A noted expert on the topic of vitamin D and public health is calling for universal vitamin D blood testing and widespread dietary supplementation to augment dietary and sunshine sources of this essential nutrient. Adoption of these practices should not wait for further definitive studies in an effort to “rescue as many patients with vitamin D-related illness as we can during the interim and not wait for further clinical trials to end.”
These are the words of Dr. Cedric F Garland, professor, Division of Epidemiology, University of California San Diego and were posted at Medscape.com in an article entitled “Vitamin D and mortality risk: should clinical practice change? [MedScape.com Aug 13, 2014] MedScape is a website dedicated to educating doctors.
The scientific promise surrounding vitamin D doesn’t solely address prevention or treatment of disease, it is about saving or extending the lives of billions of people worldwide. Vitamin D actually activates the Klotho gene which is known for its anti-aging properties. [Ageing Research Reviews Jan 2009; Ageing Research Reviews Sept 2002]
If Dr. Garland’s recommendations were fully adopted we’re talking about the end of doctoring as we know it. The masses would become less doctor dependent and mortality rates would decline more demonstrably than when antibiotics were first introduced. There would be trillions of dollars of healthcare savings that could be diverted to other important sectors of every economy in the world. But will modern medicine let such a profound revolution happen?
Dr. Garland says physicians may not be ready to lead the world’s population into what he calls “a new golden era” in preventive medicine.
Oftentimes “physicians are not impressed to do anything to correct low vitamin D levels when they are found,” says Dr. Garland. This is particularly true in northern climates where vitamin D levels are abjectly low in winter months, he notes. This suggests the public will have to take matters in their own hands rather than relying on doctors for direction.
Despite an overwhelming volume of evidence that begs for mass worldwide vitamin D supplementation to quell the incidence of a broad number of human maladies that have plagued mankind throughout history, many physicians await larger humans studies that won’t begin to be published till 2017. Essentially, modern medicine is dragging its feet over any idea of implementing preventive health measures that will reduce the demand for doctoring.
Vitamin D: the moral test for modern medicine
That it has taken modern medicine over nine decades to discover and test the full health benefits of vitamin D reveals a shameful overreliance upon prescription drugs.
This author believes vitamin D will be THE moral test for modern medicine — whether its mission is truly to prevent disease from occurring in the first place or to game the public as it is currently doing by establishment of intentionally low vitamin intake levels in order to ensure there is a certain level of disease to treat.
In 2012 the Institute of Medicine set vitamin D intake guidelines that removed 80 million Americans from the list of candidates for vitamin D supplementation. [Science Daily Oct 24, 2012]
What is a healthy blood level?
Dr. Garland says no one should run a blood serum vitamin D level of less than 30 nanograms/milliliter of blood. The Institute of Medicine guideline calls for supplementation only when blood levels drop below 20 nanograms/milliliter. Using any blood test below 30 nanogram level as an indicator, two-thirds of the American population would then need vitamin supplementation. Only one third of the US population is below 20 nanograms/milliliter.
But higher blood concentrations may yield even greater health benefits. According to Dr. Garland, raising the blood serum vitamin D levels from 20 to 30 nanograms/milliliter would reduce the incidence of breast, bowel and lung cancer by 80%!
Despite this, according to Dr. Garland, some doctors mistakenly believe their patients are “perfectly fine” with vitamin D blood levels in the 12-15 nanogram/milliliter range.
Vitamin D shortage: dark-skinned individuals suffer most
The population groups that have suffered the most from modern medicine’s aversion to vitamin therapy are dark-skinned. People of East Indian and African descent require many times more sun exposure to produce the same amount of vitamin D as light-skinned populations. Of interest, President Obama is reported has undergone vitamin D testing and found to be vitamin D-deficient (blood level of 22 nanograms) and is taking vitamin D pills. [MedScape.com Aug 13, 2014]
Universal blood testing
Dr. Garland is an advocate for universal vitamin D blood testing. In Dr. Garland’s words: “skipping this test would be equivalent to not measuring blood pressure, serum lipids, or weight at an annual exam.”
Maybe some lawsuits against doctors who fail to test for and prescribe vitamin D would force a change. That is what Dr. John Cannell, founder of The Vitamin D Council believes.
But the Endocrine Society and the American Association of Clinical Endocrinologists recently called universal vitamin D testing “unnecessary” and says the test should only be ordered when patients are suspected of decreased kidney function or over-calcification. [Healthcare Professionals Network Aug 9, 2014] In 2009 one Medicare contractor first proposed an end to payments to laboratories and physicians for routine testing for vitamin D blood levels. [Dark Daily Feb 20, 2009]
There has been a dramatic 8000% upswing in the frequency of vitamin D blood tests in the past decade. [VitaminDWiki.com]
What about risk of overdosing?
Dr. Garland says some physicians have expressed undue concern that over-doses of vitamin D may increase the incidence of disease. But he says: “Whether it is scurvy, pellagra, or beriberi, an increase in niacin for pellagra, vitamin C for scurvy, or thiamine for beriberi does not result in an increase in incidence of the disease.” He doesn’t believe there is any convincing evidence that high blood levels of vitamin D induce disease as some researchers allege.
Doctors have long held the idea high-dose vitamin D can cause over-calcification but that idea was based upon a study that employed the human equivalent of 1 million units of vitamin D (25,000 micrograms or 25 milligrams,
equal to two-hundred 5000-unit vitamin D pills) given to laboratory animals for many days. [Current Opinion In Lipidology Feb 2007]
Latest vitamin D science is compelling
Indeed, recently published reports not even considered in the data that Dr. Garland used to develop his recommendations are compelling.
Researchers with the Alzheimer’s Association report in the Journal of Neurology that low vitamin D levels double the risk for Alzheimer’s disease. [Health Day Aug 6, 2014; Neurology Aug 6, 2014]
Health authorities lament that reports showing vitamin D and dental cavities published in the 1950s weren’t given more consideration. It has been known since the 1930s that tooth cavities are more prevalent in winter months when vitamin D levels are low. [Dermatoendocrinology July 2011]
Supplemental vitamin D may help quell anemia among patients with chronic kidney disease. [Journal American Society Nephrology March 2014]
Pediatric researchers are calling for vitamin D supplementation beginning from birth. [Nutraingredients.com Aug 7, 2014; Pediatric Research Aug 2o14]
Health authorities concede the increasing prevalence of asthma and allergy over the past four decades may be linked to the public’s phobia over exposure to sunlight and the alleged risk for skin cancer. [Advances in Dermatology Allergy May 2014]
Low blood levels of vitamin D are associated with erectile dysfunction (is vitamin D the new Viagra?). [Journal Sexual Medicine Aug 5, 2014]
A recently reported study shows for every 10-nanogram decrease in vitamin D among adolescents there is a measurable increase in insulin resistance (inability of cells to utilize insulin for cell energy). [PLoS One July 29, 2014]
The ominous return to the dark ages of pre-antibiotic medicine caused by antibiotic resistance may be averted with vitamin D. Vitamin D can produce a germicidal protein called cathelicidin (kath-el-i-side-in) [Endocrine Metabolic & Immune Disorders Drug Targets July 8, 2014] that can kill bacteria, fungi, yeast and viruses. [Peptides Aug 2012] Vitamin D counters antibiotic resistant germs. [Determatoendocrinology Oct 2011]
Experts say: “vitamin D has opened new avenues to prevent or treat infections.” [Journal Leukocyte Biology Oct 2012] Look forward to the day infectious disease specialists treat pneumonia, hepatitis, blood infections (sepsis), influenza and urinary tract infections with vitamin D. [Annals New York Academy Science May 2014] Also, tuberculosis, a dreaded mycobacterial lung infection that affects one third of humanity may be quelled with vitamin D. [Proceedings Nutrition Society Feb 2012]
Furthermore, the combination of vitamin D with the red wine molecule resveratrol “weaponizes” vitamin D against germs. [Molecular Nutrition & Food Research March 2014]
The modern era of “magic bullet” drugs emanated from the first therapeutic use of penicillin in the 1940s. Dependency upon synthetic antibiotics has literally led to a dead-end-street as antibiotic resistance is now a seemingly insurmountable problem.
Regardless, whatever achievements that were attributed to the antibiotic era of medicine will appear pale next to widespread use of vitamin D food supplements.
Test a whole country
More convincing evidence could be produced if universal vitamin D blood testing and food fortification and/or dietary supplementation in a small northern European country were to take place as a demonstration project. A whole country could serve as a learning lab for the rest of the world. Vitamin D levels are typically low in winter in northern Europe.
Such a country is The Netherlands. Vitamin D blood concentrations are typically low in The Netherlands (20-25 nanograms or 50-63 nanomole). Health authorities there suggest an increase in vitamin D intake of 2500-4000 IU/day (62.5-100 micrograms, or not more than 1/10th of one milligram) to achieve optimal health benefits, which is far beyond what can be consumed from the diet or produced naturally by sunlight. [Journal Steroid Biochemistry Molecular Biology July 2010]
Big Pharma likely to drag its feet
Don’t expect Big Pharma to cooperate with any effort to replace drugs with vitamins. In fact, there are a number of vitamin D-like drugs in the research and development pipeline that Big Pharma wants to introduce as expensive substitutes for vitamin D.
A report published in the British Medical Journal says: “the manufacturers of these newly licensed vitamin D-like preparations are keen to encourage their use” and the National Health Service in Great Britain says “licensed products should be used where available.”
These vitamin D-like drugs are about two to five times as expensive as plain vitamin D and may be problematic. However, skeptics of these vitamin D-like drugs say: “unlike most drugs, it is almost impossible to overdose on vitamin D.”
The authors of this report emphatically state that “expensive licensed vitamin D-like preparations are not indicated and unlicensed preparations should not be discouraged.” It is sickeningly absurd to believe only approved drug-like versions of vitamin D are safe and effective. [British Medical Journal April 22, 2014]
Expect to hear about negative to null studies
Vitamin D advocates should not be shocked by negative or null studies involving vitamin D in human populations. Oftentimes dosage is too low or the ability to metabolize and transport vitamin D is compromised in certain groups. For example, adults who are obese may require 40% greater vitamin D intake than lean individuals to attain the same vitamin D blood level. [Endocrinology Practice Aug 6, 2014] Also, proper metabolism of vitamin D requires adequate magnesium intake, another nutrient that is commonly in short supply particularly in western diets. [BMC Medicine Oct 24, 2013] Shortages of magnesium may result in failed studies involving vitamin D.
Humanity took a giant step backwards when penicillin was first adopted
It has taken centuries to learn that many of the historical scourges of mankind dating back to leprosy in the Bible are associated with a lack of sunlight. [Acta Tropica Jan 2011]
It is not like physicians of old completely missed the link between human disease and lack of sunlight. Physicians in the first half of the 20th century successfully practiced sunlight therapy to cure rickets and tuberculosis, the latter still being a plague of mankind. [Journal Historical Sociology 2012]
Indeed, photographic evidence of “heliotherapy” practiced in 1926 at a hospital in Perrysburg, New Jersey serves to question whether the many treatments and diagnostic measures practiced in modern medicine today can be truly described an advancement.
The hospital in Perrysburg was located 1600 feet above sea level where patients basked in the sun on a 293-acre site and sick children recovered from their maladies in winter by playing in the snow dressed only in shorts to achieve optimal sunlight. The use of sunlight for preventive and therapeutic purposes has been long forgotten in this age of medical technology. [American Journal Public Health Sept 1926]
It appears many conditions that were remedied by sunlight or supplemental vitamin D when it first was synthesized and became available in the 1930s were simply forgotten. For example, in 1935 researchers in Europe reported on the first successful therapeutic use of vitamin D for glaucoma [Clinical Monatsblätter of Ophthalmology 1953], an application that is only now being recognized. [Public Health Nutrition April 2014]
A culture in modern medicine that shuns vitamin therapy
The current medicine model categorically restricts vitamin supplements to health promotion rather than treatment or prevention of disease which is the exclusive territory of prescription drugs that have undergone human clinical trials.
Yet nutritional deficiency diseases such as scurvy (vitamin C), pellagra (niacin) and beriberi (thiamin vitamin B1) were remedied without large human clinical trials because they worked almost without fail. Aspirin, digitalis, insulin, penicillin, and many vaccines also came into common use without large human clinical trials.
It is clear that the FDA drug approval process is driving up the cost of medicines and is used as a categorical barrier against vitamins being used for disease treatment or prevention. In a free market, dietary supplements like vitamin D should be regulated to prove they are relatively safe and free of contaminants and labeled correctly. Their effectiveness should be obvious to those who use them for whatever purpose they choose.
Imagine all the clinical trials needed to approve vitamin D for heart disease, cancer, diabetes, multiple sclerosis, Alzheimer’s, mental depression, infection, sepsis, tuberculosis, heart failure, osteoporosis, etc., etc. Then vitamin D would become a high-priced drug. Commercial interests in modern medicine now stand in the way of simple, economical cures like vitamin D.
Doctors cling to prescribing FDA-approved drugs because they fill their appointment book as they require a doctor’s office visit to obtain a prescription and they also garner a drug consultation fee from insurance plans.
It is obvious that patients could get well without all the doctoring by going directly to the vitamin shop and skipping the doctor’s office altogether. But patients have grown so accustomed to insurance plans paying for drugs they often won’t shell out a few dollars out of their pockets for vitamins.
Also, doctors didn’t go to medical school to become vitamin pushers. So there is a culture in modern medicine against remedies like vitamin D.
What dosage?
The Vitamin D Council says 5000 international units (IU) of natural vitamin D3 will get at least 97% of people above the 30 nanogram per milliliter blood level. [Vitamin D Council]
For children, The Vitamin D Council recommends 1000 IU/day for infants and for growing children 1000 IU/day for every 25-lbs of body weight (example: 2000 IU for a 50-lb child). [The Vitamin D Council]
The diet provides a paltry amount of vitamin D from fortified milk, fish, eggs and other sources, not enough to sufficiently raise blood levels. Even though sunshine is free and skin exposure to the sun’s UV rays produces vitamin D in the skin, the current sun-phobic indoor generation is not likely to maintain adequate vitamin D levels throughout the year, particularly during winter months. Only lifeguards and roofers are known to maintain vitamin D adequacy.
Will the public adopt vitamin D? Don’t count on it
Don’t think the public is going to be easily convinced to supplement their diet with vitamin D capsules even though they are very economical (often less than 10-cents a day). Health habits are slow to change. This author offered free vitamin D pills to a radio audience in Las Vegas. All radio listeners had to do was pick them up or just pay for the cost of shipping. However, few radio listeners took advantage of the free offer and the supply of vitamin D pills was never exhausted. So even free didn’t change health habits.
Another dilemma is that patients often rely on their doctors for advice about vitamins. And they are likely to be warned away over unfounded concerns about overdosing.
Don’t think Big Pharma, physicians groups or public health authorities are going to avidly embrace vitamin D supplementation. They have to protect turf.
True to form, the U.S. Preventive Services Task Force recently nixed the idea of routine vitamin D testing. [USA Today June 23, 2014] The National Institutes of Health should have held a major health symposium on this topic by now and the Centers for Disease Control issued a major public health bulletin calling for vitamin D supplementation as the centerpiece of a new preventive paradigm in modern medicine. None of that has happened or is expected to happen.
Real progress in modern medicine
The big message from Dr. Garland is that modern medicine and the public need not wait for results from more definitive trials. For centuries mankind had to rely upon sunlight as the sole source of vitamin D. Later sunlamps came into practice. Today, “sunlight in a bottle” in the form of commercially available vitamin D pills are an inexpensive remedy to what ails mankind. As Dr. Garland says, it is time to usher in a new golden era of medicine with vitamin D. Websites such as Dr. John Cannell’s VitaminDCouncil.com and Henry Lahore’s VitaminDWiki.com are informing the world about this revolution. So is Dr. Cedric Garland.