Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It (nytimes.com)

The New York Times tells the story of Dr. Michael Holick, a Boston University endocrinologist "who perhaps more than anyone else is responsible for creating a billion-dollar vitamin D sales and testing juggernaut." From the report: Dr. Holick's role in drafting national vitamin D guidelines, and the embrace of his message by mainstream doctors and wellness gurus alike, have helped push supplement sales to $936 million in 2017. That's a ninefold increase over the previous decade. Lab tests for vitamin D deficiency have spiked, too: Doctors ordered more than 10 million for Medicare patients in 2016, up 547 percent since 2007, at a cost of $365 million. But few of the Americans swept up in the vitamin D craze are likely aware that the industry has sent a lot of money Dr. Holick's way. A Kaiser Health News investigation for The New York Times found that he has used his prominent position in the medical community to promote practices that financially benefit corporations that have given him hundreds of thousands of dollars -- including drug makers, the indoor tanning industry and one of the country's largest commercial labs.

In an interview, Dr. Holick acknowledged he has worked as a consultant to Quest Diagnostics, which performs vitamin D tests, since 1979. Dr. Holick, 72, said that industry funding "doesn't influence me in terms of talking about the health benefits of vitamin D." There is no question that the hormone is important. Without enough of it, bones can become thin, brittle and misshapen, causing a condition called rickets in children and osteomalacia in adults. The issue is how much vitamin D is healthy, and what level constitutes deficiency.

Comments

Re:Only in America

[JoeyRox]

And yet, indeed, many people are deficient. And they've got ANOTHER doctor that cooking their skin in the sun is a pathway to melanoma and a possible miserable death.

From the NYT article:

Dr. Holick's crucial role in shaping that debate occurred in 2011. Late the previous year, the prestigious National Academy of Medicine (then known as the Institute of Medicine), a group of independent scientific experts, issued a comprehensive, 1,132-page report on vitamin D deficiency. It concluded that the vast majority of Americans get plenty of the hormone naturally, and advised doctors to test only patients at high risk of certain disorders, such as osteoporosis.

A few months later, in June 2011, Dr. Holick oversaw the publication of a report that took a starkly different view.

Quest Diagnostics?

[93 Escort Wagon]

The summary makes it sound as if they specialize in Vitamin D level analysis. They’re a general-purpose medical lab and do all sorts of analysis on most body fluids.

Without vitamin D testing they’d still be an industry behemoth. It’s probably not even a rounding error in their bottom line.

Re:It's all fuzzy.

[Ungrounded Lightning]

But it isn't always easy to say precisely how much we need,... Vitamin toxicity is a real thing, ... [D dietary need] varies based on a number of factors, including personal factors ... Though it is clear we need good nutrition, as a culture we seem to be going overboard.

Among the personal factors are issues with ageing (affecting things like synthesis and absorption) and exposure to light.

In addition to both the well-known and severe deficiency diseases and a number of lesser ones, overdosing can cause a number of problems: One of them being too-early calcification of a cracked or broken bone in the process of self-repair.

When I smashed the end of my humerus through my scapula in a bicycle accident, I asked the orthopaedist about using some nutritional (over-)supplementation to encourage healing. He said the bulk of them (E and C to discourage scarring and the latter encourage collagen generation - the first step in a bone break repair, Arginine and Ornithine on an empty stomach at bedtime to release GHRH) would just produce "expensive urine" so go ahead if I felt like it, but to NOT supplement with D other than drinking milk (which I could do) - which had entirely enough thanks to mandated fortification.

With lots of individual variation in the paths to the blood level of the Ds and a lack of an adequate regulatory pathway, (so you can't predict it from things like diet, age, sun exposure, etc.) you need to measure to tell what that level is. With both over- and under-dosing producing really nasty diseases with no symptoms until it's too late to do anything to reverse the damage, it's a really good idea to get it tested and adjust supplemtation to put it into that happy medium between the too-much and too-little pathologies.

Now whether the blood levels recommended by this guy ARE that happy medium is another can of worms. But my GP/cardiologist is onboard with it and prescribed both testing and adjusting supplementation. (Cardiologists are careful about calcium metabolism, as the calcification of plaques is a major factor in circulatory diseases.)