Whoa!  Lay Off the Vitamins!
Posted: 11 April 2014 06:37 PM   [ Ignore ]   [ # 391 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  3052
Joined  2011-11-04

My new PCP, after getting the results of my initial bloodwork, prescribed vitamin D.  No surprise, really, as I rarely get much sun.  What was a surprise was the prescription dose of 50,000 IU once per week.  When I expressed my surprise, he gave a little laugh, as if I were being naïve (I like the guy, and I don’t have a problem with him thinking me to be naïve in medical matters), and explained that we need to fill up the tank, and can then lower the dosage.  Notwithstanding his explanation, I looked up possible bad effects of high doses of Vit. D.  I found “hypercalcemia” to be a possibility that I really didn’t want, but also found that it is unlikely to occur unless one is taking even higher doses than my PCP had prescribed for me. 

Anyway, I will be finished with the prescription in about a month.  I can’t tell any obvious difference (good or bad) in how I feel from taking this high dose.  It was a generic prescription and my insurance paid for it, so I am not out any cash.

 Signature 

As a fabrication of our own consciousness, our assignations of meaning are no less “real”, but since humans and the fabrications of our consciousness are routinely fraught with error, it makes sense, to me, to, sometimes, question such fabrications.

Profile
 
 
Posted: 11 April 2014 06:47 PM   [ Ignore ]   [ # 392 ]
Moderator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7571
Joined  2007-03-02

That’s new information, but at the same time, you are involved with a dr about this, TimB.  Occam isn’t, as far as know from what he’s said.

 Signature 

Mriana
“Sometimes in order to see the light, you have to risk the dark.” ~ Iris Hineman (Lois Smith) The Minority Report

Profile
 
 
Posted: 12 April 2014 05:38 AM   [ Ignore ]   [ # 393 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2188
Joined  2007-04-26
TimB - 11 April 2014 06:37 PM

My new PCP, after getting the results of my initial bloodwork, prescribed vitamin D.  No surprise, really, as I rarely get much sun.  What was a surprise was the prescription dose of 50,000 IU once per week.  When I expressed my surprise, he gave a little laugh, as if I were being naïve (I like the guy, and I don’t have a problem with him thinking me to be naïve in medical matters), and explained that we need to fill up the tank, and can then lower the dosage.  Notwithstanding his explanation, I looked up possible bad effects of high doses of Vit. D.  I found “hypercalcemia” to be a possibility that I really didn’t want, but also found that it is unlikely to occur unless one is taking even higher doses than my PCP had prescribed for me. 

Anyway, I will be finished with the prescription in about a month.  I can’t tell any obvious difference (good or bad) in how I feel from taking this high dose.  It was a generic prescription and my insurance paid for it, so I am not out any cash.

I will reiterate what I have said previously, that I do not know your specific situation and can not advise you what to do. Taking 50,000 iu once a week for a month will most likley cause no harm but by the same token there is no evidence at all that it will do any good.

The practice of measuring and supplementing Vit D levels has become a popular fad over the past 5 years or so. I post on a medical forum and have challenged my colleagues on this practice repeatedly. It seems that a bit of herd mentality has taken over here. Doctors are doing it because other doctors are doing and also because patients are asking about it because they hear about it on TV and read about it in magazine articles.

There are absolutely no studies that support this approach and the physicians I have discussed this with on the medical forum all admit this but essentially rely on correlations demonstrated in population studies and the fact that so many others are doing it. They also say they are getting a lot of pressure from patients and don’t want to look like they aren’t up on the latest medical trends. As stated before there are population based studies showing a correlation between Vit D intake and lower rates of certain diseases but there are no studies supporting a causative role and absolutely none showing any benefit to measuring levels and then supplementing them into a somewhat arbitrarily determined normal range.

For what its worth I did my own informal study and ran Vit D levels on the first 50 or so patients who inquired about it. Only one person had normal Vit D levels. These were all perfectly healthy people who had no complaints. That statistic alone makes me suspect that there is something wrong with this whole approach.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 12 April 2014 06:26 AM   [ Ignore ]   [ # 394 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2602
Joined  2012-10-27
macgyver - 12 April 2014 05:38 AM
TimB - 11 April 2014 06:37 PM

My new PCP, after getting the results of my initial bloodwork, prescribed vitamin D.  No surprise, really, as I rarely get much sun.  What was a surprise was the prescription dose of 50,000 IU once per week.  When I expressed my surprise, he gave a little laugh, as if I were being naïve (I like the guy, and I don’t have a problem with him thinking me to be naïve in medical matters), and explained that we need to fill up the tank, and can then lower the dosage.  Notwithstanding his explanation, I looked up possible bad effects of high doses of Vit. D.  I found “hypercalcemia” to be a possibility that I really didn’t want, but also found that it is unlikely to occur unless one is taking even higher doses than my PCP had prescribed for me. 

Anyway, I will be finished with the prescription in about a month.  I can’t tell any obvious difference (good or bad) in how I feel from taking this high dose.  It was a generic prescription and my insurance paid for it, so I am not out any cash.

I will reiterate what I have said previously, that I do not know your specific situation and can not advise you what to do. Taking 50,000 iu once a week for a month will most likley cause no harm but by the same token there is no evidence at all that it will do any good.

The practice of measuring and supplementing Vit D levels has become a popular fad over the past 5 years or so. I post on a medical forum and have challenged my colleagues on this practice repeatedly. It seems that a bit of herd mentality has taken over here. Doctors are doing it because other doctors are doing and also because patients are asking about it because they hear about it on TV and read about it in magazine articles.

There are absolutely no studies that support this approach and the physicians I have discussed this with on the medical forum all admit this but essentially rely on correlations demonstrated in population studies and the fact that so many others are doing it. They also say they are getting a lot of pressure from patients and don’t want to look like they aren’t up on the latest medical trends. As stated before there are population based studies showing a correlation between Vit D intake and lower rates of certain diseases but there are no studies supporting a causative role and absolutely none showing any benefit to measuring levels and then supplementing them into a somewhat arbitrarily determined normal range.

For what its worth I did my own informal study and ran Vit D levels on the first 50 or so patients who inquired about it. Only one person had normal Vit D levels. These were all perfectly healthy people who had no complaints. That statistic alone makes me suspect that there is something wrong with this whole approach.

It’s too bad that more physicians don’t think these things through. They can be as blindsided as their patients. I’d be very skeptical of any doctor who accepts fads. It would make me wonder what else he or she is accepting blindly.

Lois

Profile
 
 
Posted: 12 April 2014 07:31 AM   [ Ignore ]   [ # 395 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  3052
Joined  2011-11-04

Well, I didn’t pressure my PCP to prescribe Vit. D.  As I said, I questioned it.  I did, OTOH, lobby for him to allow me to try fish oil for a few months to address my cholesterol (instead of immediately starting Lipitor or some equivalent).  He basically said that the fish oil would not help in a significant way, but went along with my wishes, for the time being, as I stressed my concerns about statins potential effects on the liver. 

So you would be skeptical of my PCP’s stance on Vit. D in my case, but I imagine that you would not be skeptical of his stance on the fish oil.

BTW, the vit D was a 3 month prescription.

 Signature 

As a fabrication of our own consciousness, our assignations of meaning are no less “real”, but since humans and the fabrications of our consciousness are routinely fraught with error, it makes sense, to me, to, sometimes, question such fabrications.

Profile
 
 
Posted: 12 April 2014 11:01 AM   [ Ignore ]   [ # 396 ]
Moderator
RankRankRankRankRankRankRankRankRankRank
Total Posts:  5551
Joined  2010-06-16

I try to keep up with biochemical and medical research publications, and I wish I had bothered saving the one a year or so ago that said that the recommended level of vitamin D for those over 80 was increased to 3,000 i.u. daily.  While I may kid around, here, I assure you that I base my supplement ingestion on published research.  Agreed that there often disagreements like the weird (to me) listing McKenzie quoted earlier, so I have to make my own choices based on the test data and reasoning in the articles.

It occurred to me that this topic is similar to those of politics and theology.  We all start out with our views, be it existence or nonexistence of a god, conservative or liberal, or pro or anti supplements, then in our reading we give greater value to those articles which agree with our beginning beliefs.  smile

Occam

[ Edited: 12 April 2014 11:08 AM by Occam. ]
 Signature 

Succinctness, clarity’s core.

Profile
 
 
Posted: 12 April 2014 11:14 AM   [ Ignore ]   [ # 397 ]
Moderator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  7571
Joined  2007-03-02
Occam. - 12 April 2014 11:01 AM

I try to keep up with biochemical and medical research publications, and I wish I had bothered saving the one a year or so ago that said that the recommended level of vitamin D for those over 80 was increased to 3,000 i.u. daily.  While I may kid around, here, I assure you that I base my supplement ingestion on published research.  Agreed that there often disagreements like the weird (to me) listing McKenzie quoted earlier, so I have to make my own choices based on the test data and reasoning in the articles.

It occurred to me that this topic is similar to those of politics and theology.  We all start out with our views, be it existence or nonexistence of a god, conservative or liberal, or pro or anti supplements, then in our reading we give greater value to those articles which agree with our beginning beliefs.  smile

Occam

I completely agree, Occam, both on reading as much research as we can on a topic of interest and then making our own informed decisions/choices, as well as our own preconceived views.

 Signature 

Mriana
“Sometimes in order to see the light, you have to risk the dark.” ~ Iris Hineman (Lois Smith) The Minority Report

Profile
 
 
Posted: 12 April 2014 11:58 AM   [ Ignore ]   [ # 398 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  3052
Joined  2011-11-04

Occam, if you’re 83, that’s good enough evidence for me, that you know how to take care of yourself.

 Signature 

As a fabrication of our own consciousness, our assignations of meaning are no less “real”, but since humans and the fabrications of our consciousness are routinely fraught with error, it makes sense, to me, to, sometimes, question such fabrications.

Profile
 
 
Posted: 12 April 2014 05:21 PM   [ Ignore ]   [ # 399 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4576
Joined  2008-08-14
macgyver - 09 April 2014 02:10 PM

Perhaps you will show me where the FDA says that supplements and vitamins are not a drug first.

From the FDA’s website, under the Q&A section in FDA/Food/Supplements.

What is a dietary supplement?
Congress defined the term “dietary supplement” in the Dietary Supplement Health and Education Act (DSHEA) of 1994. A dietary supplement is a product taken by mouth that contains a “dietary ingredient” intended to supplement the diet. The “dietary ingredients” in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites. Dietary supplements can also be extracts or concentrates, and may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or powders. They can also be in other forms, such as a bar, but if they are, information on their label must not represent the product as a conventional food or a sole item of a meal or diet. Whatever their form may be, DSHEA places dietary supplements in a special category under the general umbrella of “foods,” not drugs, and requires that every supplement be labeled a dietary supplement.

There you go Macgyver. The FDA considers them under the umbrella of foods-NOT drugs.  Who wouldn’t think that?
Drugs are things designed to cure illnesses, treat symptoms, and relieve people of ailments.
Foods are things people eat to supply their bodies with nutrients and calories and vitamins.

You and Mckenzie keep getting this mixed up.

 Signature 

Row row row your boat gently down the stream.  Merrily Merrily merrily merrily life is but a dream!

Profile
 
 
Posted: 12 April 2014 05:28 PM   [ Ignore ]   [ # 400 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4576
Joined  2008-08-14
mckenzievmd - 11 April 2014 01:50 PM

Vyazma,

What a totally childish response. You really don’t care about this issue at all do you? All you seem to care about is that no one tells you what to do.

I didn’t give you any advice, and I never asked you to take my word for anything. I simply posted the published reviews of the scientific evidence and offered my opinion on them. Why you need to have a tantrum every time I do is beyond me, but the evidence is here for anyone to look at and draw their own conclusions. They don’t need to take macgyver’s word for what it means, whether he’s an MD or not. They don’t need to believe my interpretation, whether or not I’m really an “Animal Doctor.” And they don’t need to blindly follow your opinion, whether you have a Nobel Prize or absolutely no medical education or credentials at all. See, aren’t we all nice and free to think and do as we please? So what’s the beef?

Well great McKenzie. What evidence did you show with that barely readable posting? That Vitamin D doesn’t cure cancer?

You said there was “evidence here for anyone to look at and draw their own conclusions.”  What evidence did you show?
Did that show that vitamin D supplementation is ineffective for providing vitamin D into the human body?
-then I suppose it won’t be long before the government stops requiring milk to be fortified with Vitamin D…Right?

Did that “evidence” you posted show that humans don’t need vitamin D?
Did it show that humans cannot get vitamin D from supplementation?

Go ahead I’ll stop there and see if you can handle these simple questions. 7 questions there…take as many or as few as you wish. I’ll wait.

 Signature 

Row row row your boat gently down the stream.  Merrily Merrily merrily merrily life is but a dream!

Profile
 
 
Posted: 12 April 2014 05:51 PM   [ Ignore ]   [ # 401 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4576
Joined  2008-08-14
macgyver - 09 April 2014 02:14 PM

I don’t have time to give you an education in vitamin D metabolism here nor is it relevant to the point. No one here said the human body doesn’t need vitamin D. What I said is that there is no current evidence that Vitamin D supplements are beneficial or necessary for most people to take. They could be helpful, harmful, or harmless. The fact is that no one knows at this point and anyone who says they do is misinformed.

So you don’t know why the body needs vitamin D then?

You’re saying the FACT is that no one knows whether vitamin D supplements introduce vitamin D into the human body for metabolization?
You just agreed that the human body needs vitamin D. But you are saying that no one knows whether a vitamin D supplement will physically
introduce vitamin D into the human body for use and metabolization?

Here we go again MacGeyver…here we go again.  Now you get to scramble around stumbling and fumbling as you try to beat around this bush.
Vitamins are food Macgeyver. Food!  Of course they are beneficial and necessary to take!
How could you possibly say that there is no evidence of this?

 Signature 

Row row row your boat gently down the stream.  Merrily Merrily merrily merrily life is but a dream!

Profile
 
 
Posted: 12 April 2014 06:12 PM   [ Ignore ]   [ # 402 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2188
Joined  2007-04-26

“Congress defined the term “dietary supplement” “

Consistent with what I told you earlier, the FDA didn’t define the term dietary supplement. A bunch of ill informed scientifically illiterate senators and congressmen led by Orin Hatch ( an even more scientifically illiterate senator) drafted that definition at the behest of the supplement industry in order to free themselves from FDA oversight.

Vitamins don;t suddenly become non-drugs simply because a group of politicians decide they aren’t drugs. the FDA did not agree with this decision and in fact lobbied against the legislation. As I said before, they are a governmental agency and are required to follow the law whether they agree with it or not once its been passed and signed into law. Congress shouldnt be legislating science for this very reason. They dont know what they are talking about or what they are doing when it comes to science.

I guess you didn’t read the earlier post where I addressed this (mentioned an ignorant senator who pushed through legislation in 1994).

[ Edited: 12 April 2014 06:39 PM by macgyver ]
 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 12 April 2014 06:35 PM   [ Ignore ]   [ # 403 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2188
Joined  2007-04-26
Occam. - 12 April 2014 11:01 AM

It occurred to me that this topic is similar to those of politics and theology.  We all start out with our views, be it existence or nonexistence of a god, conservative or liberal, or pro or anti supplements, then in our reading we give greater value to those articles which agree with our beginning beliefs.  smile

Occam

Occam as a scientist you should no better. As with all elements of science there can be areas of disagreement but in the end the data speaks for itself. The argument you are using here is the same one creationists, climate deniers, and anti-vaxers use to make it look like there are two equal sides to an argument when the data in fact comes down pretty conclusively on one side or the other. There may be some supplements and vitamins that have benefits under certain circumstances although most dont. There are many different supplements and many different claims about them. Some of these things have been decided on the same level as evolution in that there is a consensus that negates any real debate. Others may still be open for discussion, but to imply that evidence is so unclear that each of us might as well pick and choose which data we prefer to believe is like saying we can pick and choose the data concerning evolution and make decisions based on our personal biases. You can do that but not if your real interest is to find the truth.

When it comes to supplements and vitamins the logic here is pretty clear, although some on this forum fail to grasp it. Supplements and vitamins are not magic. Most supplements are likely inert with no effects good or bad. If they have a beneficial effect in the body they should be treated just like any other drug in that they are likely to also have unintended side effects. This is why its important for people to understand that these are drugs. Labeling them as supplements imparts a magical ( and imaginary) quality to them with a promise of benefits with no side effects.

While people are obviously free to do what they like on their own, supplement makers should not be allowed to manufacture and promote products to the public without evidence that the products are safe and effective based on sound randomized controlled trials of the same quality as all other drugs. Supplements are not some magic class of substances that are capable of providing benefit free of the possibility of side effects. This artificial classification should be abolished. They either have effects and side effects which means they are a drug and should be regulated as such or they are inert with no benefits to consumers and should be labeled as such.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 13 April 2014 08:38 AM   [ Ignore ]   [ # 404 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2602
Joined  2012-10-27
VYAZMA - 12 April 2014 05:51 PM
macgyver - 09 April 2014 02:14 PM

I don’t have time to give you an education in vitamin D metabolism here nor is it relevant to the point. No one here said the human body doesn’t need vitamin D. What I said is that there is no current evidence that Vitamin D supplements are beneficial or necessary for most people to take. They could be helpful, harmful, or harmless. The fact is that no one knows at this point and anyone who says they do is misinformed.

So you don’t know why the body needs vitamin D then?

You’re saying the FACT is that no one knows whether vitamin D supplements introduce vitamin D into the human body for metabolization?
You just agreed that the human body needs vitamin D. But you are saying that no one knows whether a vitamin D supplement will physically
introduce vitamin D into the human body for use and metabolization?

Here we go again MacGeyver…here we go again.  Now you get to scramble around stumbling and fumbling as you try to beat around this bush.
Vitamins are food Macgeyver. Food!  Of course they are beneficial and necessary to take!
How could you possibly say that there is no evidence of this?

I think what McGyver is saying is that although vitamins are found in food, it doesn’t mean they can be extracted from food—or made synthetically—and have any beneficial effect. So far many lab tests show that their effect is minimal at best and some could be harmful. There probably is not a great deal of harm caused by taking vitamin supplements but why spend money on and take something that has not been shown to have a beneficial effect? I agree with his premise. But anyone is free to take supplements if he wishes to despite a lack of evidence that they are doing any good and some could do real harm. They probably will have little effect but to waste your money. He has shown that most doctors don’t know squat about vitamin supplements but many have been taken in by the hype. Everyone wants to find a magic pill, even doctors.

Lois

Profile
 
 
Posted: 13 April 2014 08:50 AM   [ Ignore ]   [ # 405 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2602
Joined  2012-10-27
TimB - 12 April 2014 07:31 AM

Well, I didn’t pressure my PCP to prescribe Vit. D.  As I said, I questioned it.  I did, OTOH, lobby for him to allow me to try fish oil for a few months to address my cholesterol (instead of immediately starting Lipitor or some equivalent).  He basically said that the fish oil would not help in a significant way, but went along with my wishes, for the time being, as I stressed my concerns about statins potential effects on the liver. 

So you would be skeptical of my PCP’s stance on Vit. D in my case, but I imagine that you would not be skeptical of his stance on the fish oil.

BTW, the vit D was a 3 month prescription.

Did you need a prescription for something that is widely available over the counter for a lot less money?

As for fish oil, he was probably being honest in saying it would probably not help in any significant way but that he sees no harm in it. What else could he say? He probably knows that his patients will take things whether he advises against it or not. The only thing he can do is pass on the information he has. What you do with it is up to you.  He only has so much influence over what his patients do despite his advice. But if I were your doctor I wouldn’t have given you a prescription for Vitamin D. I would have told you that what you get over the counter will be as helpful or as harmful as what you would get with a prescription; it would just cost more.

Lois

Profile
 
 
   
27 of 30
27
 
‹‹ Acupuncture      Why are we being so stupid? ››