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.

Re:Only in America

[dwywit]

"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. "

John Cannell MD is the real hero here on vitamin D

[Paul Fernhout]

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!