Reaction to the IOM Report on Vitamin D

In email communications with Heather Breiner, information contact for the FNB on vitamin D, the most likely release date for the report on vitamin D and calcium is November 30, 2010.  I am sure that many institutions are prepared to react to whatever the report suggest.  It is almost a certainty that daily required intakes will be increased.  However, there are some reactions that would definitely benefit the economy and not the health of the individual.  We need plain language to better understand what can happen.

Over the last fifty years there have been two major concerns associated with vitamin D.  Both of these concerns kept the general population from getting an adequate amount.  First there was the issue of toxicity.  I remember when I told my doctor that I was going to supplement with enough vitamin D so that I would have the same serum level that you would maintain in the summertime.  He was startled at the 8,000 IU per day that I was suggesting and said that he thought my organs ‘would turn to stone’.  This biblical warning really scared me, but I felt that my reading of the peer reviewed medical journal articles was enough assurance that I was on sound footing.  This same conversation will happen billions of times around the world over the next years.  No large institution will be willing to admit to being so wrong for so long without extreme fear of legal action.  There have really been no major incidences of vitamin D toxicity.  The issue of death from acetaminophen toxicity with the associated liver failures is the major concern of any substance available for general use of the population.  Of course the use of acetaminophen would not be so large if everyone had enough vitamin D which would significantly reduce chronic pain.

In my reading of the literature and comments of toxicity by the researchers on D, the major bad actor has been vitamin D2, the most prescribed form of vitamin D by the medical practitioners. Vitamin D2 is made from the sterols of fungus that is irradiated.  Why do they prescribe D2 and not D3?  You cannot patent D3.  In medical practice D3 and D2 have always been considered as equal in there action in the body.  This is somewhat true at very low levels required to prevent and to heal rickets.  However, at higher levels of D2 because of the thousands of genetic pathways for vitamin D, D2 causes serious issues and leads to failure of many systems.  This has been the major issue of toxicity over the years.  Doctors have seen the bad results of D2 and associated all vitamin D with toxicity.

The use of the steroid form of vitamin D has caused misinterpretation that all vitamin D is toxic as well.  In trials where the steroid form was given instead of D3 there usually appears to be issues with too much calcium in the blood.  It turns out that the body’s mechanism is to produce a substance that destroys the steroid form at the same time the steroid form is produced to keep it from over acting in the body.  Vitamin D should never be supplemented as a nutrient or as a substance to heal disease unless it is vitamin D3.  Vitamin D3 is what your body makes in the skin from exposure to the sun.

The second concern that has caused the population to have low levels of vitamin D has been the issue with sun exposure and skin cancer.  When using sunscreen, almost all vitamin D production in the skin is stopped.  As it turns out, the melanoma rate in the US has increased by a factor of four since the 1960’s and the increased use of sun block.  So does sun block cause more skin cancer?  We will let the courts decide that if sense can be made of the convoluted research that has been presented to date.  There is too much money involved for clear thinking.  Some manufacturers of sunscreens have taking action to protect them from extreme liability in fear of the existing class action suit that is presently in the California courts.  The manufacturers of sunscreen skated by in the legal actions taken by the FDA and FTC in 2000 with good luck over the ruling by now Chief Justice John Roberts. It seems the real truth in the matter is that the amount of skin cancer caused by too much sun exposure is nothing compared to the deaths that result from all the chronic disease that is created by vitamin D deficiency.

All that the researchers are suggesting is for the population to maintain a serum level as if it was summer all year.  How could having summer all year be a bad thing?  Only for the medical economy- We will try to address this issue next post.

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