What in the world do we do with vitamin D?

November 13, 2018

 

 

Vitamin D supplementation remains a hot topic, and news stories about vitamin D can be very confusing, so I thought I'd summarize what I believe the data show so far.  

 

Proposed health benefits 

 

bone health (decreased bone fractures)

cancer prevention

heart health.

 

Challenges with Vitamin D 

 

The lab tests used to measure vitamin D are not standardized and currently are somewhat imprecise.  This makes it difficult to determine a threshold for recommending supplementation.   Based on a review of multiple studies, the Institute of Medicine recommends keeping a the vitamin D level between 20 and 40 ng/mL.  Other organizations recommend keeping the level over 30, and this is what I recommend for my patients.

 

 

Benefits of Vitamin D

 

There is good research supporting the claim that vitamin D helps prevent bone loss and bone fractures in older individuals (over age 65). 

 

Lack of Benefit with Vitamin D

 

A study released 2 days ago (11/10/18) showed that taking vitamin D supplements did not reduce the risk of cancer or cardiovascular disease.  Published in the prestigious New England Journal of Medicine, this robust study randomized 25,000 patients - half were given vitamin D and half were given a placebo.   There were no differences between the groups in incidence of any kind of cancer or in heart attacks or other cardiovascular events.  Some news outlets are stating that vitamin D decreased the risk of death from cancer, but this is an overstatement of the statistics.

 

Conclusions

bone health (decreased bone fractures) - helpful 

cancer prevention - not helpful

heart health - not helpful

 

 

References:

https://www.nejm.org/doi/full/10.1056/NEJMoa1809944?query=featured_home

PMID 9278463

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