8 ms·

I'm old enough to remember when the fad was taking supplemental Vitamin A and E as 'antioxidants' to reduce cancer risk. Then long term studies in Sweden on Vit

by yborg 9y ago

I'm old enough to remember when the fad was taking supplemental Vitamin A and E as 'antioxidants' to reduce cancer risk. Then long term studies in Sweden on Vitamin A showed it actually increased risk, at least for lung cancer. I would be hesitant to go all-in on Vitamin D loading until such studies have been done here. There is a good reason why medicine is conservative - first, do no harm.

JoshMnem 9y ago
RE: Vitamin E, see "Selenium, vitamin E supplements increase prostate cancer risk" https://www.health.harvard.edu/blog/selenium-vitamin-e-supplements-increase-decrease-prostate-cancer-risk-201402287059 https://www.health.harvard.edu/blog/selenium-vitamin-e-suppl...
- acchow 9y ago
  So, basically correlation studies are bullshit.
derefr 9y ago
Mind you, what was previously (and mostly still is!) considered “high doses” of vitamim D are actually closer to the RDI than the doses anyone is taking. The RDI for vitamin D was miscalculated as 1/10th its proper value decades ago, and this error was only recently corrected: https://www.sciencedaily.com/releases/2015/03/150317122458.htm https://www.sciencedaily.com/releases/2015/03/150317122458.h... So when a science journalist—or even most scientists still—say “high doses” of vitamin D, they really mean proper doses of vitamin D. Including in this article! They’re quoting the same improper 600IU RDI standard that the article above refutes, and quoting 4000IU as an abnormal amount rather than being perfectly-well-within the correct RDI value.
- gojomo 9y ago
  In terms of importance in interpreting this result, this comment should be the top-voted, top-level comment.
- fao_ 9y ago
  Interesting, because a paper was released early last year that reduced the RDI for vitamin D by about 1/2 "After re-measurement of vitamin D by improved technology, the Recommended Dietary Allowance (RDA) for vitamin D intake drops from 800 to 400 International Units (IU) per day, new research reports." https://www.sciencedaily.com/releases/2017/04/170403083103.htm https://www.sciencedaily.com/releases/2017/04/170403083103.h...
  - naasking 9y ago
    Note the caveat at the end: > "Remember, this RDA is for bone health only," Gallagher cautioned. "It may be different for other diseases. Although trials looking into cancer, diabetes, and other diseases are ongoing, we do not have information about this yet."
    - dragonwriter 9y ago
      The actual RDA for Vitamin D is set based on bone health, since there is not sufficient data for other conditions it may effect, so that's not a significant caveat when it comes to a recommendation to change the RDA.
    - fao_ 9y ago
      The RDI baseline is always set to bone health. It's an indicator for the general population, not people with illnesses that may increase their RDI amount.
      - naasking 9y ago
        Except Vitamin D influences more than just bone health, and the recent research suggesting we should increase recommended dosages has centered on that.
  - dragonwriter 9y ago
    No, it reduced what the same authors recommended the RDA should be based on the same researchers previous work by half, but that's only a reduction by a third from what the actual RDA is.
- dragonwriter 9y ago
  > Mind you, what was previously (and mostly still is!) considered “high doses” of vitamim D are actually closer to the RDI than the doses anyone is taking. The RDI for vitamin D was miscalculated as 1/10th its proper value decades ago, and this error was only recently corrected: No, there is a paper claiming that it was miscalculated and should be corrected (and, as another comment notes, there is a later paper calling for a reduction rather than an increase.) The actual current numbers remain (for most age groups): Estimated Average Requirement: 400IU/day Recommended Daily Allowance: 600IU/day Tolerable Upper Intake Level: 4000IU/day A paper calling for a change in the RDA is not a change in the RDA.
  - iooi 9y ago
    Why are most sold supplements in the 3000-5000UI range?
    - dragonwriter 9y ago
      I don't think they are, though there certainly are supplements in that range and higher. But supplements don't mostly sell based on either science or government recommendations, but fads which are often unrelated to either.
    - Tharkun 9y ago
      Vitamin D is fat-soluble and can be stored in body fat. Supplements in the higher range are meant to be taken once a week or once a month. Supplements in the 400-1000IU range are meant to be taken daily.
    - amckenna 9y ago
      Vitamin D is fat soluble and isn't cleared by the body as quickly as other vitamins such as B. Therefore it can be taken in higher doses, but less frequently. This is often done for convenience sake. A 3000-5000IU pill every week is easier to remember than a 500-600IU pill every day.
  - LMYahooTFY 9y ago
    I'm on mobile at the moment, but I think there is more than just one paper suggesting that Vitamin D RDI is too low, even if they don't explicitly call for raising the official level? I can dig for links when I'm back at a Desktop.
- Nomentatus 9y ago
  2017 (relies on earlier studies cited.) The Big Vitamin D Mistake https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/
sametmax 9y ago
> There is a good reason why medicine is conservative Let's be honest, medicine is not just conservative for this reason. It's also because of inertia, politics, economics, stereotypes, and the fact people don't want to take the blame if the new thing fail. But also because of resources and human limitation. I had an example recently in my life. I got malaria years ago because I lived in Mali. The medias, all my friends, family and doctors told me 2 things: - you gotta take your anti malaria pills (nivaquine, lariam, malarone...) for the whole trip cause there is no curative treatment for malaria - if you get malaria, it's for life And surely, when I got back home with the parasite, I got hit with a malaria episode from time to time, to remind me it was here. Not funny. 7 years later, I end up having diner with a scientist from the Pasteur Institute in Paris (pretty much the biology equivalent of NASA, but in France). He calmly explained to me that actually you don't have to take your pills for the whole trip. Malarone is a curative drug, and you can just take it when the first symptoms appear. Also, I don't have to keep having malaria episodes for life: they have protocols, again based on simple Malarone, that can get rid of the little bugger. I took the number of a colleague of his, a tropical disease specialist, and went to the institute. Surprise, everything is true. There is no mystery. No secret. The information is just there. Scientifically robust. And yet it doesn't reach you. So now you gotta wonder: what are the other thousands missing informations or misinformations you get every day in medicine ? And remember how many food facts fad you lived through. Remember that companies spent a lot of money for stuff like "carots are good for sight", "drink milk to grow up", etc. Remember that red meat is considered "Group 1, carcinogenic to humans" by WHO and nobody is talking about it. Remember that it took decades between asbestos being marked as deadly and any move to forbid it. We need to keep a healthy criticism about medicine. Doctors, after all, are only human.
- maxerickson 9y ago
  Here's a source that makes it clear enough that malaria can be cured: https://www.cdc.gov/malaria/about/faqs.html https://www.cdc.gov/malaria/about/faqs.html
- StavrosK 9y ago
  Is red meat really considered carcinogenic?
mtgx 9y ago
First off, if you're so skeptical, then at least get a 25(OH)D level blood test. If you're under 32 ng/ml (80 nmol/l) that's bad. You don't even get the absolute minimum necessary not to get sick very often. The benefits start showing up from 40 and above. Strongest benefits seem to be around 55 ng/ml, and toxicity starts around 66 ng/ml. To get to 40 ng/ml you need around 9000 IU (240 mcg) per day. So get your test, see that you're deficient (very likely), and then I would suggest starting on 5,000 IU per day. Then 6 months later, take another test. See if you've at least passed 40 ng/ml. If you haven't, I'd suggest going to 10,000. Then 6 months later do the test again. See if you're anywhere near the toxicity level. If you aren't, keep taking 10,000, and do the test in another year. See if anything has changed. This could save your life or at least make you feel way better every day (kind of like how we feel when we're bathing in the sun). See my other comment here for more details on this Vitamin D issue.
- exhilaration 9y ago
  The benefits start showing up from 40 and above. Strongest benefits seem to be around 55 ng/ml, and toxicity starts around 66 ng/ml. I'm curious, do you have a source for this or a link where I could read more about recommended levels? I got a blood test in April and it was 27.7 ng/mL, I've upped my intake to around 2700 IU per day but don't really have a 25(OH)D target in mind.
raverbashing 9y ago
While this happens, vitamin A always "gave some clues" it wasn't all that good in higher doses. (Accutane is kinda like a controlled "overdose" of Vit A for medical purposes) Other vitamins behave differently, especially depending if they're fat-soluble or water-soluble (and also what we call Vitamins are several different substances)
gwern 9y ago
All-cause mortality in Vitamin D RCTs is consistently lower in the vitamin D groups: https://www.gwern.net/docs/vitamind/2014-bolland.pdf https://www.gwern.net/docs/vitamind/2014-bolland.pdf
jjoe 9y ago
Vitamin D is a steroid hormone. Its potential impact on the body is substantial.
Fuzzgun 9y ago
first, do no harm. First Law: A medicine may not injure a human being or, through inaction, allow a human being to come to harm. Second Law: A medicine must obey the orders given it by human beings except where such orders would conflict with the First Law. Third Law: A medicine must protect its own existence as long as such protection does not conflict with the First or Second Laws.
- amelius 9y ago
  The Hippocratic oath was there long before Asimov's laws.
  - Fuzzgun 9y ago
    And this song predates the Hippocratic oath: https://www.youtube.com/watch?v=XtaSiGD_SVI https://www.youtube.com/watch?v=XtaSiGD_SVI
Pete_D 9y ago
Out of curiosity, I looked up the effects of taking too much vitamin D, and: > Recent epidemiologic evidence suggests that there is a narrow range of vitamin D levels in which vascular function is optimized. Levels above or below this range increased mortality.[14] Animal research suggests that both excess and deficiency of vitamin D appears to cause abnormal functioning and premature aging.[42][43][44] https://en.wikipedia.org/wiki/Hypervitaminosis_D https://en.wikipedia.org/wiki/Hypervitaminosis_D There's a bigger subsection on cardiovascular disease too, but all I can understand from it is "it's complicated".
- slezyr 9y ago
  Yep. Sounds a lot like with radiation. With it we will get cancer, without it we will get cancer.
walshemj 9y ago
Well its only personal experience but I am on a lot of immuno suppressant drugs (enough so the flu jab wouldn't work on me) and 20k IU Vit D a week. Fingers crossed I don't seem to have had a winter cold this year.
deleted 9y ago
[deleted]
m0llusk 9y ago
That is true, but this situation is very different. Vitamin D is very much unlike other vitamins and is arguably a steroid more than a vitamin. The body does not make its own and is not very good at taking it up. Large amounts of Vitamin D have been studied for a while and do not show the risks that other vitamins do including multivitamins. Vitamin D supplementation has been shown to have a broad range of positive effects including reducing cancer and incidents of flu and common cold.
- maxerickson 9y ago
  Vitamin D is synthesized in the skin when it is exposed to sunlight. That means that it technically isn't a vitamin (a necessary dietary component).
- pbhjpbhj 9y ago
  >Vitamin D supplementation has been shown to have a broad range of positive effects // So it should be supplemented rather than acquired through diet? Is there some mechanism that makes it less beneficial to eat foods with VitD rather than to supplement?

by yborg 9y ago

JoshMnem 9y ago

RE: Vitamin E, see "Selenium, vitamin E supplements increase prostate cancer risk" https://www.health.harvard.edu/blog/selenium-vitamin-e-supplements-increase-decrease-prostate-cancer-risk-201402287059 https://www.health.harvard.edu/blog/selenium-vitamin-e-suppl...

acchow 9y ago
So, basically correlation studies are bullshit.

derefr 9y ago

Mind you, what was previously (and mostly still is!) considered “high doses” of vitamim D are actually closer to the RDI than the doses anyone is taking. The RDI for vitamin D was miscalculated as 1/10th its proper value decades ago, and this error was only recently corrected: https://www.sciencedaily.com/releases/2015/03/150317122458.htm https://www.sciencedaily.com/releases/2015/03/150317122458.h... So when a science journalist—or even most scientists still—say “high doses” of vitamin D, they really mean proper doses of vitamin D. Including in this article! They’re quoting the same improper 600IU RDI standard that the article above refutes, and quoting 4000IU as an abnormal amount rather than being perfectly-well-within the correct RDI value.

gojomo 9y ago
In terms of importance in interpreting this result, this comment should be the top-voted, top-level comment.
fao_ 9y ago
Interesting, because a paper was released early last year that reduced the RDI for vitamin D by about 1/2 "After re-measurement of vitamin D by improved technology, the Recommended Dietary Allowance (RDA) for vitamin D intake drops from 800 to 400 International Units (IU) per day, new research reports." https://www.sciencedaily.com/releases/2017/04/170403083103.htm https://www.sciencedaily.com/releases/2017/04/170403083103.h...
- naasking 9y ago
  Note the caveat at the end: > "Remember, this RDA is for bone health only," Gallagher cautioned. "It may be different for other diseases. Although trials looking into cancer, diabetes, and other diseases are ongoing, we do not have information about this yet."
  - dragonwriter 9y ago
    The actual RDA for Vitamin D is set based on bone health, since there is not sufficient data for other conditions it may effect, so that's not a significant caveat when it comes to a recommendation to change the RDA.
  - fao_ 9y ago
    The RDI baseline is always set to bone health. It's an indicator for the general population, not people with illnesses that may increase their RDI amount.
    - naasking 9y ago
      Except Vitamin D influences more than just bone health, and the recent research suggesting we should increase recommended dosages has centered on that.
- dragonwriter 9y ago
  No, it reduced what the same authors recommended the RDA should be based on the same researchers previous work by half, but that's only a reduction by a third from what the actual RDA is.
dragonwriter 9y ago
> Mind you, what was previously (and mostly still is!) considered “high doses” of vitamim D are actually closer to the RDI than the doses anyone is taking. The RDI for vitamin D was miscalculated as 1/10th its proper value decades ago, and this error was only recently corrected: No, there is a paper claiming that it was miscalculated and should be corrected (and, as another comment notes, there is a later paper calling for a reduction rather than an increase.) The actual current numbers remain (for most age groups): Estimated Average Requirement: 400IU/day Recommended Daily Allowance: 600IU/day Tolerable Upper Intake Level: 4000IU/day A paper calling for a change in the RDA is not a change in the RDA.
- iooi 9y ago
  Why are most sold supplements in the 3000-5000UI range?
  - dragonwriter 9y ago
    I don't think they are, though there certainly are supplements in that range and higher. But supplements don't mostly sell based on either science or government recommendations, but fads which are often unrelated to either.
  - Tharkun 9y ago
    Vitamin D is fat-soluble and can be stored in body fat. Supplements in the higher range are meant to be taken once a week or once a month. Supplements in the 400-1000IU range are meant to be taken daily.
  - amckenna 9y ago
    Vitamin D is fat soluble and isn't cleared by the body as quickly as other vitamins such as B. Therefore it can be taken in higher doses, but less frequently. This is often done for convenience sake. A 3000-5000IU pill every week is easier to remember than a 500-600IU pill every day.
- LMYahooTFY 9y ago
  I'm on mobile at the moment, but I think there is more than just one paper suggesting that Vitamin D RDI is too low, even if they don't explicitly call for raising the official level? I can dig for links when I'm back at a Desktop.
Nomentatus 9y ago
2017 (relies on earlier studies cited.) The Big Vitamin D Mistake https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541280/

sametmax 9y ago

> There is a good reason why medicine is conservative Let's be honest, medicine is not just conservative for this reason. It's also because of inertia, politics, economics, stereotypes, and the fact people don't want to take the blame if the new thing fail. But also because of resources and human limitation. I had an example recently in my life. I got malaria years ago because I lived in Mali. The medias, all my friends, family and doctors told me 2 things: - you gotta take your anti malaria pills (nivaquine, lariam, malarone...) for the whole trip cause there is no curative treatment for malaria - if you get malaria, it's for life And surely, when I got back home with the parasite, I got hit with a malaria episode from time to time, to remind me it was here. Not funny. 7 years later, I end up having diner with a scientist from the Pasteur Institute in Paris (pretty much the biology equivalent of NASA, but in France). He calmly explained to me that actually you don't have to take your pills for the whole trip. Malarone is a curative drug, and you can just take it when the first symptoms appear. Also, I don't have to keep having malaria episodes for life: they have protocols, again based on simple Malarone, that can get rid of the little bugger. I took the number of a colleague of his, a tropical disease specialist, and went to the institute. Surprise, everything is true. There is no mystery. No secret. The information is just there. Scientifically robust. And yet it doesn't reach you. So now you gotta wonder: what are the other thousands missing informations or misinformations you get every day in medicine ? And remember how many food facts fad you lived through. Remember that companies spent a lot of money for stuff like "carots are good for sight", "drink milk to grow up", etc. Remember that red meat is considered "Group 1, carcinogenic to humans" by WHO and nobody is talking about it. Remember that it took decades between asbestos being marked as deadly and any move to forbid it. We need to keep a healthy criticism about medicine. Doctors, after all, are only human.

maxerickson 9y ago
Here's a source that makes it clear enough that malaria can be cured: https://www.cdc.gov/malaria/about/faqs.html https://www.cdc.gov/malaria/about/faqs.html
StavrosK 9y ago
Is red meat really considered carcinogenic?

mtgx 9y ago

First off, if you're so skeptical, then at least get a 25(OH)D level blood test. If you're under 32 ng/ml (80 nmol/l) that's bad. You don't even get the absolute minimum necessary not to get sick very often. The benefits start showing up from 40 and above. Strongest benefits seem to be around 55 ng/ml, and toxicity starts around 66 ng/ml. To get to 40 ng/ml you need around 9000 IU (240 mcg) per day. So get your test, see that you're deficient (very likely), and then I would suggest starting on 5,000 IU per day. Then 6 months later, take another test. See if you've at least passed 40 ng/ml. If you haven't, I'd suggest going to 10,000. Then 6 months later do the test again. See if you're anywhere near the toxicity level. If you aren't, keep taking 10,000, and do the test in another year. See if anything has changed. This could save your life or at least make you feel way better every day (kind of like how we feel when we're bathing in the sun). See my other comment here for more details on this Vitamin D issue.

exhilaration 9y ago
The benefits start showing up from 40 and above. Strongest benefits seem to be around 55 ng/ml, and toxicity starts around 66 ng/ml. I'm curious, do you have a source for this or a link where I could read more about recommended levels? I got a blood test in April and it was 27.7 ng/mL, I've upped my intake to around 2700 IU per day but don't really have a 25(OH)D target in mind.

raverbashing 9y ago

While this happens, vitamin A always "gave some clues" it wasn't all that good in higher doses. (Accutane is kinda like a controlled "overdose" of Vit A for medical purposes) Other vitamins behave differently, especially depending if they're fat-soluble or water-soluble (and also what we call Vitamins are several different substances)

gwern 9y ago

All-cause mortality in Vitamin D RCTs is consistently lower in the vitamin D groups: https://www.gwern.net/docs/vitamind/2014-bolland.pdf https://www.gwern.net/docs/vitamind/2014-bolland.pdf

jjoe 9y ago

Vitamin D is a steroid hormone. Its potential impact on the body is substantial.

Fuzzgun 9y ago

first, do no harm. First Law: A medicine may not injure a human being or, through inaction, allow a human being to come to harm. Second Law: A medicine must obey the orders given it by human beings except where such orders would conflict with the First Law. Third Law: A medicine must protect its own existence as long as such protection does not conflict with the First or Second Laws.

amelius 9y ago
The Hippocratic oath was there long before Asimov's laws.
- Fuzzgun 9y ago
  And this song predates the Hippocratic oath: https://www.youtube.com/watch?v=XtaSiGD_SVI https://www.youtube.com/watch?v=XtaSiGD_SVI

Pete_D 9y ago

Out of curiosity, I looked up the effects of taking too much vitamin D, and: > Recent epidemiologic evidence suggests that there is a narrow range of vitamin D levels in which vascular function is optimized. Levels above or below this range increased mortality.[14] Animal research suggests that both excess and deficiency of vitamin D appears to cause abnormal functioning and premature aging.[42][43][44] https://en.wikipedia.org/wiki/Hypervitaminosis_D https://en.wikipedia.org/wiki/Hypervitaminosis_D There's a bigger subsection on cardiovascular disease too, but all I can understand from it is "it's complicated".

slezyr 9y ago
Yep. Sounds a lot like with radiation. With it we will get cancer, without it we will get cancer.

walshemj 9y ago

Well its only personal experience but I am on a lot of immuno suppressant drugs (enough so the flu jab wouldn't work on me) and 20k IU Vit D a week. Fingers crossed I don't seem to have had a winter cold this year.

deleted 9y ago

[deleted]

m0llusk 9y ago

That is true, but this situation is very different. Vitamin D is very much unlike other vitamins and is arguably a steroid more than a vitamin. The body does not make its own and is not very good at taking it up. Large amounts of Vitamin D have been studied for a while and do not show the risks that other vitamins do including multivitamins. Vitamin D supplementation has been shown to have a broad range of positive effects including reducing cancer and incidents of flu and common cold.

maxerickson 9y ago
Vitamin D is synthesized in the skin when it is exposed to sunlight. That means that it technically isn't a vitamin (a necessary dietary component).
pbhjpbhj 9y ago
>Vitamin D supplementation has been shown to have a broad range of positive effects // So it should be supplemented rather than acquired through diet? Is there some mechanism that makes it less beneficial to eat foods with VitD rather than to supplement?