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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.
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.
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.
Don't disappoint your bird dog. Go to the range.
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.
It's the same general principal as money in politics. You don't actually have to influence the individual for your contribution to further your point of view.
A corporation finds politicians with views naturally aligned to their objectives and helps those politicians get into office.
Similarly, a corporation finds researchers with view naturally aligned to their objectives and helps those researchers get papers into top journals and conferences.
The key is more public funding of science so private donors can't have such a big influence.
I stole this Sig
"Dr. Holick, 72, said that industry funding "doesn't influence me in terms of talking about the health benefits of vitamin D."
It is arguable that this doctor wasn't directly influenced by lobbying money. However, there is a definite appearance of impropriety. The doctor's statement above is not believable. What he should have said is, "I accepted money that influences me to promote ideas that I already believed in."
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.
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USDA daily recommended levels are so high I couldn't possibly hit them even if I ate a perfect diet. Yet I've had blood work done and never once been low on any vitamins. And the only doctor who's ever suggested I take one is my heart doc said I should take a magnesium supplement (but I get the idea that was just to give me something to do rather than an actual doctor's order).
So it would make sense that the high levels of recommended daily allotments were coming from regulatory capture.
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For many people it doesn't.
Compensating for low vitamin D levels with sun exposure is asking for skin cancer.
My Dr. suggested that I take a Vitamin D supplement. I purchased a bottle of 600 capsules at Costco for something like $12. So it costs me less than $10 per year for a little piece of mind. Do I need it? Maybe, maybe not. There is some cost to manufacturing the vitamins and getting them to the store, so it doesn't seem like there is tremendous profit in Vitamin D. Sure, if there are a couple dollars profit per bottle and everyone purchased the supplement, we are talking about decent money, but everyone doesn't purchase the stuff. It seems like a focus on things that almost everyone buys and that has a higher margin (like cable TV, Internet service, cellular service, etc.) would be a better thing to focus on for profit.
How much do you swallow?
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.)
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The thing is that the vitamin D test is really expensive for a run of the mill blood test. Ridiculously expensive in America due to the overinflated healthcare costs in general, but even in cheaper countries like Britain it is still pricey relative to a lot of the routine blood tests.
I have a vitamin D deficiency so it was worthwhile for me to get the test, but the bill provided some serious sticker shock.
"Compensating for low vitamin D levels with sun exposure is asking for skin cancer."
No, it bloody isn't. You don't need to sit in the sun for hours, 10-15 minutes per day is sufficient (with modifiers for extreme tropical and frigid climate zones - extreme northern and southern dwellers definitely need supplements during the dark).
And it isn't even whole-body exposure. If you wear a short-sleeved shirt for work, and you walk in the open air to get your lunch, you'll get enough.
I have pale skin, and I live in the melanoma capitol of the world (Queensland, Australia), and my own GP just tells me to follow the guidelines from the Cancer Council:
https://cancerqld.org.au/cance...
"Vitamin D â" how much sun is enough
In Queensland where UV levels are high all year round, most people receive adequate sun exposure to produce vitamin D through their daily incidental activities. These activities include hanging out the washing, checking the letterbox or walking to and from your car. "
They sentenced me to twenty years of boredom
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.
There is definitely some sort of big D conspiracy going on.
I'm not a doctor, and I don't even play one on TV; but I can state I'm skeptical of the whole Vit D. Every year my doctor tells me to up my D intake. First it was, take a multivitamin; then it was... that's not enough, that only has 100% of daily need- you should be getting 500% of what is recommended the recommended level is too low.
Every year he tells me I should be taking more and more... ... I've stopped listening to him about the issue, even though every year he tells my Vit D levels in my blood are too low- they're merely average. I think he's become brain washed by some strange D cult. He's all about the D.
"That's the way to do it" - Punch
One last time:
KALE is what you put AROUND the salad - it is the garnish, it is NOT the salad!
Within reason, people should eat whatever they want. Ideally it would be something healthy (and kale isn't unhealthy).
I'm not a huge fan of the stuff myself, but if people want to eat kale, let them eat kale.
"That's the way to do it" - Punch
And you don't need to sit in the sun for hours to get skin cancer either.
And a large percentage of adults in the West carry gene variants that lead to low vitamin D levels even with normal sun exposure. That's not surprising given that vitamin D is supplied by eggs, cheese, and fish, meaning there has been little selective pressure against deficiencies, and it may be in the process of becoming an essential vitamin for many humans.
Vitamin D is also generic and trivially cheap, at around two cents per day. The idea that recommending supplementation is due to some corporate scheme drumming up support for expensive drugs is laughable.
It's important to remember that just because the American medical industry is infested with corporatism that the basis of their argument still has some truth. Him overdosing you on Vitamin D to make some nice profits doesn't mean you should abstain completely.
The rest of the world which isn't in such a state can provide a quite sane source of information. If it's winter and you live above above the 45deg line then just take a supplement daily like everyone who doesn't see the sun for half a year and move on with your life.
Big Calcium would be very happy if you did.
https://www.vitamindcouncil.or...
https://en.wikipedia.org/wiki/...
He has been demonstrating a need for vitamin D since around 2000 (before Holick).
Bottom line:
* Humans are adapted overall for an outdoor lifestyle partially clothed in the sunshine without regular bathing.
* Humans in industrialized countries now spend most of their time indoors -- or travelling in enclosed vehicles where glass is designed to prevent UV transmission to prevent faded carpets but not faded people.
* When humans in industrialized countries go outdoors they tend to wear a lot of clothes.
* Bathing (especially with soap) disrupts the formation of vitamin D by removing natural oils from the skin which are needed to make vitamin D.
Three other factors have made vitamin D deficiency worse:
* Dermatologists claiming time in the sun gives you cancer -- which is a half-truth because while sunlight can increase melanoma risk (a relatively easily treatable cancer), vitamin D reduces cancer risk for many cancers including melanoma -- which is why more office workers get melanomas than outdoor workers and why many office workers get melanomas in places they wear clothes.
* The USA RDA for vitamin D was set to prevent the worst cases of rickets not to ensure optimal health and so for decades has been ten times or more too low. Only recently has it been raised to perhaps adequate for infants but the RDA is still too low for adults
* Historically, a patent was granted for Vitamin D2, a synthetic and less effective form of vitamin D, and that was what doctors pushed instead of the better vitamin D3.
* In order to use vitamin D optimally, you also need a health diet like with vitamin K2 and other cofactors like magnesium, zinc, and boron -- and the standard American diet tends to be lacking in these.
Another complication: if a pregnant or nursing mother has low vitamin D her child will also have low vitamin D -- which may be a contributor to autism and other health problems for young children.
And yet another (politically charged) complication: people with darker skin moving far north or south from the equator are going to be even more impacted by vitamin D deficiency (e.g. especially Somalis moving to Minnesota who also wear burkas and have a high autism rate). Just like people with lighter skin who move to the equator are at elevated risk from melanoma. Skin color is adaptive for latitude (some exceptions being people who get vitamin D in their diet from fish or other animal products). However, this is made more complicated by uncertainty about whether vitamin D needs may differ in connection with other metabolic genes varying along with skin color genes.
Also, while vitamin D is the biggest immediate problem form lack of adequate sunlight, it is not the only substance our skin makes when exposed to sunlight -- so taking the right amount of vitamin D3 is beneficial but maybe not the entire answer.
Yes, there are now conflicts of interest by multiple advocates of adequate Vitamin D3 like with Holick or even now Cannell. But there still is a health crisis going on!
A 21st century issue: the irony of technologies of abundance in the hands of those still thinking in terms of scarcity.