In spite of claims from misguided “doctors”, wellness gurus and the bloated supplement industry, the evidence is accumilating that Vitamin D supplements are completely useless for the majority of people. It’s human nature to opt for the easy way to strengthen bones or prevent cancer – just pop a pill – when eating healthy and exercise is by far the best but harder option. Vitamin D supplement sales in the US were $936 million in 2017.
Substantial Lack of Evidence
“The new research, published in Lancet Diabetes &
Endocrinology, looked at 81 randomized trials on whether vitamin D prevents
fractures and falls, and improves bone mineral density in adults. The findings
of the review were unequivocal. ‘There is little justification for the use of
vitamin D supplements to maintain or improve musculoskeletal health,’ the authors
wrote, except in rare cases when patients are at high risk of or being treated
for rickets and osteomalacia.
“‘Something like 40 percent of older adults in the US
take vitamin D supplements because they think it’s going to prevent against
fractures and falls or cancer,’ said Alison Avenell, the clinical chair of
health services research at the University of Aberdeen and an author on the
Lancet study, ‘and we’re saying the supplements for fractures and falls aren’t
going to do that.’
“This new research builds on previous meta-studies and
the large-scale randomized trials that have shown the fat-soluble hormone
doesn’t prevent fractures and may not have a role in preventing cancer, but can
increase the risk of kidney stones when taken along with calcium. Of course,
there are some cases when supplementation can be helpful: During pregnancy,
for example, or for people who have been diagnosed with health conditions that
may lead to vitamin deficiencies, like liver disease or multiple sclerosis.
People with asthma, those don’t get into the sun at all (like the homebound or
institutionalized), or those from ethnic backgrounds with darker skin —
African, Afro-Caribbean and South Asian — may also benefit from a supplement.
“But for a health boost in people with no symptoms of
deficiency, the tablet shows so little utility that doctors are even
questioning why we bother measuring vitamin D levels in people who aren’t at
risk. Most of us actually get enough vitamin D without even trying.”
Bone Health for Seniors?
“For many
years, recommendations for prevention and treatment of osteoporosis have
included increasing calcium intake (by diet or supplements) and use of vitamin
D supplements. Since the average dietary calcium intake in most countries is
much less than that recommended by guidelines, many older people are advised to
take calcium supplements to prevent osteoporosis. The recommendations have been
implemented successfully: over half of older Americans take calcium and vitamin
D supplements, either prescribed or over the counter, and bone health is the
most common specific motivation for use of nutritional supplements.
“However,
this behaviour does not reflect evidence that has emerged since 2002 that such
supplements do not reduce the risk of fracture and may result in harm.
Guideline bodies also continue to recommend calcium and vitamin D supplements.
Here, we argue that change is made difficult by a complex web of interactions
between industry, advocacy organisations, and academia.”
Vitamin D For Multiple Sclerosis Patients
“The bottom line was that vitamin D supplementation did not change bone
health in patients with MS after 96 weeks. ‘Our results do not support that
high dose weekly vitamin D supplementation is beneficial for bone health in
ambulatory persons with MS, and suggest that weekly vitamin D supplementation
alone is not sufficient to prevent bone loss in persons with MS who are not
vitamin D deficient,’ researchers concluded.”
Screening for Vitamin D
“Most organizations do not recommend universal
screening for vitamin D. The US Preventive Services Task Force concluded that
the benefits as well as any potential harms from vitamin D screening and early
interventions cannot be determined.
“Further more, groups such as the Endocrine Society, the
American Geriatrics Society, the American Academy of Pediatrics, and the
American College of Obstetricians and Gynecologists have concluded that routine
screening is not necessary.
“Nevertheless, routine laboratory blood work on
patients may include screening for 25(OH)D levels. Some clinicians may be
concerned about potential legal liability if they fail to screen their patients
for vitamin D status, particularly if it is part of a clinical pathways or
standard order sheet, but vitamin D screening is not considered a mandatory
health care practice. Widespread screening in the face of these recommendations
can incur unnecessary health care costs. The marked increase in routine vitamin
D screening in the last several years has undoubtedly incurred substantial
costs for the health care system.”
Holick, Paltrow, Oz and Oprah
Dr. Michael Holick of Boston University Medical Center has
been the prime force behind the supposed benefits, and has convinced several
influencers of popular culture to parrot his beliefs:
“Since 2011,
Dr. Holick’s advocacy has been embraced by the wellness-industrial complex.
Gwyneth Paltrow’s website, Goop, cites his writing. Dr. Mehmet Oz has described
vitamin D as ‘the No. 1 thing you need more of,’ telling his audience that it
can help them avoid heart disease, depression, weight gain, memory loss and
cancer. And Oprah Winfrey’s website tells readers that, ‘knowing your vitamin D
levels might save your life.’ Mainstream doctors have also urged Americans to
get more of the hormone, including Dr. Walter Willett, a widely respected
professor at Harvard Medical School…….
“Yet Dr.
Holick also has extensive financial ties to the pharmaceutical industry. He
received nearly $163,000 from 2013 to 2017 from pharmaceutical companies for
consulting and other services, according to Medicare’s Open Payments database,
which tracks payments from drug and device manufacturers. The companies paying
him included Sanofi-Aventis, which markets vitamin D supplements; Shire, which
makes drugs for hormonal disorders that are given with vitamin D; Amgen, which
makes an osteoporosis treatment; and Roche Diagnostics and Quidel Corporation,
which both make vitamin D tests……
“Some
researchers say vitamin D may never have been the miracle pill that it appeared
to be. Sick people who stay indoors tend to have low vitamin D levels; their
poor health is likely the cause of their low vitamin D levels, not the other
way around, said Dr. JoAnn Manson, chief of preventive medicine at Brigham and
Women’s Hospital in Boston.”
What’s really behind Vitamin D
Deficiency?
“Though
observational studies have linked low blood levels of vitamin D to a wide
variety of diseases and conditions, it is very possible that low vitamin D is
not a cause of these conditions but rather an effect of them (this is called
reverse causality)—or it may also be just a marker of poor health in general.
That is, disorders such as heart disease, depression, and diabetes, even in
their early stages, may result in vitamin D deficiency because they keep people
indoors and thus reduce sun exposure. Healthy, active people may simply spend
more time outdoors, so they have higher blood levels of D.”
Additional Info
Effect of
Monthly High-Dose Vitamin D Supplementation on Cardiovascular Disease in the
Vitamin D Assessment Study: A Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/article-abstract/2615260
Interventions
to Prevent Falls in Older Adults: Updated Evidence Report and Systematic Review
for the US Preventive Services Task Force
https://jamanetwork.com/journals/jama/fullarticle/2678103
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Jerry De Luca is a Christian freelance writer who loves perusing dozens of interesting and informative publications. When he finds any useful info he summarizes it, taking the main points, and creates a (hopefully) helpful blog post.
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