7 ms·

Vitamin D supplementation reduces autoimmune disease risk in trial findings

138 points by sizzle 5y ago

pknomad 5y ago
I'm 10 years removed from life science research at this point... but aren't these vitamin studies a dime a dozen at this point? I don't think I see a comparison of outcomes between groups that were vitamin D deficient/insufficient vs vitamin D sufficient, which I think could be a bit more useful?
- d883kd8 5y ago
  I'm actually getting submarine vibes from the amount of positive Vitamin D coverage I've seen recently
  - themikesanto 5y ago
    What does that mean?
    - lkbm 5y ago
      PR/astroturfing. It's a reference to Paul Graham's essay "The Submarine: http://www.paulgraham.com/submarine.html http://www.paulgraham.com/submarine.html
    - ozim 5y ago
      That someone is pumping vitamin D supplementation promotion. I have also my own example of N(1) where supplementing vit-D made me healthier and I am nerd sitting most of the time hidden from the sun. Pre-Covid after start of supplementation I noticed less infections, easier hangovers overall better health. That said I mostly sit inside by the screen and live in countries where is not that much sun so it is easy for me to get positive outcome of supplementation. I think there is a lot of people like that and that is why there is so much positive reaction for D supplementation.
- nradov 5y ago
  Yes most studies on micronutrient supplementation are badly flawed in that way. They typically give a supplement to the study group and a placebo to the control group, but since vitamins also come from other sources the supplements are only loosely correlated with actual levels. A better approach is to pick at least two different target levels for separate study groups. Then use periodic blood tests to precisely titrate those levels using varying amounts of supplements as needed. If the results show a clear relationship between the different blood levels and the study goal then it's likely a real causal relationship exists.
- _qua 5y ago
  Vitamin D is one of the most overstudied topics in medicine. Yes, there are probably aspects of vitamin D function that we do not understand well, but if there were a large signal for benefit, it should have been discovered by now.
  - bagacrap 5y ago
    and hasn't it been discovered by now? my understanding of all the studies I see is that they confirm and reconfirm the importance of vit d. I have a coworker whose doctor prescribes vit d shots every winter because he's so deficient. The big question is why preventative care such as this is not emphasized as much by the powers that be as therapeutics.
    - _qua 5y ago
      The US Preventative Services Task Force has recently reviewed the vitamin D literatue, it is summarized here: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-d-deficiency-screening https://www.uspreventiveservicestaskforce.org/uspstf/recomme... Primary care is largely concerned with preventative care. It's not that we don't want to help, it's just that in many ways we are impotent. We generally do not change practice based on single studies. But since this post is about a single study, I'll share a recent RCT in The Lancet which showed no change in mortality and signals of increased cancer with vitamin D supplementation: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00345-4/fulltext https://www.thelancet.com/journals/landia/article/PIIS2213-8... .
    - ipaddr 5y ago
      That's why they add it to milk.
kmonad 5y ago
While the vitamin D result was significant, this is not a slam dunk result. 123 (treatment) vs 155 (placebo) had a confirmed autoimmune disease. Low incidence rate with a small effect size hamper the power here. This is somewhat expected given the complexity of autoimmune diseases; I would have been highly suspicious of a slam dunk, silver bullet result.
edejong 5y ago
Talking about Vitamin D and calcifediol: why are we not informed that Calcifediol treatment (and as such Vitamin D supplementation) significantly reduces the chance of ICU admission and mortality in COVID-19 based on RCTs [1,2]? [1] https://pubmed.ncbi.nlm.nih.gov/34097036/ https://pubmed.ncbi.nlm.nih.gov/34097036/ [2] https://www.sciencedirect.com/science/article/pii/S0960076020302764 https://www.sciencedirect.com/science/article/pii/S096007602...
- PragmaticPulp 5y ago
  > why are we not informed What do you mean? I've been bombarded with Vitamin D recommendations since COVID started, from my doctor through countless podcasts. It also comes up frequently in any online discussion about COVID. And before anyone suggests otherwise, yes, Dr. Fauci has also spoken about Vitamin D. But Vitamin D isn't a magic bullet. It helps, but it's not a miracle cure like some of the internet articles or early ad-hoc studies would imply.
  - _nothing 5y ago
    Yeah, people have been talking about the decreased Vitamin D levels in COVID patients and suggesting supplementation since almost the very beginning of the pandemic. Maybe they just don't want to draw attention away from the fact that vaccination and masking are still by far the best means of avoiding hospitalization.
    - deleted 5y ago
      [deleted]
    - Supermancho 5y ago
      iirc, the first mention I remember was from a Stanford, CA area Doctor who was not waiting for the CDC to make a press release before making a statement about what he saw anecdotally (~Nov 2019) given how quickly his hospital was overwhelmed. Specifically, he noted that patients with Vitamin D deficiencies were having the worst symptoms.
  - edejong 5y ago
fumar 5y ago
We need to understand the impact of increased vitamin D on vitamin D average vs vitamin D deficient people. I was vitamin D deficient, lowest part of the spectrum, and since taking daily supplements I noticed less health issues overall. I believe it also helps with my sleep cycle. YMMV I am regularly tested for vitamin D and its consistently above average, but you must monitor to not exceed the threshold.
- dominotw 5y ago
  i've been skiing 3-4 days/week with around 8 hrs out in the sun. Would this have the same beneficial effects on me? I am always deficient but i din't bother taking anything so far due to lazyness.
  - hyencomper 5y ago
    For Vitamin D synthesis, the sun needs to be at an angle of 50 degrees or higher. Depending on the latitude where you live, the sun may not get that high all winter so you may need to supplement.
    - tim333 5y ago
      Surely sunlight is still sunlight even if it's from a low angle?
      - lodi 5y ago
        No, the composition of sunlight literally changes throughout the day. When the sun is low in the sky in the morning or evening, light is traveling through more atmosphere than it is at noon. As light travels through the atmosphere, a certain fraction is scattered in a wavelength-dependent way. UV-B light--the Vitamin-D-causing kind--has a hard time passing through the atmosphere because of interactions with ozone molecules, so at grazing angles almost none gets through. However UV-A light is less affected by ozone and can still give you a sunburn. Interestingly, ordinary glass blocks both.
      - beagle3 5y ago
wheelerof4te 5y ago
Or, I don't know...go outside if you need vitamin D.
- matsemann 5y ago
  Sun goes up at 09:34 and down at 15:16, most of us are at work. And that doesn't include the mountains blocking the sun, some weeks it barely goes above them. So there's light, but no direct sun light. And when it's -10C, only a few square centimeters of my skin is exposed to the elements, not really producing any vit D.
  - 8bitsrule 5y ago
    Also not much help if the daytime sky is clouded much of the winter. Might as well go outside in Alaska.
- clajiness 5y ago
  Some of us live at higher latitudes and work during the day. It's not as simple or easy as just going outside.
- newsbinator 5y ago
  No, this doesn't work. You'd have to be outside in summer sunlight with your shirt off to get enough. In the Northern Hemisphere about half the year it's impossible to get enough Vitamin D by going outside.
  - wheelerof4te 5y ago
    If Russians can do it, so can you! Don't be a small cat!
    - themaninthedark 5y ago
      There are many photos of Russian children in a circle around a sunlamp with only bottom underwear on.
    - 5y ago
salberts 5y ago
Interesting, however statistical significance seems borderline at best
belter 5y ago
Don't exaggerate your daily dose. Its difficult to overdose, requires multiple exaggerated daily intakes for several months, but some individuals have managed to achieve dangerous levels. "Vitamin D toxicity" https://en.wikipedia.org/wiki/Vitamin_D_toxicity https://en.wikipedia.org/wiki/Vitamin_D_toxicity
- vanusa 5y ago
  Yeah, but you have to be basically gobbling these pills to get anywhere near the dangerous levels. People dumb enough to do that are probably making all sorts of other poor decisions about their health and life.
- pyotr55 5y ago
  i was once accidentally taking 25.000 IU daily for a few months instead of 5.000 (400-600 IU being official recommended dosages, although many sources claim that that's way to little, hence the 5.000). went to an endocrinologist for really weird bouts of whole body weakness and exhaustion after even light activity. nothing like i had ever experienced. lab results came back with a vitamin d level of the maximum measurement level (so probably more, maybe a lot more). that's when i realized i was taking 5 times more than i had planned. i looked up vitamin d toxicity and found fatigue and muscle weakness as symptoms and had the answer to my condition. i don't want to know what would have happened if i hadn't looked it up myself, because the doctor didn't even want to see me again, claiming by letter that my blood work was just fine. so yeah, pay attention to your supplement regime.
- goostavos 5y ago
  Really, best course of action is not to guess and just get blood work done regularly. It builds up slowly enough that your doc may suggest mega-dosing for a few weeks to bring things back in line. Pure anectdata on the auto-immmune thing: since getting my vitamin D levels up, my alopecia barbae has completely disappeared. It's pretty crazy cause it's something I've had my entire life (and very severe at times). My doc mentioned a link between auto-immune and vitamin D, and after bringing my levels back in line, all the patches filled back in. Pretty wild, tbh.
- EvanAnderson 5y ago

138 points by sizzle 5y ago

I'm 10 years removed from life science research at this point... but aren't these vitamin studies a dime a dozen at this point? I don't think I see a comparison of outcomes between groups that were vitamin D deficient/insufficient vs vitamin D sufficient, which I think could be a bit more useful?

d883kd8 5y ago
I'm actually getting submarine vibes from the amount of positive Vitamin D coverage I've seen recently
- themikesanto 5y ago
  What does that mean?
  - lkbm 5y ago
    PR/astroturfing. It's a reference to Paul Graham's essay "The Submarine: http://www.paulgraham.com/submarine.html http://www.paulgraham.com/submarine.html
  - ozim 5y ago
    That someone is pumping vitamin D supplementation promotion. I have also my own example of N(1) where supplementing vit-D made me healthier and I am nerd sitting most of the time hidden from the sun. Pre-Covid after start of supplementation I noticed less infections, easier hangovers overall better health. That said I mostly sit inside by the screen and live in countries where is not that much sun so it is easy for me to get positive outcome of supplementation. I think there is a lot of people like that and that is why there is so much positive reaction for D supplementation.
nradov 5y ago
Yes most studies on micronutrient supplementation are badly flawed in that way. They typically give a supplement to the study group and a placebo to the control group, but since vitamins also come from other sources the supplements are only loosely correlated with actual levels. A better approach is to pick at least two different target levels for separate study groups. Then use periodic blood tests to precisely titrate those levels using varying amounts of supplements as needed. If the results show a clear relationship between the different blood levels and the study goal then it's likely a real causal relationship exists.
_qua 5y ago
Vitamin D is one of the most overstudied topics in medicine. Yes, there are probably aspects of vitamin D function that we do not understand well, but if there were a large signal for benefit, it should have been discovered by now.
- bagacrap 5y ago
  and hasn't it been discovered by now? my understanding of all the studies I see is that they confirm and reconfirm the importance of vit d. I have a coworker whose doctor prescribes vit d shots every winter because he's so deficient. The big question is why preventative care such as this is not emphasized as much by the powers that be as therapeutics.
  - _qua 5y ago
    The US Preventative Services Task Force has recently reviewed the vitamin D literatue, it is summarized here: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-d-deficiency-screening https://www.uspreventiveservicestaskforce.org/uspstf/recomme... Primary care is largely concerned with preventative care. It's not that we don't want to help, it's just that in many ways we are impotent. We generally do not change practice based on single studies. But since this post is about a single study, I'll share a recent RCT in The Lancet which showed no change in mortality and signals of increased cancer with vitamin D supplementation: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(21)00345-4/fulltext https://www.thelancet.com/journals/landia/article/PIIS2213-8... .
  - ipaddr 5y ago
    That's why they add it to milk.

kmonad 5y ago

While the vitamin D result was significant, this is not a slam dunk result. 123 (treatment) vs 155 (placebo) had a confirmed autoimmune disease. Low incidence rate with a small effect size hamper the power here. This is somewhat expected given the complexity of autoimmune diseases; I would have been highly suspicious of a slam dunk, silver bullet result.

edejong 5y ago

Talking about Vitamin D and calcifediol: why are we not informed that Calcifediol treatment (and as such Vitamin D supplementation) significantly reduces the chance of ICU admission and mortality in COVID-19 based on RCTs [1,2]? [1] https://pubmed.ncbi.nlm.nih.gov/34097036/ https://pubmed.ncbi.nlm.nih.gov/34097036/ [2] https://www.sciencedirect.com/science/article/pii/S0960076020302764 https://www.sciencedirect.com/science/article/pii/S096007602...

PragmaticPulp 5y ago
> why are we not informed What do you mean? I've been bombarded with Vitamin D recommendations since COVID started, from my doctor through countless podcasts. It also comes up frequently in any online discussion about COVID. And before anyone suggests otherwise, yes, Dr. Fauci has also spoken about Vitamin D. But Vitamin D isn't a magic bullet. It helps, but it's not a miracle cure like some of the internet articles or early ad-hoc studies would imply.
- _nothing 5y ago
  Yeah, people have been talking about the decreased Vitamin D levels in COVID patients and suggesting supplementation since almost the very beginning of the pandemic. Maybe they just don't want to draw attention away from the fact that vaccination and masking are still by far the best means of avoiding hospitalization.
  - deleted 5y ago
    [deleted]
  - Supermancho 5y ago
    iirc, the first mention I remember was from a Stanford, CA area Doctor who was not waiting for the CDC to make a press release before making a statement about what he saw anecdotally (~Nov 2019) given how quickly his hospital was overwhelmed. Specifically, he noted that patients with Vitamin D deficiencies were having the worst symptoms.
- edejong 5y ago

fumar 5y ago

We need to understand the impact of increased vitamin D on vitamin D average vs vitamin D deficient people. I was vitamin D deficient, lowest part of the spectrum, and since taking daily supplements I noticed less health issues overall. I believe it also helps with my sleep cycle. YMMV I am regularly tested for vitamin D and its consistently above average, but you must monitor to not exceed the threshold.

dominotw 5y ago
i've been skiing 3-4 days/week with around 8 hrs out in the sun. Would this have the same beneficial effects on me? I am always deficient but i din't bother taking anything so far due to lazyness.
- hyencomper 5y ago
  For Vitamin D synthesis, the sun needs to be at an angle of 50 degrees or higher. Depending on the latitude where you live, the sun may not get that high all winter so you may need to supplement.
  - tim333 5y ago
    Surely sunlight is still sunlight even if it's from a low angle?
    - lodi 5y ago
      No, the composition of sunlight literally changes throughout the day. When the sun is low in the sky in the morning or evening, light is traveling through more atmosphere than it is at noon. As light travels through the atmosphere, a certain fraction is scattered in a wavelength-dependent way. UV-B light--the Vitamin-D-causing kind--has a hard time passing through the atmosphere because of interactions with ozone molecules, so at grazing angles almost none gets through. However UV-A light is less affected by ozone and can still give you a sunburn. Interestingly, ordinary glass blocks both.
    - beagle3 5y ago

wheelerof4te 5y ago

Or, I don't know...go outside if you need vitamin D.

matsemann 5y ago
Sun goes up at 09:34 and down at 15:16, most of us are at work. And that doesn't include the mountains blocking the sun, some weeks it barely goes above them. So there's light, but no direct sun light. And when it's -10C, only a few square centimeters of my skin is exposed to the elements, not really producing any vit D.
- 8bitsrule 5y ago
  Also not much help if the daytime sky is clouded much of the winter. Might as well go outside in Alaska.
clajiness 5y ago
Some of us live at higher latitudes and work during the day. It's not as simple or easy as just going outside.
newsbinator 5y ago
No, this doesn't work. You'd have to be outside in summer sunlight with your shirt off to get enough. In the Northern Hemisphere about half the year it's impossible to get enough Vitamin D by going outside.
- wheelerof4te 5y ago
  If Russians can do it, so can you! Don't be a small cat!
  - themaninthedark 5y ago
    There are many photos of Russian children in a circle around a sunlamp with only bottom underwear on.
  - 5y ago

salberts 5y ago

Interesting, however statistical significance seems borderline at best

belter 5y ago

Don't exaggerate your daily dose. Its difficult to overdose, requires multiple exaggerated daily intakes for several months, but some individuals have managed to achieve dangerous levels. "Vitamin D toxicity" https://en.wikipedia.org/wiki/Vitamin_D_toxicity https://en.wikipedia.org/wiki/Vitamin_D_toxicity

vanusa 5y ago
Yeah, but you have to be basically gobbling these pills to get anywhere near the dangerous levels. People dumb enough to do that are probably making all sorts of other poor decisions about their health and life.
pyotr55 5y ago
i was once accidentally taking 25.000 IU daily for a few months instead of 5.000 (400-600 IU being official recommended dosages, although many sources claim that that's way to little, hence the 5.000). went to an endocrinologist for really weird bouts of whole body weakness and exhaustion after even light activity. nothing like i had ever experienced. lab results came back with a vitamin d level of the maximum measurement level (so probably more, maybe a lot more). that's when i realized i was taking 5 times more than i had planned. i looked up vitamin d toxicity and found fatigue and muscle weakness as symptoms and had the answer to my condition. i don't want to know what would have happened if i hadn't looked it up myself, because the doctor didn't even want to see me again, claiming by letter that my blood work was just fine. so yeah, pay attention to your supplement regime.
goostavos 5y ago
Really, best course of action is not to guess and just get blood work done regularly. It builds up slowly enough that your doc may suggest mega-dosing for a few weeks to bring things back in line. Pure anectdata on the auto-immmune thing: since getting my vitamin D levels up, my alopecia barbae has completely disappeared. It's pretty crazy cause it's something I've had my entire life (and very severe at times). My doc mentioned a link between auto-immune and vitamin D, and after bringing my levels back in line, all the patches filled back in. Pretty wild, tbh.
EvanAnderson 5y ago