As I begin to research vitamin D and its functions in the human body, the first thing that I noticed was any compound that was related to vitamin D was called vitamin D.  I found these same errors in reading the AHRQ-Tufts Evidence Based Report on Vitamin D and Calcium.  Tufts was contracted by the Agency for Healthcare Research and Quality formerly known as the Agency for Health Care Policy and Research.  AHRQ is one of twelve agencies that report to Health and Human Services.  The IoM then used this report to make decisions about your health. The report was requested and funded by The Office of Dietary Supplements/National Institutes of Health, the Public Health Agency of Canada, Health Canada, and Food and Drug Administration.  You may access the report here as a pdf file.  It is also appendix D in the IoM report on vitamin D and calcium.

I think the ‘Policy’ name fits AHRQ better as they are responsible for maintaining clinical practice guidelines.  If you do not know, these guidelines drive the economy for the medical industry and are used as rules to determine if procedures were followed that can be paid for by the insurers.  As far as quality in the name, they produced a report that was far from what I expected.  As a taxpayer I was failed since they did not meet the quality standard.  Quality, as defined by the experts, is meeting customer’s expectations.  AHRQ mission statement: The Agency for Healthcare Research and Quality’s (AHRQ) mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.

First Expectation:  Vitamin D2 and Vitamin D3 are not to be treated as equivalent substances in the human body.  This is from the report: “Whenever the type of vitamin D supplement (D2 or D3) was clearly reported, we extracted and reported this information. Otherwise, we used the general term “vitamin D”.” – pdf page 52 – report page 36

Second Expectation: The difference between serum levels of 25(OH)D for D2 versus 25(OH)D from D3 should be clearly defined or the research should be considered invalid.  There is no mention whatsoever that a distinction was considered when reviewing the literature.

Why do we expect this distinction between D2 and D3?  Because there are more than 2700 genes with vitamin D pathways and the difference of an additional methyl group or an additional double bond are huge.  As we learn more about how genes are turned off and on, vitamin D has become the major player in controlling gene switching for chronic disease.  I will give you the example of what was batted around by the press after the IoM report was issued about an increase in the risk of pancreatic cancer with an increase in serum 25(OH)D in Finland smokers.  It is well known that this country has offered stoss injections of vitamin D2 and D3.  Is the u-shaped curve that was much discussed different for D2 versus D3?  I think the answer is yes.  There have been many recent papers discussing the difference in the two compounds, but the one that sticks in my mind is the Moon and Reich paper from 1975.  The Vitamin D Problem, and Important Lesson in Orthomolecular Medicine. Link to pdf

In this paper we find that the reports of toxicity did not even start to occur until the introduction of irradiated ergosterol, vitamin D2 or worse an unwanted compound from this process apply named toxisterol.  Vitamin D2 is a compound made from a fungus.  There had been years of supplementing with large amounts of cod liver oil without incidence except for two reported by the same doctor.  During the next several decades the compounds started to be treated as equivalent, for economic purposes I suspect.  The reports on toxicity started rolling in every month.  Only irradiated 7-dihydracholesterol produces vitamin D3, it was much easier to irradiate other sterols for profit.  Moon and Reich listed diseases that are made worse by D2.  Here are a few: Atherosclerosis, Rheumatoid Arthritis, Peripheral Vascular Disease, Idiopathic Hypercalcemia.  Could pancreatic cancer or prostate cancer be a couple of others?

Third Expectation:  The amounts of vitamin D considered should be large enough to make a clinical difference in outcomes.  The IoM committee covered themselves on these diseases by bluntly stating that the report only covered bone health.  The AHRQ-Tufts report in many cases used studies for chronic disease that reported a difference between 400 IU versus 800 IU of intake per day.  Why would they think that two minutes in the sunshine versus four minutes makes a clinical outcome difference in cancer?

Based on this lack quality in the AHRQ-Tufts report and consequently the IoM report, I reject both as not being of quality for my use.  However, the patent holders of vitamin D analogs, I am sure, are delighted.  – Pandemic Survivor